Question from an IFer-- weigh-in on low e2 levels? — The Bump
Pregnant after IF

Question from an IFer-- weigh-in on low e2 levels?

Hi folks. I usually post on infertility, LGBTParenting, and Third Party Reproduction, but @2MamazinSeattle suggested I ask here. I hope you don't mind me popping in to ask for your experiences with low early e2 levels during IVF.

My partner (@Manada) and I are doing Partner IVF. She has DOR and we did 6 unsuccessful, medicated IUIs with her. I had a bilateral salpingectomy and have stage IV endo with a total of 3 endometriomas (two at 2cm and 3cm on the right ovary and one at 2cm on left ovary). That said, my AMH is signficantly better than Manada's, so our RE thinks our best chance of pregnancy is with my eggs. We will transfer into M using donor sperm and ICSI and she will  carry (if we get that far).

In December we had a cancelled IVF cycle due to poor response in me. Details are in my siggy but it was an antagonist protocol starting with 150 GonalF and 75 Repronex and increasing to 225 GonalF and then 300 GonalF.

Now we are doing a down regulation/lupron protocol. I did 2 weeks of BCPs (loestrin) with one week of Lupron 10unit overlap. On day 3 of my period, I started with 300 Bravelle and 150 Menopur and lowered Lupron to 5 units. Today is day 4 of stims and I went in for my ultrasound and bloods. I have a reasonably good handful of follicles in the 7mm-9mm range (I didn't get the exact number since most aren't measurable yet), but my e2 levels are only 71. My RE is concerned by these low levels, especially given that I'm already on her usual max dose of stims. She's increasing me to 375 of Bravelle and 150 of Menopur for tomorrow and I will go in on Monday for my next check.

I'm wondering if any of you had experiences with low e2 levels early in IVF that improved adequately. If so, did you do anything other than increase stims?

Any thoughts or advice would be much appreciated.

Thank you for letting me take advantage of your experience and expertise.
****loss discussed*****

We're queer. I'm 33, have severe stage 4 endo, and had both fallopian tubes removed. My love ("Manada" on the boards, 32) was diagnosed with diminished ovarian reserve. We did Partner IVF (my eggs, her uterus). We lost our twins Tavin and Casey at 21 weeks gestation.

Our IUIs
with @Manada: IUI# 1-7 (December 2012- September 2013) all BFN. Tried natural, femara, clomid, puregon/follistim, clomid and menopur combo, both the ovidrel and HCG triggers.

Our IVFs:
IVF #1 my eggs November/December 2013: Cancelled IVF due to poor response

IVF #2 my eggs/Manada's uterus January/February 2014
BCPs and lupron overlap Stimmed: 1/22-2/2: Bravelle and Menopur (dosage ranged from B300 and M150 to B375 and M150 to B300 and M225)
2/4 retrieved 10 eggs. Endo was much worse than expected. Only 3 eggs fertilized; February 7 transferred two day 3 embryos, froze one. All great condition.
BFP eve of 6dp3dt; Beta 1 (11dp3dt): 110; Beta 2 (13dp3dt): 175; Beta 3 (15dp3dt): 348; Beta 4 (19dp3dt): 2222; Beta 5 (21dp3dt): 4255
1st ultrasound (3/6  6w 1d): TWINS!!!! Twin A measuring 6w1d with a heartbeat of 118bpm. Twin B measuring 6w0d with a heartbeat of 113bpm. 

***July 18, 2014 we lost our beautiful babies at 21 weeks gestation. They were born too early. Tavin Sara T. and Casey Elizabeth T. are beautiful and precious and we will love them and miss them forever.***

FET #1 December 2014
Intralipid infusion on Dec 10. Transfer of 1 day 3 nine-cell embryo into my uterus on Dec. 19. (acupuncture immediately before and after)
BFP on Dec. 27; Beta 1 Jan 2 (14dp3dt): 665, Beta 2 Jan 4 (16dp3dt): 1859, Beta 3 Jan 6 (18dp3dt): 4449, Beta 4 Jan 10 (22dp3dt): 12,251.



  Lilypie Angel and Memorial tickers
2MamazInSeattle

Re: Question from an IFer-- weigh-in on low e2 levels?

  • During my IUI cycles and my IVF cycle I had issues with low or slow to rise E2 levels. During my IVF cycle (which resulted in my BFP), I had a similar E2 number after 4 days of stims. My RE just kept on slowly increasing my meds until they found the right dose. Once they got the right dose my E2 levels took off. I ended up stimming for longer then average (13/14 days), but I ended up with 29 follicles with 27 mature eggs. The day before trigger my E2 was 1919. I'm sure it at least doubled by trigger based on the number of mature eggs retrieved. 

    I was so nervous about my E2 levels in the beginning but it ended up just fine. I hope it's the same for you! Best wishes for you and your partner. 
    DX: Ovulatory Disorder/ Anovulation (possible PCOS)
    DD (2 yrs) conceived 2nd IUI w/ Gonal F

    TTC#2: IUI #1 and 2: BFN; IUI #3 CP; IUI #4 BFN; IUI #5 CP 
    Sept/Oct 2013 IVF#1: Antagonist: 27 R, 27 M, 22 F (7 frozen)
    5dt of one AA blast
    Beta #1: 12dp5dt: 1,093 Beta #2: 14dp5dt: 2,497
    Due date: 6/22/14 :)
    It's a Boy!

    **Everyone welcome**

    image

  • I was always in the slightly lower end and then when theyd increase my body would take off. The first cycle i was also in the 70s in day 5 i believe and it eventually caught up once the dose was increased although that cycle was canceled due to early ovulation. Give it time sometimes all you need is a little boost and it really jumps up. Youre still early.
    image



    Me 28 DH 30

    After 4+ years TTC

    FET #2 = DS Madden Jeffery <3 July 29, 2014 <3
  • Loading the player...
  • Mine were low in the beginning but grew steadily and while I only got 7 eggs, all were around the same size and were mature. 6 fertilized and 4 made it to blast so I think slow and steady is good sometimes. I was on their max dose of stims to begin with so they didn't increase- 450 iu of Follistim and 150 of menopur. I think as long as your E2 rises each appt and they see follies, you should be good.
    Good luck- I was stressed about my levels the whole time but it call came together in the end.
    Me 36/DH 46 Me: Low AMH (.21) DOR, mild endo; Started seeing RE 11/12
    Jan-March '13 3 IUIs Clomid + Trigger = BFN
    April '13 IVF 1 MDLF converted to 4th IUI due to 3 runaway follicles! BFN
    July/Aug '13 IVF 1.2 Long Lupron = 7R, 6F, 2T= BFP!!!
    Beta 1=512, Beta 2=1,368 Beta 3= 4,128
    It's a boy!!!!
    SUA, GD
    EDD 4/26/14

    He's Here! Arrived 4/15/14!!!!

    September 2015 - FET with remaining embryos
    Twins! EDD: 6/14/15

    PAIF/SAIF Everyone welcome!
  • Thank you all. I really appreciate all the feedback and encouragement.
    Today I had my next check and my e2 was up to 222. Not great after 5 days of stims, but certainly an improvement from 71. My RE was happier, too, although she's still changing around my stims to try to find the combo that works best. I hope like some of you I'm just a late starter on the follicle growth front and that things will continue to improve from here.
    ****loss discussed*****

    We're queer. I'm 33, have severe stage 4 endo, and had both fallopian tubes removed. My love ("Manada" on the boards, 32) was diagnosed with diminished ovarian reserve. We did Partner IVF (my eggs, her uterus). We lost our twins Tavin and Casey at 21 weeks gestation.

    Our IUIs
    with @Manada: IUI# 1-7 (December 2012- September 2013) all BFN. Tried natural, femara, clomid, puregon/follistim, clomid and menopur combo, both the ovidrel and HCG triggers.

    Our IVFs:
    IVF #1 my eggs November/December 2013: Cancelled IVF due to poor response

    IVF #2 my eggs/Manada's uterus January/February 2014
    BCPs and lupron overlap Stimmed: 1/22-2/2: Bravelle and Menopur (dosage ranged from B300 and M150 to B375 and M150 to B300 and M225)
    2/4 retrieved 10 eggs. Endo was much worse than expected. Only 3 eggs fertilized; February 7 transferred two day 3 embryos, froze one. All great condition.
    BFP eve of 6dp3dt; Beta 1 (11dp3dt): 110; Beta 2 (13dp3dt): 175; Beta 3 (15dp3dt): 348; Beta 4 (19dp3dt): 2222; Beta 5 (21dp3dt): 4255
    1st ultrasound (3/6  6w 1d): TWINS!!!! Twin A measuring 6w1d with a heartbeat of 118bpm. Twin B measuring 6w0d with a heartbeat of 113bpm. 

    ***July 18, 2014 we lost our beautiful babies at 21 weeks gestation. They were born too early. Tavin Sara T. and Casey Elizabeth T. are beautiful and precious and we will love them and miss them forever.***

    FET #1 December 2014
    Intralipid infusion on Dec 10. Transfer of 1 day 3 nine-cell embryo into my uterus on Dec. 19. (acupuncture immediately before and after)
    BFP on Dec. 27; Beta 1 Jan 2 (14dp3dt): 665, Beta 2 Jan 4 (16dp3dt): 1859, Beta 3 Jan 6 (18dp3dt): 4449, Beta 4 Jan 10 (22dp3dt): 12,251.



      Lilypie Angel and Memorial tickers
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