Walaikum Salam,

I am doing great, thanks. And thank you for your kind words and being so appreciative. And I am glad to be of some help. Certainly, my pleasure:)

Regarding injectibles, these are hormonal shots that stimulate egg maturation/ovulation, either to be used on their own, or prior to the IVF. Several different ones are available, HCG being a more common one, and different clinics use them according to different protocols.

Yes, they require very close monitoring through serial ultrasounds and blood work ( E2 levels or estradiol Levels), and the timing of the administration of the shot is crucial, because if not given at the correct time, treatment fails. In women who are not ovulating on their own, a series of shots is given prior to the HCG trigger. However, the HCG shot is just a single shot and is invariably followed by ovulation in 35-40 hours. Depending upon whether your doctor is planning to give you HCG as standalone treatment, you would be advised regarding the timing/frequency of intercourse, or if the doctor is planning IVF, the egg would be retrieved the day following the shot.

The success rate depends upon a variety of factors, including the underlying reasons for infertility, timing of the shot, body's response to the shot etc etc.

Regarding the number of cycles, there is no absolute number, and the success rate generally is the same for the first 4 cycles. As far as their side effects, there is a risk of OHSS ( Ovarian Hyper Stimulation Syndrome), which in most cases is mild and self limited, but in rare cases could be  serious as well. There is increased chance of multiple pregnancies( twins, triplets), risk of ectopic pregnancies ( pregnancy that implants in an abnormal place instead of the uterus), risk of miscarriage etc. Most likely, symptoms that you will experience would be mild nausea, vomiting, diarrhea, abdominal pain, headache, and some breast enlargement.

I know my answer is rather non specific, but without knowing what exactly your doctor is planning on doing, either standalone treatment or as part of IVF, this is the best that I can tell you. If you give me more specific information as to what your doctor is suggesting, then ofcourse I would be able to tell you more clearly.

As always, my best wishes for you:)

Walaikum Salam,

Sorry to hear about your experience. I know it really hurts when things like these happen, particularly when we have invested so much of our time, our energies, our hopes and our emotions, and still things don't come to fruition. I know you must be feeling very frustrated right now.

You had an excessive response to pergoveris, and your doctor did the right thing by not giving you the HCG trigger.

I want to make sure that you did not have a potentially serious complication called OHSS; which can sometimes cause excessive weight gain of several pounds during the few days of treatment, pain and swelling in the belly, and lack of urination? Generally, OHSS is a mild condition and is self limited, but sometimes can cause complications that I just described. I want to make sure that you did not have any of these symptoms.

When exactly was your E2 level checked?

You mentioned that you felt like having multiple miscarriages. Must be really hard for you to go through all this, and I certainly hope and pray that next cycle would bring about the desired outcome for you, Ameen.

With my prayers and best wishes for you!