E2 of 5 pg/mL after 4 days of stims

KareyG

3 Posts
Reply Posted on: Jan 19, 2014 at 10:34am
Hello. I just had my first IVF cycle cancelled at a well respected clinic. My Dr. cannot explain what happened and Im trying to figure it out.
Age : 42 next month. Trying for 1.5 years
Regular cycles
FSH= 10.3 to 9.5 mu/mL
AMH= 0.59-0.8 ng/mL
Never had a + pregnancy test even.
No issues found except high resistance to blood flow by Doppler and 2 polyps (uterus/ cervix).
Antral follicle count: 9 all

Dr. Braverman

2026 Posts
RE: E2 of 5 pg/mL after 4 days of stims Posted on: Jan 20, 2014 at 12:45pm
This is not enough information to help you . When you say no issues that depends on what they knew to look for. I would be happy to help you , simply fill out a consult request from our website and we will be in touch to organize this for you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

KareyG

3 Posts
Reply RE: E2 of 5 pg/mL after 4 days of stims Posted on: Jan 20, 2014 at 12:57pm
Sorry for that- I dont know why my message was truncated! Let me try again!

I just had my first IVF cycle cancelled at a well respected clinic because my estrogen would not rise. Im trying to figure out what went wrong. My Dr doesnt know. My protocol looked like this:

Priming: 2mg estradiol 2x/ day for 12 days
CD2 suppression check: E2 was 219, P4=2 Clinic thought the E2 was high, but said ok to continue. No cysts, 9 follicles all < 10 mm
Stim day 1: 2 vials menopur in AM / 300 IU gonal F, 2 clomid, dexamethasone in PM
Stim day 5: E2 was 5, P4 was 0.07 3mm and 5 mm follicle only. Gonal F increased to 450 IU
Stim day 7: E2 was 33, P4 was 0.03 Total testosterone= 2.5 5 and 7.5 mm follicle only.
Cycle cancelled due to lack of response.

My doctor said “something” suppressed me, but he doesn’t know what. He doesn’t think it was the estradiol priming because he says it’s a low dose.

In previous injectables cycles, my E2 on CD3 was 30 and 50 (no priming). I also stimmed very quickly with 150 IU of follistim. Both times, I was ready to ovulate after 4 days of follistim.

Age: 41. FSH: 10.3-9.5 AMH= 0.59 -0.8 No other factors except resistance to bloodflow and 2 polyps. Never been pregnant.

Do you have a theory as to what could have suppressed me? If it wasn’t the estradiol what could it be? For my next protocol, my dr is suggesting estradiol again (2mg/ day for a month) and testosterone for priming. This makes me very nervous.

How would you proceed?

Do you know why my follicles would not grow on Menopur / Gonal F when they grew very quickly (too quickly) on Follistim? Is it possible the stimulants were too much for my ovaries and they shut down? Maybe I need lower doses?

I was not asked to confirm ovulation before I started the estradiol priming. They just said to start 2 days after LH surge. If I had not ovulated by the time I started it, would this have caused my response? I did have my CD1 bleeding at the expected time though.

Thank you for any response, it is appreciated!

Dr. Braverman

2026 Posts
RE: E2 of 5 pg/mL after 4 days of stims Posted on: Jan 20, 2014 at 2:06pm
sometimes after estrogen priming it takes a while to stimulate I might have gone a bit furhter before stopping.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.