I am 30 years old undergoing ivf. I am fit and healthy, my results are all normal and I have been pregnant before. I have completed the long protocol and responded well to the drugs, 12 follicles at least. We are having ivf because my husband has abnormal sperm counts. I took my hcg shot 2330 on Saturday night. My last scan was Thursday and they were considering doing egg collection Saturday but decided that Monday would be best. I had no scan or bloods between Thursday and Monday. I took all the drugs correctly. On Monday I turned up for my egg collection early, I ended up going to theatre over 40 minutes late as they were running late. I woke up from the procedure to find they only retrieved 2 eggs. A blood test showed I had already ovulated. This was our only chance on the NHs and I feel that this should not have happened. Not only was the egg collection delayed but i was not monitored between Thursday and Monday. I would really appreciate some advice on this matter as I feel we should not have to now pay for another cycle .
Hello CJ from the UK,
In terms of not having to pay, that question would be best put to an attorney (solicitor).
In terms of the medical aspect of your story, the usual protocol is to retrieve 35-36 hours after the HCG injection. In most cases, ovulation will not have occurred. However, premature ovulation has occurred to most of us that do IVF and is unpredictable. Did your doctor/clinic use some type of medication to prevent your body from mounting an LH surge? If you used the long protocol, that would have been Lupron and you would have taken it up to the day of HCG. If it was stopped earlier than that point, it is possible that your body mounted a natural LH surge and the timing of ovulation was thrown off.
It is a little unusual that here was no monitoring done between Thursday and Saturday. Usually monitoring occurs on a daily basis when you are close to reaching the appropriate follicular size, to determine when to give the HCG. In your case, it sounds like your doctor just designated a day without knowing if the follicles were ready or not, which I might say is a little unusual but is not necessarily wrong. Maybe that is the protocol your doctor uses based on his/her knowledge and training? Maybe it's to save cost and eliminate two visits and ultrasounds? It certainly is something I think your doctor needs to sit down and explain to you.
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com
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