This story about whether to trust your doctor was shared on the discussion board, and because I know from women over the years that our doctors are not infallible and fertility science is not always perfect, I’m posting it here as a point of conversation. Please offer your comments below.
I have now missed 2 (medicated!) IUIs in a row. The first because I was out of town and I (of course) ovulated earlier than I have ever ovulated (EVER!) — even on medicated cycles. AARRGGH! But… on to the next cycle.
So this cycle I have all my usual signs of pending ovulation. I’m using multiple brands of ovulation predictor kits (OPKs) and on Day 20 (a normal range for me), two different test that have both been reliable in the past pick up an LH surge, so I make an appointment of an IUI the next day. Because I’d been sick for two weeks with a G.I. bug and had really not been feeling/eating/sleeping well at all, I talked my way into having an ultrasound the morning of the planned IUI.
My regular RE was on vacation, but one of the other Docs at the clinic (who has a good reputation) did it. She said there was no dominant follicle on the right and though initially she had some difficulty seeing the left ovary after poking around a bit, she said she had good visualization and there was no dominant follicle — or collapsed follicle indicating recent ovulation — present there either. She said I was, if anything, days and days away from developing a dominant follicle and that most likely it was a false positive OPK.
That made absolutely no sense, given that my typical ovulation signs were present, the timing was right, and and TWO different brands said yes to LH. But when an RE tells you there is no dominant follicle (nor one that looked like it just released an egg) what do you do? You cancel your $300 IUI with your $700 vial of donor sperm.
I thought I had a pretty good understanding of the physiology involved. But I certainly don’t know everything. Does anyone know if it is possible to have an LH surge in the absence of a dominant follicle? Or to see a rise in basal temperature if ovulation did not occur?
I am very puzzled about this. Either something is very wrong with my own physiology, or the RE involved was overconfident in her assessment that there was no way there was anything close to a dominant follicle present, now or in the last 24 hours. Or perhaps my understanding of how it all works is off.
Women chimed in, generally with encouragement that she did the right thing in not using her more expensive vial of sperm for the less expensive procedure, even though she had spent money that cycle on the medications and thought it was a go. They expressed hopes that she would eventually solve the mystery and be able to find the right time for insemination, despite the delays. Then, she wrote with her follow-up:
Frustrated. A progesterone blood test showed that I did indeed ovulate. The Doc was wrong in stating that there was no dominant follicle. She just couldn’t SEE it. But she left no room for the possibility that it *could* be there. She was quite definite that it wasn’t. I missed the cycle for nothing.
And now because the clinic closes the week over Christmas I either am stuck missing another cycle (I would be due to ovulate right in that week), or move forward to IVF now (2 cycles earlier than I need to). See a follow-up post on this question here.
I am left wondering: RE incompetence, vs RE overconfidence, vs RE simply not realizing that we actually do have way more insight into our own bodies than we are given credit for, vs part of RE’s grand plan to get us moving to IVF sooner??!