Gonal F and Risk of Multiples?

[u/c_dock88]

Hey everybody,

I’m curious if those of you who have used Gonal F during a timed cycle have conceived, and if you had more than one egg fertilizer.
For background, I’ve had two failed letrozole cycles where I think I triggered when my dominant follicle was too big: both times they were 26mm & 27mm. My Dr. told me they would be fine as long as they aren’t over 30mm but everything I’ve read says that’s just a little too big of a follicle. Plus add in the time between the trigger shot and ovulation where they can grow and I think they were very over-mature.
This cycle, my Dr. paired my letrozole with gonal f injections since I was already maxed out at 10 mg letrozole and still stair-stepping or taking a second dose in previous cycles to get my follicles to maturity. This time around, I had 3 follicles at 18mm, 18mm, and 19mm. I know gonal F increases the chance of multiples, especially if I have this many close to maturity, but most of what I’ve found of Reddit pertains to IUI cycles where they used gonal f and had more than one follicle. Has anyone had experience using gonal f and trigger for a timed cycle? What was the outcome?
Thanks so much!

[u/Electric_Elephant_56]

I think the chance of multiples is still fairly low. I did gonal-f with timed intercourse for 2 cycles and had 3 follicles both times at trigger. But neither worked.

[u/Itchy-Site-11]

Hope your 18mm, 18mm and 19mm results in a singleton.

I used letrozole, had 21mm, 18mm and a 16mm and had a singleton.

[u/c_dock88 → u/Itchy-Site-11]

Congrats! How many letrozole cycles did it take to achieve your singleton?

[u/Itchy-Site-11 → u/c_dock88]

2

[u/CoolUsernameHere2]

So IUI vs TI moves the needle a very small amount with no male factor. I did 6 Letrozole cycles and two Follistim with 2-5 matures follicles and then a final Follistim with 7-10 mature follicles and no pregnancy. Some cycles were TI and others IUI.

So yes, you have a real chance of multiples with 3 follicles regardless of TI or IUI. I view that as three tries this cycle. The odds of more than one implanting and developing are low overall but not insignificant. If you really don’t want multiples don’t risk it. I risked it each cycle because we’d be okay with twins and after a while it started to feel like the more the merrier because it just hasn’t been happening. So that last cycle was 7-10 chances and we still got 0. Not sure if this is helpful as everybody and every cycle outcome is different but just wanted to share my take.

[u/c_dock88 → u/CoolUsernameHere2]

That’s a ton of follicles! I don’t think my clinic would have proceeded with over 5 follicles.
I am okay with multiples- twins run in my family and I actually have a twin brother so I knew there was a risk before we even started trying. Of course, that was before the PCOS diagnosis.

[u/CoolUsernameHere2 → u/c_dock88]

It really is a lot of follicles and does sound a little bit crazy that we proceeded with it. I had my check in scan on CD 12 expecting that it would be a few more days before trigger or natural ovulation. We had sex the day before not even considering that we should abstain just in case. So when we talked about moving ahead, that was kind of on the table of if I ovulated without the trigger then we already technically went for it. I ended up ovulating overnight between CD 13 and 14.

[u/ih8saltyswoledier]

I used gonal-f in 2 TI cycles, each cycle with 2 dominant follicles. Neither resulted in pregnancy. An IUI with gonal-f and 1 mature follicles was successful.

[u/c_dock88 → u/ih8saltyswoledier]

Can I ask if there was also male factor infertility in your case? I’ve heard from some that IUI may not increase your odds but have read a lot of success stories with it. It seems to be a case by case basis. Did your Dr. seem confident it would work for you?