I'm 24 and under Gonal-F treatment. I had an insemination on day 15 of my cycle. On day 20 I went in for an ovary check, and the doctor said my ovaries are the size of grapefruit, and that this is good. I really didn't get much more explanation than that. Would you be able to fill in the blanks and tell me what that means?

Roberta

Gonal-F and other ovulation medications spur the formation of multiple follicles in the ovaries. Each follicle contains an egg. Ovulation, during which one or more eggs are released from their follicles, occurs about 42 hours after the body produces an LH surge or you get an hCG shot. After ovulation, the empty follicle becomes a cyst, called a corpus luteum, and starts producing progesterone. The corpus luteum is often large. If you had many follicles that produced eggs during ovulation, you will likely have a large number of visibly enlarged corpora luteum after ovulation, making your ovaries appear large.

A large ovary can be tender, so intercourse or a rough pelvic exam that twists or traumatizes it can cause severe pain. In fact, a pelvic exam by a physician unfamiliar with enlarged (hyperstimulated) ovaries can result in ovarian rupture and loss of the ovary. So it is important that you see your own physician first for any pelvic discomfort while you are undergoing infertility treatment with injectable medications.

I can't really say that grapefruit-sized ovaries are good. Hyperstimulation in itself is not the goal of ovulation induction treatment, as this condition can lead to severe complications. But quite often we find that women who experience hyperstimulation are pregnant. So let's keep our fingers crossed. And take it easy -- avoid strenuous activity, and notify your physician should you experience increasing pain.