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deb67 - December 13th, 2006 4:18 PM

Hello! I have been having trouble finding out what a normal P4 and E2 level should be after ET. I had ET 5 day (3 morulas) put in last Saturday. My Re doesn't do many blood tests. I asked him to do a P4 as it is my worst fear that I don't have enough for the embies to stick. He said that number came back fine. What is fine? He said my E2 levels came back low and wants to put me on estrace bid. First off what is a normal level of E2 after ET and what does the estrace even do with the embies? I was on estrace before during past FET's to help with lining issues. But after ET wouldn't it be too late to be worrying about a lining issue????
Confused!
Thank you!
Debra ???

Dr Smith - December 14th, 2006 10:09 AM

Your question is more of a clincal nature. It falls outside my area of expertise (I'm not a physician, nor do I play one on TV). I will forward your post to Dr. Jane Miller, the RE I work with. She will respond as soon as she gets a chance.

Dr Jane - December 14th, 2006 11:02 AM

The Estrace doesn't effect the embryos but I don't believe that starting it once the estradiol is already low would be of any value.I routinely begin estogen supplementation the same day as ER. The purpose is to prevent the patient's estrogen from plummeting as this may adversely affect implantation. From natural cycles we know that even a level as low as 75 pg/ml - and probably even lower - is sufficient to sustain an early implantation. Progesterone levels are best around 20. We often get used to seeing supraphysiologic levels of progesterone >40. These are not necessary for embryo implantation and early pregnancy.

deb67 - December 14th, 2006 12:05 PM

Hi Dr. Jane! First off thank you for taking time out of your busy day to write me. I really appreciate it. My old RE (we moved recently) used to do the estrace vaginally 2mg bid. I had asked my new RE (although he is not new to the field, just me) about using some during my ER. He said that he wasn't going to use it with me. I have no idea why. I had asked for a blood test and I just got the results back today. My E2 levels are 51 and my P4 is 33.5.
I started taking the estrace last night but at 4 days past my transfer I wonder if likeyou said it is too late. I also have a history of thin lining although I did get pregnant with my daughter with a 6.7 lining. My lining this time before ER was 8.5 but is there a chance it could have dropped with a drop in my estrogen level?
My last estrogen level at day 9 stims on December 1st was 2,000...then my ER was on December 4th and ET on December 9th. I am a little worried now to say the least about this!
Thanks,
Debra

Dr Jane - December 21st, 2006 10:30 AM

Hi Debra,
As I said, I use transdermal estrogen post ER. I am not happy with your last E2 level but you have more than enough P4 to support a pregnancy. One problem is that we don't know much about this crop of embryos that were transferred. True it was day 5 but they were morulas - we don't know if they would make it to blast and, if so, what grade blast ie - adequate or inadequate stem cel mass. Your endometrial thickness was probably not a factor given your past OB hx.
Dr. Jane

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