I know my last few posts have veered into a weird dime-a-dozen infertility blog type of bleakness, but today we are back on the educational and informative train. Today's topic is useful for hetties and queers alike, so make yourself comfy and let me tell you about follicles.
If you have ovaries, you are born with all of your eggs. They just sit about until you're ten or thirteen or sixteen or whenever your body decides it's ready to make babies, then your body starts spitting out one every three or four or six or whatever-your-body-decides weeks. I had never cared even a little bit about the who, how or what of the "spitting out" process part of the whole equation, but it turns out it's a bit important when you're trying to get pregnant.
Follicles are little things that suck a wee eggo up from your ovaries and ping them into your fallopian tubes. It turns out your eggs can't just be trusted to make this leap in an orderly schedule, so follicles do it. After each period your body tells a follicle to form, said follicle picks up an egg from your ovary, and "ovulation" is when it releases it into your fallopes. It's like those gates you have to go through when you're coming out of a bird sanctuary or whatever - you go through one door into the follicle, that door closes behind you so the other eggs can't escape, then a door opens in front of you and you go out into the zoo. I feel like calling my previous sentence a "mixed metaphor" is an insult to other mixed metaphors, but hopefully you're picking up what I'm putting down here.
Why do we care about this? Well, we usually don't. The details of how the egg gets from your ovaries to the follopies is hardly of critical importance in 99.9% of life's circumstances. Even for baby-making it doesn't matter, so long as you're DIY-ing or even for unmedicated IUI. As soon as you start to medicate that shit, though? Follicles start to matter a bunch.
When writing about the medications you use to help with fertility in the past, I said that they "increase egg production". That... is not how they work. I don't know what I even meant by that. To be honest I think I thought that we would never get to the point of needing the medication so I didn't really care. Turns out I now care about this more than most things I used to care about. What the medications actually do is increase the number of follicles your body produces. Suddenly, instead of only one exit from the bird house-y thing, there are multiple exits. Each follicle picks up its own egg, and they release them all into the tubes at the same time. This is why fertility treatment is more likely to result in twins - multiple eggs in the fallopian tubes means that when the little sperms get there, more than one egg might get fertilized.
Great! So. Linda took the medications, then we went in for a scan to see how many follicles had grown and therefore how many eggs would be waiting in her tubes to get made into babies. There were two! Two is the perfect number of follicles to have, apparently. Doubles your chances of success but doesn't increase your risk of twins too much because the odds of both eggs being fertilised is slim. Well, it turns out our previous chances of success must have been very very low indeed because even with them doubled, the pregnancy test came back negative. Tantrums abounded.
So next month, same deal. Take the same dose of the same medications, go in for the scan. A cool thing that's happened is that I can now read ultrasounds, which meant that I didn't need the doctor to say anything. I just looked at the screen and said "ah, shit."
No follicles, you ask? Oh no my friend. Not no follicles. FIVE follicles.
Each fertility clinic has their own upper limits on how many follicles you can have. Fertility Associate's is three. More than three, they don't go ahead with insemination, because the risk of twins/triplets/a truly horrifying number of children for one pregnancy is too high. Most people in cis-het relationships go home and bang like crazy, and lots end up with multiple pregnancies. But for those of us with their sperm locked in the Fertility Associates freezer, we have zero options. IUI is cancelled for the month. In IVF, you want to have as many follicles as you can because they're going to suck the eggos out with a needle and fertilise them one-by-one in their lab. In IUI, they're just sending a bunch of sperms on up to do what they will, so they draw a line at three follicles.
"But it was the same dose!" I yelped at the poor person just trying to measure the damn things. "How are there so many there were only two last time what happened why are there so many this is terrible this is our last chance at IUI what happened why is this happening."
The woman told us in a soothing voice that she would scan Linda again in a few days, because sometimes some of the follicles just die off and the body focuses on making just a couple of them real great. I did not believe a word of it. I was fairly certain that our IUI was cancelled and she just wanted another person to have to tell us. We cried and sulked and cancelled our dinner plans with a dear pal and it was all terrible. Three not-pregnants and one non-starter. We were now officially in the minority - over 60% of people, even people with known fertility problems, achieve a pregnancy after four rounds of IUI. We even had to pay for this round even though no sperm would actually be sent towards the five lil eggos waiting to be released. Everything felt too heavy and too unfair and we felt too tired and too sad. Fucking follicles.
Then we went back for another scan and only two follicles were still growing. Linda's body had done exactly what the doctor had said it might do. I was elated, then exhausted. This just meant more waiting: waiting for Linda's bloods to show that her follicles were ready to spit the eggs out into the zoo, then the endlessly long two week wait to find out if she was pregnant. The only tiny positive of too-many-follicles was that the turmoil was over early, and it left a couple of bright, fresh, not-trying not-waiting weeks where trying and waiting would otherwise have been.
But still. Two bonus tiny chances. Two little eggos in two little follicles just waiting, waiting, to maybe one day be a person that we love. And if not, get ready: IVF blog posts coming your way.
If you have ovaries, you are born with all of your eggs. They just sit about until you're ten or thirteen or sixteen or whenever your body decides it's ready to make babies, then your body starts spitting out one every three or four or six or whatever-your-body-decides weeks. I had never cared even a little bit about the who, how or what of the "spitting out" process part of the whole equation, but it turns out it's a bit important when you're trying to get pregnant.
Follicles are little things that suck a wee eggo up from your ovaries and ping them into your fallopian tubes. It turns out your eggs can't just be trusted to make this leap in an orderly schedule, so follicles do it. After each period your body tells a follicle to form, said follicle picks up an egg from your ovary, and "ovulation" is when it releases it into your fallopes. It's like those gates you have to go through when you're coming out of a bird sanctuary or whatever - you go through one door into the follicle, that door closes behind you so the other eggs can't escape, then a door opens in front of you and you go out into the zoo. I feel like calling my previous sentence a "mixed metaphor" is an insult to other mixed metaphors, but hopefully you're picking up what I'm putting down here.
Why do we care about this? Well, we usually don't. The details of how the egg gets from your ovaries to the follopies is hardly of critical importance in 99.9% of life's circumstances. Even for baby-making it doesn't matter, so long as you're DIY-ing or even for unmedicated IUI. As soon as you start to medicate that shit, though? Follicles start to matter a bunch.
When writing about the medications you use to help with fertility in the past, I said that they "increase egg production". That... is not how they work. I don't know what I even meant by that. To be honest I think I thought that we would never get to the point of needing the medication so I didn't really care. Turns out I now care about this more than most things I used to care about. What the medications actually do is increase the number of follicles your body produces. Suddenly, instead of only one exit from the bird house-y thing, there are multiple exits. Each follicle picks up its own egg, and they release them all into the tubes at the same time. This is why fertility treatment is more likely to result in twins - multiple eggs in the fallopian tubes means that when the little sperms get there, more than one egg might get fertilized.
Great! So. Linda took the medications, then we went in for a scan to see how many follicles had grown and therefore how many eggs would be waiting in her tubes to get made into babies. There were two! Two is the perfect number of follicles to have, apparently. Doubles your chances of success but doesn't increase your risk of twins too much because the odds of both eggs being fertilised is slim. Well, it turns out our previous chances of success must have been very very low indeed because even with them doubled, the pregnancy test came back negative. Tantrums abounded.
So next month, same deal. Take the same dose of the same medications, go in for the scan. A cool thing that's happened is that I can now read ultrasounds, which meant that I didn't need the doctor to say anything. I just looked at the screen and said "ah, shit."
No follicles, you ask? Oh no my friend. Not no follicles. FIVE follicles.
Each fertility clinic has their own upper limits on how many follicles you can have. Fertility Associate's is three. More than three, they don't go ahead with insemination, because the risk of twins/triplets/a truly horrifying number of children for one pregnancy is too high. Most people in cis-het relationships go home and bang like crazy, and lots end up with multiple pregnancies. But for those of us with their sperm locked in the Fertility Associates freezer, we have zero options. IUI is cancelled for the month. In IVF, you want to have as many follicles as you can because they're going to suck the eggos out with a needle and fertilise them one-by-one in their lab. In IUI, they're just sending a bunch of sperms on up to do what they will, so they draw a line at three follicles.
"But it was the same dose!" I yelped at the poor person just trying to measure the damn things. "How are there so many there were only two last time what happened why are there so many this is terrible this is our last chance at IUI what happened why is this happening."
The woman told us in a soothing voice that she would scan Linda again in a few days, because sometimes some of the follicles just die off and the body focuses on making just a couple of them real great. I did not believe a word of it. I was fairly certain that our IUI was cancelled and she just wanted another person to have to tell us. We cried and sulked and cancelled our dinner plans with a dear pal and it was all terrible. Three not-pregnants and one non-starter. We were now officially in the minority - over 60% of people, even people with known fertility problems, achieve a pregnancy after four rounds of IUI. We even had to pay for this round even though no sperm would actually be sent towards the five lil eggos waiting to be released. Everything felt too heavy and too unfair and we felt too tired and too sad. Fucking follicles.
Then we went back for another scan and only two follicles were still growing. Linda's body had done exactly what the doctor had said it might do. I was elated, then exhausted. This just meant more waiting: waiting for Linda's bloods to show that her follicles were ready to spit the eggs out into the zoo, then the endlessly long two week wait to find out if she was pregnant. The only tiny positive of too-many-follicles was that the turmoil was over early, and it left a couple of bright, fresh, not-trying not-waiting weeks where trying and waiting would otherwise have been.
But still. Two bonus tiny chances. Two little eggos in two little follicles just waiting, waiting, to maybe one day be a person that we love. And if not, get ready: IVF blog posts coming your way.
Oh my god what a palaver! I was wondering, what happens if the finite ammount of eggs is released with these extra follicles? Does that diminish you chances by double each time? Like say theres 100 eggs ( i have no idea how many eggs is actually a thing) and each month 1 is released with ovulation. say that happens for 6 months, so 6 eggs. We're down to 94. But then the next cycle with the 2 follicles, 2 eggs are released. So we're down to 92 after just 1 cycle? And what would have happened if Linda was (for eg) on the pill? Would 12 eggs be saved for each year of her life on the pill as it doesn't produce ovulation? I am sending you so much luck x
ReplyDeleteHi hello, these are great questions (and yes, SUCH a palaver).
DeleteFrom what I understand so far, yes, releasing two or five eggs from your reserve means that those eggs are used up and therefore your eggs will run out slightly faster. But as far as the birth control thing goes, nope - I've been on the pill or had an IUD since I was 14, and my AMH (egg count) is right in the middle of the normal range. My understanding is that you lose a whole bunch annually just bc they like die of old age or something, the ones you ovulate out count for a very small number (you're born with like a million or something absurd like that!). So losing extra eggs through having extra follicles only matters if you're scraping the bottom of the barrel egg-count wise already.
Hey, so will you be going straight to ivf with Linda? Have you considered swapping and then have you go through the unmedicated, then medicated cycles (so then you have taken all the cheaper options) and hopefully get a baby before you have to fork out on ivf?
ReplyDeleteWe're not even going to try any sort of IUI with me (Molly) because my insides are too messed up! So from here on it'll be IVF for both of us.
DeleteThis post and your comments have been educational! I got my period quite young and then have been on birth control for the last decade so I wondered whether I'd run out of eggs earlier OR if there would be extra stock since I haven't been ovulating. But now it seems it probably doesn't make a difference anyway.
ReplyDeleteAside from that, wishing you both the best - I hope there's some good news in your future.