Infertility/Fertility/FOLLICLE NOT RUPTURING


Respected Sir,
         I and my wife wanted to have a baby. But after trying for several months she did not conceive. So we went to a doctor. The doctor gave couple of medicines and did ultrasound checking and than gave Clomid. After taking Clomid my had good follicle but it had thick border as said by the doctor. So the doctor gave HCG 10000 injection and after two days did ultra sound testing but than also the follicle did not rupture. So the doctor again gave HCG 10000 injection and after again doing ultra sound testing after 2 days there were two follicle and one follicle had become cyst. On asking the doctor about what further procedures the doctor is going to do the doctor told that after the next cycle the doctor would increase the dosage of HCG injections. So, i wanted to know weather the procedure is going in correct directions and also high dosages of HCG injections would do any harmful side effects. Kindly suggest

Hello Ilmas from India,

Based on the limited information that you've given me, I am suspicious of your doctor's credentials for treating infertility.  HCG 10,000 units is sufficient to induce ovulation and an ultrasound two days later does not necessarily rule out ovulation.  A pre-ovulatory follicle can ovulate and then refill with fluid to become the corpus luteum cyst (which is required for progesterone production and implantation).  If the doctor is going to monitor for ovulation (which, by the way, is not usually done with simple Clomid cycles), then he needs to do an ultrasound each day after the HCG injection.

However, there is no harm in giving increased dosage of HCG.  I just don't think it has any benefit.

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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