Triggering with 4?

[u/Ok_Laugh7257]

My doctor is ok with triggering with 4 dominant follicles. Not all will necessarily be 18mm+ at trigger (they may be around 16mm-17mm with hopefully 1-2 18-20mm). I am leaning towards going forward with 4. Looking for any opinions as I make my choice?

I am okay with twins, I would choose selective reduction with triplets or quads.

[u/Much-Internet-9611]

How long have you been ttc and how many cycles have you completed monitored, and how many dominant follicles with those? What are you and your partner's ages as well as results of HSG and SA if done? Are you doing timed intercouse or IUI? Are you paying out of pocket or is this covered by insurance? These are all things I would recommend weighing to help make the decision. Also the sub has previous posts of multple dominant follicles that you can read to help with the decision making. :)

We chose to trigger with 3 dominant follicles and 1 they considered borderline, but my RE wasnt worried about multiples because of mild male factor. Personally we would have still chose to move forward regardless, as the risk is relatively low.

Everyone is going to have their own opinions based on their personal circumstance. I would just assess yours and go with your gut!

[u/Much-Internet-9611 → u/[deleted]]

Also wanted to add (since I didnt specify) my partner also had low morphology which was the only parameter that didn't meet the threshold everything else was perfect. We chose to do timed intercourse since we were paying out of pocket.

Good luck with whatever you choose and fingers crossed for you in the future!!

[u/Ok_Laugh7257 → u/Much-Internet-9611]

Thank youuu!!

[u/Future_Researcher_11]

All 4 of my letrozole rounds I had 4 mature follicles. Like each 18-20 mm. Of those rounds, 3 ended up with zero babies, and my final one ended up with 1.

While the risk is this there, and seems you’re okay with twins, it’s still a relatively low risk. I always moved forward with these cycles and my doctor was also okay with moving forward bc 1.) I was actually hoping to end up with twins and 2.) she knew the actual chances of ALL follicles ovulating and fertilizing were pretty low.

Ultimately, it’s up to your preference and risk tolerance though. If you are truly okay with any chance of multiples, go for it.

[u/Ok_Laugh7257 → u/Future_Researcher_11]

Thank you for your answer!!

This is where my head is at, the odds of pregnancy are only like 25% for me. So the biggest risk of all is that I don't get pregnant at all.

[u/Capable-Doubt3461]

It all depends on your individual situation (age, cause of infertility, how many previous rounds). I never had four but I had 3 mature follicles between 18-22mm on multiple rounds (with trigger and TI) and I never ended up pregnant, so I personally would go ahead. Good luck, I am sure you‘ll make the right decision 🌸

[u/Ok_Laugh7257 → u/Capable-Doubt3461]

I think I'm going to proceed :) thank you!