ER after E2 levels "crash"? Any hope??
1 Replies
littlebitty - May 21

My RE had me on Follistim/Repronex and became concerned that I was over-stimming when on Day 10 of stims my E2 level was over 6,000. He suggested either cancelling the cycle completely or "coasting" for a few days to get my E2 level to come back down to what he was "comfortable" with (around 3,000). On Day 12, my level WAS coming down, but only slightly (I'm assuming I "peaked" on Day 11). On Day 13, it had dropped another 1200 points, but was still not low enough for HIM. On Day 14, it had pretty much started to bottom out -- at 1700!!!!! He told me to go ahead and trigger, and we're set to do the ER tomorrow morning (Day 16). But at this point I am devastated over what has happened and feel it's a hopeless cycle.

Here's how it broke down:

Day 10: 6,000+ stopped all stims, continue Lupron until trigger
Day 12: 5,700
Day 13: 4,500
Day 14: 1,700 told to go ahead and trigger

I've read enough, and done enough research to feel that when the E2 level starts to crash like this, that the quality of the eggs is compromised. I'm so worried about this I can't even be hopeful and am not looking forward to the ER tomorrow morning at all. I was showing an abundance of follicles during my stim phase, and as of yesterday, they were all still there....but I'm really thinking that by tomorrow morning, not only will my E2 level be almost NOTHING, but that all of my 's are going to be degenerating! Is there a point where the E2 level is considered "too low"??

Is there any hope at all in this situation??


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.

There is only one big problem and that is the peak E2 level was over 6000 pg/ml. When the E2 gets over 6000, we cancel the cycle because an E2 level over 6000 is associated with poor quality eggs. However, coasting for up to 4 days is acceptable, and yes, the E2 can drop dramatically at the end of the coasting and things can still be O.K. In your case, the damage may already been done when the E2 got over 6000. Just wait and see. I would anticipate a lower fertilization rate and reduced embryo quality, but you may still sweak through with a few good ones. It only takes one. Hang in there.



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