Varied response to stimulation
1 Replies
paddy - March 31

I have learnt a lot from this site and i like this site.


I just turned 40.
My day 3 E2 level was normal. They did not measure my FSH level. I was told if my E2 Level was normal it is most unlikely that my FSH level will be high.

Is this normally the case?

I am going through IVF/PGD.
I was on lupron for 10 days. My 11th day E2 level was 32 and I was asked to do Gonal F 225 units twice a day = 550units for 2 days with lupron and then lower my dose to 150 units twice a day for 2 more days. My E2 level after 4 days was 120 and u/s showed 9 follicles. The doc asked me to increase my dosage to 225 units and continuing Lupron for 2 days and then my E2 dropped to 112 and I still had 9 follicles.

What is making my E2 go down

The doc went ahead and changed my plan to stop Lupron and went to 75 units Gonal F and 75 Repronex. Now my 2nd day E2 now level was 550. Since I responded to this I was asked to continue with the same plan for 2 more days but was given Antagon once a day. Them my 2nd day E2 level was 1020. Then my went to 150 repronex and 75 gonal with antagon and my E2 level was 1640 and eventually the follicle were 20 mm 19mm 17mm and i don’t remember the other readings. Then the day came and I got the HCG shot. They retrieved 17eggs and 14 went through normal fertilization.

Why did I not respond to Gonalf but with the repronex combination combination? Is it possible that Lupron inhibited my follicle growth. Can this be the case?

 

Dr Smith - April 6

The general opinion is that embryos that reach the blastocyst stage on Day 5 have a slightly better developmental potential compared to embryos that reach the blastocyst stage on Day 6. However, the difference is very small if, in both cases, the embryos are fully expanded blastocysts with an adequate number of stem cells. Embryos that grow slowly at the cell stage (2-8 cells) can be normal or abnormal (so its not al that predictive). However, embryos that stop growing at the cell stage are always genetically abnormal (assuming that lab conditions are optimized).

The percentage of genetically normal emryos for women over 40 is somewhat variable, but ranges from approximately 20% at 40 to very near zero at 45+.

 

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