Infertility/Fertility/natural ivf


Hi doc, i m undergoing Modified natural ivf with antagonist and gonalf as addback. I dont want to take any stims. The follicle size on cd11 was 11.5 and 10.5. Does it look good or not for follies on day 11. I normally have 30 daY cycle. Amh and other tests are ok.

Hello Rich from India,

If you are using Gonal-f, then you are undergoing stimulation (after all Gonal-f is FSH and i used to stimulate ovaries in IVF.  In a natural IVF cycle, there is NOT additional FSH used).  It is not "natural".  There is not requirement or formula for the size of follicles on any given day of stimulation.  Some people will stimulate quickly and others will stimulate slowly.  In some cases it can take up to 18 days for the follicle to reach maturity size.  So as long as the follicles continue to grow, it's going just fine.

Good Luck,

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 check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  I now provide personalized fee for service consultations/advice/direction via email and payable via Pay Pal.  If interested, contact me via my email at  This service will allow you to have your own personal on-demand infertility expert.


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Edward Joseph Ramirez, MD, FACOG


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.


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 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

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

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