IVF monitoring stats: what do they mean?

DMD1029

I'm 38, dx w/ diminished ovarian reserve and am on the microdose lupron flare protocol.  I had my second monitoring appointment this morning (day 7 stimming).  The nurse was not very helpful in explaining what all of this information means.  Can someone interpret for me?  My doctor said that I should just continue my current level of drugs, come in for another monitoring appt on Wednesday and that they'd probably do the retrieval on Friday or over the weekend. 

Day 7 stimming: E2 = 334; progesterone = 0.4; 3 follicles on left side (sizes: 15 by 12, 13, and 6); 2 follicles on right (sizes: 11 & 9)

Day 3 stimming: E2 = 118; 3 follicles (all the same size)

Baseline: E2 =45; the doctor noted that there was something (a cyst?) left over from the last cycle

peztopper

I haven't done IVF but want to wish you good luck.

The E2 is the estrogen level which should rise and it looks like it is. ?

Hopefully an experienced IVF'er can help you out more.?

QE2

I am also 38 with DOR, and do the MDL flare protocol. I never paid much attention to my E2 levels, but I THINK E2 levels will rise 200 points for each mature follicle. Your progesterone will only rise after you O or have an ER.

As for follie sizes, my RE likes mature follies to be between 18-24mm at retrieval. I'm a slooow responder and have to stim for 13-14 days in order to get my follies to mature. Good luck!

QE2

I should also add the follies usually grow 1-2mm per day.

smilee

Again.. ditto everything QE2 said!

 

lilacfritz

Your E2 should continues to increase as your follicles develop and mature.  Typically a mature (ready to go) follicle has an E2 of b/w 150-300, so for example w/5 mature follicles your E2 would probably be 750-1500.  On my last IVF cycle I had 5 mature eggs and at trigger before retrieval my E2 was 1740. (I also had several follicles that didn't have mature eggs that bumped up my E2).

A mature follicles measures about 20 on average, but it can vary - you hear stories of women getting mature eggs out of 15, and women who have follicles that measure 24 before retrieval.  They will typically take you to retrieval when you have 18-20's, some 16's perhaps, and your E2 corresponds w/maturity.  Follicles usually grow 1-2 mm a day, sometimes more, so for example on Wed. the ones you had might measure 15.5 (your 15 by 12 averages to 13.5), 15, 8, 13, and 11.  They could of course be more or less than that, just an example, and your E2 should rise accordingly.  So by Friday, on that increase schedule, they might be 18, 17, 15 and 13 or bigger, which will determine when you go to retrieval. 

You want your progesterone to stay low because it means you're not ready to ovulate/have already ovulated, so this level is good. 

Sorry for the book here, but basically, things are going fine! I know it's a lot to digest - good luck!

MrsKario

Ditto what PP said. 
The only thing to add is that your trigger will also cause your follicles to grow.  So some of the smaller ones may join the game at the last minute. 

I am also doing the MDL protocol next cycle. 

Best of luck with the next few days of stims!!!   Grow follicles grow.