P4 and E2 levels after xfer
5 Replies
ttc#2carrie - November 30

hi Dr. Smith, was wondering what you would make of my levels.
I am 5dpt3dt and my p4 was 59 and E2 was somewhere around 550. Do you think I should be on more PIO or an estrogen patch (or supplement)? Any insight would be greatly appreciated



ttc#2carrie - December 1

Also, asked my RE to do immunology testing (as you had suggested). He worked with Repromedics(?) out of boston. I came up "moderately positive" for some clotting thing that I am now taking heparin and asprin therapy for. I asked him to test for NK cells and he said "he wouldn't know what to make of that." My questions is, what do you do for NK cells? If this cycle failes (please hope it doesnt) then I am going to ask to be tested for that, but feel I need to "educate" my RE on what to do....something seems wrong this that, but whatever!
Thanks so much for your insight and knowledge.


Dr Smith - December 5

Because your question is more of a clinical nature, I'm going to forward your question to Dr. Jane Miller, the RE I work with.


Dr Jane - December 5

Hello Carrie,
I hope that your cycle is a success and, actually, your #s are encouraging! I routinely have my patients on an estrogen patch after ER because it allows the expected drop in estrogen to be less dramatic. Nevertheless your level is not too low for the day post ET - even without supplemental estrogen. Your progesterone level is also appropriate. I'm glad that your doctor is addressing the abnormal clotting factors with the heparin and the low dose asprin. We treat many patients who have abnormal # and activation of NK cells. We treat these patients (per Dr. Carolyn Coulomb's protocol) with IVIG infusions and we have had positive outcomes again and again. Nevertheless we do tell our patients that this is considered an experimental treatment. We have had patients come from other states to receive these treatments when necessary.
Best of luck with your cycle.
Yours truly,
Dr. Miller


ttc#2carrie - December 5

Hi Dr. Miller (and Dr. Smith),
Unfortunately, another BFN
I really appreciate your reply. I am not totally familiar with IVIG infusions. Could you explain? Would that me the solution if I tested positive for NK cells? Weird thing is, I am not someone who has miscarriages, just cant get pg. My 1st IVF I got pg and had a successful pregnancy. I have had 3 more all BFN. This cycle, my embryos were called "text book" for D3, obviously my body is rejecting them.
Could you provide some of your information so I could contact you for a consultation if possible.
Thanks so much!


Dr Jane - December 14

Hi Carrie,
I'm really sorry for the negative result. I was rooting for you!!! We have seen + NK cells in people who have had prior normal pregnancies. These cells, if present in excess, can prevent implantation. I'm sure you already know our belief in blastocyst transfer as opposed to day 3 ET. If we have good quality blastocysts to transfer on day 5 we start the IVIG several hours before ET. It takes about 3.5 hrs and it's OK to transfer once about 1 hour's worth has been infused. Our patients sleep, read, or watch TV during this time. After ET they rest for 1.5 hrs, finish the infusion if necessary, and then go home. IVIG treatment is repeated monthly throughout the first trimester in patients who have experienced implantation failure.
Please feel free to call me at 201-871-1999. Our website is www.northhudsonivf.com.
I hope we can help!
Dr. Miller



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