late Ganirelix shot - did I ruin the cycle?

Hi there,

I'm not sure if anyone knows the answer to this, but - I am on Day 9 of ovarian stimulation for IVF. My protocol has been 200iu Follistim, 75iu Menopur in the evening for about 4 days and 250 mcg Ganirelix in the morning. For history's sake, we added the Ganirelix and Menopur and increased the Follistim from 175 at day 6. Yesterday, I was about 4 hours late with the Ganirelix, and I'm very nervous that I messed the whole thing up (i.e. caused ovulation)! I can't get a clear answer from my clinic on whether this would create an issue.

My estradiol was 279 on day 5 of stims; 798 on day 7; 1212 on day 8; and 1318 today(day 9). They measured LH and progesterone today for the first time this cycle (why?); it was 1.46. And progesterone was 1.58. 

They increased my Follistim to 250 for tonight but otherwise did not offer any details. Should I be concerned?

Re: late Ganirelix shot - did I ruin the cycle?

  • I wouldn't be concerned. Your protocol sounds really similar to mine - I was on 300 units of Follistim and 2 vials of Menopur for 4 nights (along with Clomid for a few days), then added Ganirelix to the Follistim and Menopur for 3 more nights, and then my trigger was two different medications the next night. That was the only one that was scheduled for a very specific time to work for a scheduled egg retrieval. The other injections were just suggested to be given at about the same time, give or take an hour or so, so Ganirelix a little bit later than that time frame shouldn't be a problem, I'm guessing. It's really the trigger shot(s) that are super time sensitive. 
  • Thank you! Do you think it's normal for E2 to barely increase in a day?
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  • I don't know, it must plateau somewhere, right? For what it's worth, my doctor had me trigger at an estrogen level of 1485, so I'm guessing they're looking for a certain amount to show that trigger should happen soon? It's probably more about what the number is than how much it increased from day to day. But that's just my guess - I've only done one egg retrieval. 
  • If your LH is only 1.46 (and progesterone nearly baseline), you didn't ovulate.
  • Oh, thank you! I have no idea what these numbers should be at any given time. If only the clinic could have been as straightforward as you were!
    [Deleted User]
  • No problem!  I have been doing this for a while already, and at some point I realized I was just going to have to make a point to ask the questions if I wasn't sure.  I mean, that's what they get paid for, right? 😅 You can also look at the sheets when they draw your labs, it will show you all the ranges for different points in your cycle.
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