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What are the chances of pregnancy and having twins with induced ovulation by hCG injection?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am 34 years old and have been trying to conceive for second pregnancy for eight months. My first pregnancy was a natural conception. We consulted a doctor after being unsuccessful. She prescribed Progynova during the cycle and then hCG injection. Both follicles ruptured. Now I am on Pregcert-200 SR. 1. The following are my questions,

  1. What are the chances I will conceive?
  2. What are the chances that it will have twins?
  3. What will happen to the other released egg if only one egg fertilizes? Will I bleed it out?
  4. The injection was given ten days after my last menstrual period. When can I take a pregnancy test?

Hello,

Welcome to icliniq.com.

You have done ovulation induction in this cycle. The chances for fertilization in any cycle are roughly around 60 %. The likelihood of twins is low as two sperms need to fertilize the two ova if the ova reach the fallopian tubes. The incidence of twins is more in procedures like IVF (in-vitro fertilization). The pregnancy test can be done 14 to 16 days after the hCG injection or as soon as you miss your periods, whichever is earlier. Generally, a serum beta-hCG level would be preferred in these cases compared to a urine pregnancy test.

Patient's Query

Hello doctor,

Thank you for the reply.

We have been trying for nine months. For two cycles, we did a follicular study without drugs. Follicles ruptured, but conception did not happen. Hence this cycle, we went for induction. The follicle size at the time of rupture was 2.1×1.9 cm. Are these numbers good? What more can we do to increase the chances of conception? Serum analysis was not done as the doctor said for the 1st pregnancy; it was done, and the chances of his sperms having issues are low.

Hello,

Welcome back to icliniq.com.

The numbers are good. Technically you cannot do anything to increase the chances of pregnancy. If this does not work, the next step could be to try intrauterine insemination.

Patient's Query

Hello doctor,

Thank you for the reply.

It has been 20 days since my last menstrual period and ten days since having an hCG injection. I had slight bleeding - first brownish and then slight reddish. I rubbed a tissue and found it. What can I make of it? Am I getting my period?

Hello,

Welcome back to icliniq.com.

  • Get a urine pregnancy test to be safe if it is just spotting.
  • If it is proper bleeding, then yes, unfortunately, it is your period.
  • The most important thing is to try being less anxious and stressed about this process because stress hampers the results. Try meditation and relaxation techniques. Hopefully, that should help too.

Patient's Query

Hello doctor,

Thank you for the reply.

It was indeed my cycle. I was on Pregcert 200 and still got my periods. I got it in 21 days. What does that mean?

I just got a blood test done, and the result showed TSH - 2.7, fasting blood sugar - 88, and AMH serum - 1.68 ng/ml. I will turn 35 in the next few months. Does it mean I will have difficulty conceiving?

Hello,

Welcome back to icliniq.com.

There was no fertilization in this cycle. Your lab reports are normal. It generally takes time to conceive. If you have been trying for more than a year, I recommend starting IUI (intrauterine insemination), which will improve your chances of conceiving.

Patient's Query

Hello doctor,

Thank you for the reply.

After this menstrual period, I was given Letrozole on day 3 to day 7 and FSH and LH injections on day 12 and day 13 since the follicles did not grow much. Day14 scan showed a 15 cm follicle, and day19 showed it reduced to 12 cm.

Now, I am on day 36, but still no periods. I did a urine pregnancy test, and it was negative. My questions are,

1. Can I be pregnant?

2. What is causing the delay in the cycle?

3. Could the LH and FSH injection harm in any way?

Hello,

Welcome back to icliniq.com.

You are not pregnant if the urine pregnancy test is negative. So the follicle reached a maximum size of 15 and then reduced. Most probably, this was not an ovulatory cycle hence the delay. The ovulation occurs after the follicle size of 18 to 20. FSH (follicle-stimulating hormone) and LH (luteinizing hormone ) are not harmful. You might have to take them from the start instead of Letrozole. If you want, you can take Progesterone for withdrawal bleeding to start your periods or wait till they start. It is your choice. You also might experience slightly heavier bleeding this time as it is delayed

Patient's Query

Hello doctor,

Thank you for the reply.

My last scan ET (endometrial thickness) was 15 cm. Is that normal? Will this delay cause any complications?

Hello,

Welcome back to icliniq.com.

No, it will not cause complications, but the bleeding could be heavier than usual. Endometrial thickness of 15 cm is normal.

Medically reviewed byiCliniq medical review team

Published At August 11, 2022
Reviewed AtOctober 11, 2023

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