Empty follicles even with dual trigger?
Hi ladies - thanks in advance for any advice as I am spiraling while trying to prepare questions for my RE. Really appreciate everyone's insights from their own journeys.
I already searched the subreddit for older posts on the topic of empty follicles, and most comments mention that dual trigger helped resolve the issue. However, I did use a dual trigger (10,000 hcg and 80 iu lupron) and I injected exactly at the time instructed. The clinic took my bloodwork the next morning and did not flag any concerns, so I just assumed that meant the triggers were absorbed as expected.
Another common reason cited in other posts is early ovulation, however I asked the doctor who did my retrieval and the doctor said they did not see any evidence of that. Unfortunately I wasn't prepared to ask additional questions because I was completely thrown off. My retrieval was ~35 hours after trigger shot, and I had taken 3 ganirelix the day of the trigger shot. Protocol leading up to trigger was estrogen priming, clomid, then follistim and menopur.
The morning of my trigger shot, I had 4 follicles in the 17-21mm range, which gave me some optimism because I'm 34 with AMH 0.3 and the doctors all told me during monitoring that I was responding well. I don't have the exact estrogen number for that morning but two days prior it was over 1,100 so my clinic said everything was on track.
So with all that, I headed into my retrieval this morning with the 4 follicles in mind. When I woke up after the procedure, I was informed they only retrieved 2. Of course I am still grateful to have retrieved anything, but I am genuinely baffled at what could have happened.
I feel like we did everything by the book? What am I missing here?
Thank you again for any and all feedback.