Circus School: Luteal Phase Follicle Edition

I am a Geek, a Nerd, a Dork. I want to know statistics, algorithms, percentages. I want to know whats happening to me, to understand the language.

Dr Yelian has commented on it before, saying that most patients don’t want to know, or don’t care, they just do what the Dr says. I say, this is something I am invested in being successful with so, I want to understand the language. That means breaking it down into terms the normal person can understand.

While I am sure many of you would disagree, I am the normal person in this scenario.

What is happening to me this month is an anomaly, because I get every weird scenario/cycle possible. So much for normal. Welcome to my life.

In the Mini-IVF community, the Luteal Phase Follicle is mythical. Everyone has heard of them, knows someone who had one, but no one really understands them, what they mean, why they happen or what their quality or outcomes are.

They occur, but not often and not usually with very good results. (this information is subject to change because Dr Yelian vehemently disagreed with me when I saw him on Monday but didn’t have time to go into specifics) I have asked him about these before, and he was ambivalent about them. Not sure if there was any real value to them, however he just returned from a conference in China and says he has some data that has changed his mind. I will be asking for that data the next time I sit down with him. Because I need to know things.

To review: I am doing Mini IVF, which is IVF with fewer medications, so you don’t get lots of eggs each cycle you may get 1 to 8 depending on your age, secondary fertility issues, autoimmune issues, and whether you have Diminished Ovarian Reserve (DOR), or Primary Ovarian Failure (POF) PCOS, Cysts or Endometriosis.  I have had as many as 5 and as few as 1. It varies from month to month.

I have diminished ovarian reserve, low AMH and I am of advanced maternal age.

Today, I am CD 17, have one follicle that Monday, before it was assaulted with Menopur and Clomid measured 9.8mm. Anything after CD 14 is considered to be “Luteal Phase” or post ovulation.

During an IVF cycle, the dr retrieves an egg right before the woman ovulates, while the mature follicle is still in the ovary. They want the follicle to be as mature as possible but don’t want it to have ruptured from the ovary. In a normal natural cycle (non medicated), this is the only egg that would be retrieved, and so you begin the 2ww wait for the next menstrual cycle and follicular phase to begin. However, sometimes there will be other follicles in the ovaries that may not have been mature enough to rupture at the time of ovulation, but are still viable. With monitoring and sometimes stimulation, the Dr is able to retrieve another mature follicle that has developed even after the patient has entered the Luteal Phase.

The statistics and data on the success rates of Luteal Phase Follicles is murky at best. Generally the egg quality is thought to be poorer by 10 to 20%. I know that there have been LPF pregnancies however again, the data is not easily found. If I could translate the Kato Ladies Clinic white papers and general information about it into English I could make a fortune. The Japanese don’t believe that American women want to know this information. So they see no need to translate these documents. Which harkens back to what Dr Yelian said about some patients not wanting to know.

I don’t understand that. As in, I can not wrap my head around the idea of not wanting to know. I want to know EVERYTHING. Not to second guess the Dr, but to be informed about whats happening to me, why, and if there is anything I can do to change it, stack the odds in my favor or improve my outcomes. Who the hell puts themselves through this without wanting to know?

Anyway. There is one scenario under which my chances might be improved this time. My cycles started getting bizarre in March. Why? I’m not sure, possibly over suppression, however it created a sync issue between my follicular stage and my menstrual cycle which I’ve been combating ever since.

Last cycle from start of my menses, through the aspiration of the cysts, the 10 days of Provera to the beginning of my next cycle was only 16 days. I don’t have confirmation on this yet but it would seem logical to me that while this is another abnormal cycle, the condition where a sync issue exists, would also show that while this may be a luteal phase follicle, it may also be a regular follicle that happens to have begun maturation later since the duration of my previous cycle was so short. By “regular follicle” I mean one of good quality.

This logic could also be a mechanism to encourage myself to move forward with it, and keep my head from exploding.

Maybe no one else really wants to know this information. Maybe I really am an anomaly. I find writing it down in words that make sense to me, helps me process through it. If its boring, I’m sorry. Maybe these school posts are really just for me.

Acupuncture today, Clomid with a big shot of Menopur tonight, and doing everything I can to keep my stress level down. Which means vegging out and trying not to think too much. There should be an off button. Seriously.

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11 comments on “Circus School: Luteal Phase Follicle Edition

  1. Very helpful!!! Thanks for sharing what you are learning!

  2. Louisa says:

    I used to be like you, wanting ALL the info, asking a million questions until I realized 2 things: 1. Although this is science you ask the same question to 10 MDs and you’ll get 10 different answers. Having the information has VERY little effect on the outcome. Depressing but true. Wishing you the best of luck!

    • Jeanette says:

      Thanks Louisa. How are you doing? Are you ok?

      I dont have high expectations right now. I know it doesn’t change the outcomes but I cant help myself. I want to know stuff.

  3. Daryl says:

    Can’t blame you for wanting to know. If I was in your situation, I’d be asking a ton of questions, too!

  4. Theresa says:

    That’s actually really interesting. And I’m with you on wanting an off button

  5. I say get all of the information you can. I am the same way. Like you said, arm yourself with everything you possibly can. Sometimes doctors don’t always put the pieces together. I think we are our best advocates. Good luck, sweetie!

  6. Jeanette says:

    Thank you! I hope you and your little bean are doing well!

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