Molly’s third ultrasound to assess her response to the gonadotropins revealed that the 4 follicles on the right had grown to 11.5, 12, 12.5, and 14mm, and there was one on the left about 12mm. Her Estradiol level was 300, which is good but the reproductive endocrinologist said he’d like to see it slightly higher. So, we’re increasing the dose of Gonal-F from 75 IU/night back to 112.5 IU/night.
Interestingly, he did see something on the right ovary that measured 16mm. Similar to the last ultrasound of this cycle, none of the follicles should be that big by now. Because it was in the same area that the suspect-cyst was located, and it is approximately the same size, that pretty much gives us the answer – there is most definitely some kind of cyst on/near the right ovary that is measuring about 16mm. Back at our first ultrasound monitoring on the first Clomid cycle in May, they saw something that may have been a cyst, but because it measured similar to an almost-mature follicle, they had us do the Ovidrel to stimulate ovulation. This means that it’s possible that on both Clomid cycles, they were really measuring the cyst (thinking it was an almost-mature follicle), thus causing us to use the Ovidrel (to simulate ovulation) too early (before the real follicles were fully developed). The thought of this is incredibly frustrating since that means we didn’t even have a chance that either of the Clomid cycles were going to work.
The only reason the fact it is a cyst was even caught was because our new fertility center does more aggressive ultrasound monitoring; going in for the first ultrasound much earlier in the cycle allowed them to see something that looked like a follicle, but couldn’t be one due to its large size relative to what was expected at that point in the cycle. However, it’s important to note that this cyst was not seen on the baseline ultrasound on Cycle Day 2 (something our new fertility center does; a baseline was not done at our old fertility center). And thus the very problem with ultrasounds – just because you don’t see it, doesn’t necessarily mean it isn’t there.
Very frustrating, but at least we know now for this cycle, and future cycles if they are needed, that there is a fairly large cyst on the right that intermittently shows up on the ultrasound…and that measures similar in size to an almost-mature follicle. Yep, that would have been nice to know about 6 cycles ago.