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About Edward Joseph Ramirez, MD, FACOG
Expertise
I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience
I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 15 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

You are here: Experts > Health/Fitness > Women's Health > Infertility/Fertility > IUI

Infertility/Fertility - IUI

Expert: Edward Joseph Ramirez, MD, FACOG - 11/5/2009

Question
Hello, My name is Kris and I am from Maryland. My question is about my IUI. On cd12 I went to my RE for a ultrasound and bloodwork after taking clomid (50mg because 100mg produced to many follies) for days 3-7, the ultrasound showed three follies size 19.6,17.3, and 27.3. Later in the evening my nurse called to say that my bloodwork showed that my LH was surging and that my IUI would be changed to cd13. She told me to trigger with Ovidrel that night (cd12) and come on for a IUI at 11am the next day (cd13). My question is was the timing of my IUI good? My last cycle I did not have a natural lh surge so why did I have one this cycle. Is is possible that I ovulated on cd12? Thank you for answering my question

Answer
Hello Kris from the U.S.,

Your doctor's method is a little different that mine or what is usual With a 27, 20 and 17 mm follicle, you should have triggered with HCG on that day. I would then do the first IUI at 24 hrs and the second at 48 hrs (rather than just one the next day). It is just a different philosophy. If you had an LH surge, then the HCG was probably not necessary, as you body was already doing what the HCG would do.

Bottom line, is that the IUI the next day was appropriate.

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf

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