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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should I Be Worried For The Dominant Follicle On Both The Ovaries With Minimal Fluid?

Good morning, my name is Eva, I was diagnosed with anovulation, have been on hmg n hcg. On the first month on the treatment, I started with hmg 75ui from day 9to day 11 then followed by hcg on day 11 n 12. My dominant follicle was just 1.3 on day 15. On d second month, my dose was increased to 150ui and I got 2.1cm follicle but still didn t get pregnant. Now I went on 225 ui from day 8to 11 then hcg 12-13. Went for my ultra scan on day 13 but was told that no follicle was seen on dominant follicle was seen on both ovaries but there was minimal fluid in d pod. What does that mean? I m kind of worried
Thu, 16 Apr 2020
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OBGYN,  's  Response
Hi,

According to your history the possibilities are with the increasing dose of hormonal injections your ovaries responded in second cycle and you got good size of follicle. Usually ovulation can occur between 13th to 17th day in case of 28 to 30 days cycles. But sometimes that can occur early also, as this time you have taken high dose of hormonal injections, there is possibility that your follicle might have ruptured little early. And minimal free fluid in pouch of Douglas may representing this.

If so, you can plan unprotected intercourse in these 13th to 15th days, which can increase the possibility of pregnancy. If not, and you need to go for ovulation induction again, better to check for AMH (Anti Mullerian hormone) levels to find out the ovarian reserve and antral follicle count in ultrasound and proceed accordingly.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Sree Gouri S. R., OBGYN
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Should I Be Worried For The Dominant Follicle On Both The Ovaries With Minimal Fluid?

Hi, According to your history the possibilities are with the increasing dose of hormonal injections your ovaries responded in second cycle and you got good size of follicle. Usually ovulation can occur between 13th to 17th day in case of 28 to 30 days cycles. But sometimes that can occur early also, as this time you have taken high dose of hormonal injections, there is possibility that your follicle might have ruptured little early. And minimal free fluid in pouch of Douglas may representing this. If so, you can plan unprotected intercourse in these 13th to 15th days, which can increase the possibility of pregnancy. If not, and you need to go for ovulation induction again, better to check for AMH (Anti Mullerian hormone) levels to find out the ovarian reserve and antral follicle count in ultrasound and proceed accordingly. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sree Gouri S. R., OBGYN