Higher E2 & lower Progesterone levels
1 Replies
blueberry - May 20

Hello Dr.Smith:
First of all I would like to thank you for giving us your precious time & answering our concerns.I really appreciate your efforts.
I have had three failed IVF/ICSI/PGD cycles.Little about me.
Me: Age32
DH: 38
Doing PGD for albinism as me & DH both are albinism genes carrier.Have two Albino Daughters 12 & 6yr old,concieved naturally without any problems so basically fertility is not the issue here.
I am concern about my E2 levels & my Progesterone intake in my three previous cycles.Doing a 4th fresh cycle in june.
My E2 levels in previous three cycles:

IVF#1
Day 6 of stims E2 1374, LH 5.7(Gonal F 300IU,MicroOvidrel 0.1),11 follies,(12,11,9,9,8,8,14,13,12,12,10)

Day 9 of stims E2 3397,LH 0.4 (Samedose),12 follies(18,17,13,13,12,10,
21,20,18,17,15,11)Endo10mm
at day 9

Day 12 was Egg retrieval,14 Eggs retrieved,12 Fert, After PGD 4 Normal,2 trans.
HCG 99 at 9DP5DT was a chemical.

IVF #2
Day 5 of Stims E2 510 (Gonal F 300IU,Micro ovidrel 0.1) 4follies,(14,9,9,10)

Day 7 of Stims E2 1450 (Same Dose),6follies,(17,11,9,14,15,14)

Day 10 of Stims E2 4007,LH0.4,Endo 9mm,12FOLLIES(23,18,16,14,
12,9,20,20,19,15,15,14) >

Day 12 E.R.10 Eggs retrieved,4 Fert,2Normal after PGD,2trans,HCG 22 at 11DP5DT,another chem.

IVF#3
Day 4 of Stims E2 576,LH 3.7(Gonal f 450,Micro ovidrel 0.1)Ten follicles seen

Day 6 of stims, E2 couldn't get the no(same dose)

Day 8 of stims, E2 1535,About 12 follies seen.
(same dose)Endo 11mm

Day 10 of stims,E2 3444,LH 1.1,Endo 10mm

Day 12 ER,10 eggs retrieved,7 fert,3Normal, 3trans,
2 blasts 1morula,HCG 0 @ 10dp5dt.
Progesterone level at 9dp5dt was 10.4.

My Question is that my E2 levels are high since day 4 as compare to the number of follicles in all my cycles, so shouldn't the dose of Gonal F BE LOWER THAN 300iu MAY BE 275iu.
I have read somewhere that the Higher levels of E2 affect the quality of eggs maybe they get overcooked.
As my endo is good may be I need to up my Progesterone intake after ER & ET.That might help in implantation.
My Progesterone intake in all my cycles was 3 PROMETRIUM VAGINAL each 100 mg.you think is this enough to take considering my previous cycles.
So what would you suggest about these two things
1) Lowering the Gonalf dose to 275iu.
2) Increasing the intake of Progesterone,how much & in what formi.e. PIO shots,Suppositories 400mg/suppository?
I have seen women taking 1 to 2cc of PIO shots plus two suppositories 400 mg each & having Progesterone levels of 110 or more at 10dp3dt & getting pregnant so does progesterone helps in implantation?
Thanks in advance for helping us in achieveing our dream.Any suggestion would be greatly appreciated.
Michelle

 

Dr Smith - May 24

Sorry for the delay. I've been swamped with regulatory compliance issues associated with the new FDA rules regarding screening of egg donors.

I'm not a Reproductive Endocrinologist, so I can't really answer your questions (they are out of realm of expertise). However, E2s in the range you describe are well below the levels that are detrimental to the eggs (i.e. >6000 pg/ml). I suggest you get Dr Jacobs ideas by posting your question on his Infertility 101 Message Board.

 

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