Why the number of follicles won’t help you predict multiple pregnancies with IUI

Over the years, technological advancement has been able to help a lot of women having problems with conception and pregnancy. 

There have been a lot of complications in the past surrounding childbirth and pregnancy. Modern technology has changed all that for us to have different channels other than the traditional way of getting pregnant. 

With the positive impact this has made, people should also be wary of the type of treatment they seek.

What is a follicle?

A follicle is a small sac of fluid that contains a developing egg and is found in the ovaries. When a woman reaches puberty, a number of follicles are released in her body.

Several follicles are produced during each month’s menstrual cycle which contains an egg. Because of this, only one follicle is allowed to grow and mature at a stage where it is ready to release its egg. 

This naturally occurs around 14 days into the menstrual cycle.

When the follicle is matured and is ready, it ruptures and releases an egg which is ready for fertilization.

How many follicles per ovary are considered normal?

It is difficult to determine the average number of follicles in each ovary because it is absolutely impossible to count them all. 

This is due to the fact that no test can detect the primordial follicles, which are known as such until they start to mature because they are microscopic.

With each cycle, multiple follicles may begin to form, but often only one of these follicles will produce an egg, with the others degenerating.

What is Intrauterine Insemination (IUI)?

In a reproductive procedure known as intrauterine insemination (IUI), a concentrated sample of motile sperm is injected right into the uterus.

This is a technique in which sperm is put directly into the uterus.

During IUI, the sperm is placed directly into the uterus bypassing the vagina and the cervix to prevent a lot of the sperm from being killed and stuck in the cervix.

This provides the sperm with direct access to the uterus and increases the chance of fertility. 

By raising the quantity of healthy sperm that enter the fallopian tubes when the woman is most fertile, this treatment seeks to increase the likelihood of conception. 

How IUI works

Ovulation stimulation is administered to the patient to increase follicular growth. These are basically medications given to the patient to produce more follicles in the ovaries.

If you don’t ovulate or your ovulation is infrequent, your doctor can recommend drugs like Clomiphene Citrate (Clomid) or Letrozole or injectable hormones like Gonal-F, Follistim, or Menopur to help.

When ovulation is ready, a concentrated amount of healthy sperm, either from your partner or from a sperm donor, is put directly into the uterus using a small pipe to fertilize the egg.

Intrauterine Insemination(IUI) is very useful but it can also be dangerous as well. 

When ovulation stimulations are given to a patient to increase the number of follicles, It produces multiple eggs from the ovary to ovulate. 

Fertility in this case is at a higher percentage but there is no control over how many eggs you ovulate, how many are fertilized inside the fallopian tube, and how many implants are inside the uterus.

Follicular growth increase is a complication and it is unpredictable which results in multiple pregnancies.

What Risks Are Associated With IUI and Ovarian Stimulation?

There is a chance that more than one follicle will grow when fertility drugs are utilized. 

As a result, there is a greater likelihood of ovulating more than one mature egg and multiple egg fertilization. 

The likelihood of having multiple pregnancies rises as the number of developed follicles increases, hence making it difficult to predict multiple pregnancies and can result in the patient having multiple babies. 

However, the kind of ovarian stimulation employed affects the possibility of having multiple pregnancies as well.

The likelihood of getting pregnant with twins after using oral ovulation inducers is about 8%.

Following injectable hormones and IUI, there is a 20% chance of conceiving twins.

In fewer than 1% of IUI cycles, triplets or more are born.

Although the precise number of mature follicles that raises the likelihood of multiple pregnancies is not proven, most medical professionals exercise caution when there are three or more of them. 

In some circumstances, stimulating the ovulation of three or more follicles may be necessary depending on the patient’s age and medical history. 

Based on your medical history and the ultrasound results you should talk to your doctor about the advantages and disadvantages of ovulation stimulation.

Why Is Having Multiple Pregnancies a Risk?

Twin, triplet, or more pregnancies carry a higher risk of injury to the mother and the unborn children. Mothers who have several pregnancies may experience the following health problems:

  • High blood pressure
  • Diabetes
  • Delivery complications

There can also cause complications for the baby

  •  Disorders in the brain
  • Low birth weight
  • Preterm delivery

 Multiple pregnancies raise these health hazards (triplets or more). 

Therefore, if you are expecting triplets or more, you should think about scheduling a meeting with a high-risk obstetrician/doctor of fetal medicine to talk about the possibility of selective pregnancy reduction.

A selective decrease may reduce the health hazards to the mother and the fetus, but it also increases the chance that the entire pregnancy may end in miscarriage. 

Therefore, it should only be carried out by a doctor with extensive training and expertise.


With your doctor, you should compare the advantages and disadvantages of starting ovulation with three or more developed follicles. 

You should refrain from sexual activity and wait until your next period to let ovulation happen naturally if you and your fertility specialist decide to postpone your IUI because of the possibility of multiple pregnancies. 

To reduce risk in upcoming cycles, you and your doctor may also talk about other ovulation induction methods.

You can also contact us if you have any questions about any reproductive procedures. 

Vivek is a published author of Meidilight and a cofounder of Zestful Outreach Agency. He is passionate about helping webmaster to rank their keywords through good-quality website backlinks. In his spare time, he loves to swim and cycle. You can find him on Twitter and Linkedin.