We have an excellent group of fertility experts who provide sponsorship of Choice Mom resources. Periodically we go to them with "Ask the Fertility Expert" questions. Here's one that appeared on the discussion board recently, and the response of one of the doctors in our network.
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Posted June 2, 2011 at 8:10 AM
Q&A: hCG timing
Expert Insight
"My doctor has me on a protocol of clomiphene from days 2-6 of my cycle, with follicle tracking beginning on day 10. If the follicle looks good, he has me go in for my hCG injection and schedules the IUI for the next day. However, everything I've read about hCG injections says that insemination should occur anywhere from 36-40 hours after the injection. Has anyone ever heard of having an IUI 24 hours after an hCG injection? I'm a bit concerned about this and wonder if I should discuss this with my doctor."
Dr. Lee Kao, of Laurel Fertility in San Francisco responded:
First, we’re happy to hear that you’re working with a physician. In the literature, traditionally people start clomiphene citrate during Day 3 to Day 7, or Day 5 to Day 9. Occasionally people will start the protocol Day 2 to Day 6. No evidence suggests success rates are better between start dates.
As to your question, according to literature, there is no difference between the effectiveness of timing during an IUI when comparing 24, 48, and 36 hours after a hCG injection. However, according to ASRM, "The physician may use ultrasound and blood estrogen levels to determine the day on which to administer hCG. Ovulation will usually occur 36 to 48 hours after hCG is administered."
Thus, I would advise that you discuss the timing more with your doctor. It sounds like your doctor might be performing a routine that he/she has found successful, but it’s always good to have open communication with your doctor. For more information, check out Medications for Inducing Ovulation pages 7 and 10.
Best wishes growing your family!
Dr. Lee Kao, Reproductive Specialist at Laurel Fertility Care, GLMA Member
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