Long Lurpon Protocol
3 Replies
shansy - July 21

Hi Dr. Jacobs,

I posted about a week ago regarding my E2 levels. I am waiting to start stims for an IVF cycle.

After one week of 10 units of Lupron my E2 was 90 so the RE kept me on it another week at the same dose. Then it went up to 113, so the RE upped my dose to 20 units and to come back after a week on that amount. Today I went back for my bloodwork and they just called- my E2 is now at 95- still not what they want at 50. I am feeling very discouraged at this time- the nurse said not to worry that this will not effect the cycle at all. In your opinion, would this long Lupron protocol affect the IVF cycle?? Also, do you think that staying on 20 units for this week is what you would recommend? I am to go back next Friday to test again. I thought perhaps my dosage should be upped even higher seeing as it did not go down that much, but the nurse said to stay at 20. What do you think?

Also, I have PCOS and last week I had 21 follicles on my own and this week the u/s showed 15 follicles. Would the decrease in the number of follicles be the result of my E2 going down?

Thank you,


B. Jacobs, M. D. - July 21

There is no reported over-dose syndrome with Lupron. We do note that continuling the administration of Lupron for more than 2 weeks, without stimulating the ovaries, tends to decrease the response of ovaries to the stimulation protocol.
Good luck.


shansy - July 28

Hi Dr. Jacobs,

I went back again this morning for blood and u/s to see if my E2 levels have FINALLY gone down. I should be hearing later what the verdict is, but the u/s showed that I now have 22 follicles (15 last Friday) and that the biggest one is at 10mm (6-7 mm last Friday). In your opinion would this indicate that my E2 level has actually gone up or sustained?? Is it possible that it has gone down while my follicles have grown?

Also, is it possible that since I have PCOS, my body will never go down to lower than 50 for the E2 level?? I am beginning to feel very frustrated and not sure what to ask the nurse when she calls later today. Also, I was on 10 units of Lupron for two weeks and 20 units of Lupron for these past two weeks- shouldn't they be upping the dose of Lupron seeing as my levels haven't gone down that much??? What is the max amount of Lupron you would prescribe?

Sorry for so many questions!!



B. Jacobs, M. D. - July 28

Increasing the dose of Lupron will not have any greater effect than a lower dose, which produces the effect desired. Follicle count and measurement, alone, are not really predictive of estradiol level.
Good luck.



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