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

healz413

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.

ld08271

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. 

HeatherHam10

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.

PhillyJ33

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.

healz413

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.