30 day cycle and high fsh
2 Replies
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Dr. Smith,
I am 40 yrs old and during my 30's till now my menstrual cycles have always been every 24 - 25 days. Never irregular.
A year and a half ago I took Clomid to check my progesterone level. My next menstrual cycle took 30 days to come on. For that menstrual cycle, I had a day 3 FSH test done. It came back a 10. About 6 months later after I took the Clomid, my day 3 FSH was at 6.5, Estradiol 140 and a few months later I tested again at 6.6 FSH, 141 Estradiol.
In February, I had my first IVF that made it to transfer and the embryos did not implant. When I was taken off the prog. injections, my period started a few days later and my next menstrual cycle again took 30 days. I started the BCP during that period to prepare for my next attempt in May. I was on them for about 3 weeks when we had to cancel(my husband couldnt make it). When I was told to stop taking the BCP, my period started again in a few days. However, my next period didnt come on again for 30 days(May 20th). I had my FSH done yesterday and the result came back as 9.8. My estradiol will not be ready for a couple more days. I'm thinking that my long cycles and high fsh has to be tied to me being on the medications. My RE had me on their max. protocol of Follistim, Menopur, Ganirelix, E2V supp., prog. inj. and supp.
Could I please have your opinion.
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I think you should also post your question on Dr Jacob's Infertility 101 Message Board, since he's an RE.
What I can say is that FSH and E2 are inversly related. High E2 will drive the FSH down and low E2 will allow FSH to rise, so hormonal maniplulations that result in atypical E2 levels can affect the FSH level. For an accurate FSH level, the E2 should ideally be less than 20 pg/ml or a least less than 40 pg/ml on DAy 2-3 of the cycle.
Also, since you're older (notice I didn't say old), the FSH level will bounce around a bit from cycle to cycle. Particularly if the cycle length is also unusual for you.
Don't read too much into FSH values. They are only a rough indicator of ovarian reserve (how many follicles will develop during a stimulated cycle). A baseline follicle count (A.K.A. antral follicle count) performed on Day 2-3 of a "normal" cycle is a better predictor of ovarian reserve. FSH says nothing about egg quality. That is more closely tied to your age.
"And that's all I'm gonna say about that" - Forest Gump.
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Thank you Dr. Smith,
Your Forest Gump comment made me laugh and that's exactly what I needed. I did receive my day 3 estradiol results today--92. I see now how they can be inversely related.
My nurse at my clinic also said other women has had unusual menstrual cycles after an IVF cycle and she wasnt worried about the numbers.
Thanks again for your help and knowledge.
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