Another Follie/E2 level before trigger concern/question..

sarahgcapecod

So, as a back story, last cycle I had three follicles but my E2 level was all weird. The first check it was 72 and they said it was too low. Then it dropped to 35 or so, and then it jumped back up to 77 and they triggered due to the size of the follicles.  They measured 17-18 the day before I triggered.  Obviously BFN.  For my first two children (different doctor), I never triggered, he always just monitored me until I naturally ovulated after Clomid/Femara.

So, now this cycle I went into today at CD13 and had three follicles measuring 20, 15 and 13.  E2 was 95.  They are having me trigger tomorrow night.

So, I had a big conversation about triggering and if my body was ready.  They said that with Femara, Estrogen can stay lower so they don't worry too much about that, but they look at follicle size.  They did say that if I wanted to, they would keep monitoring me and let me try to ovulate on my own but that most people like to know exactly when they ovulate for timing and they would recommend I trigger.  I am going to do that this cycle, but my concern is that EVERYTHING I have read and heard from my past doctor and a nurse with this practice said that E2 should be between 150-200 for each mature follicle and mine doesn't seem to get there before they trigger.

What does your practice say?  I'm starting to question whether or not this is all going to be futile because my body is not really ready to ovulate and we are forcing it before the follicle is mature enough.  I trust the doctor I guess......but sometimes I think maybe I know my own body too and it isn't cooperating with her plan.

TIA.  Trying not to second guess things and go with the flow...but it's hard :-).

 

sail123

The whole "150-200" per mature follicle is not always true. Certain meds can mask/supress estrogen, which is why they often go by follicle size instead. My RE also told me that your estrogen number is just a "snapshot", meaning that it does not stay perfectly constant so blood draws can sometimes be inacurate.

If I were you I would do the trigger. It will help the follies mature and will ensure that your body releases all of them. It will also help with timing.

Good luck!

Jill070707

Well, I've never been on femara.  But I know during my IVF cycle, my E2 never got as high as 200 per follicle.  My doctor said it was because they had me on low doses and because the ganirelix suppressed my E2.  So they went by follicle size.

So it happens it what I'm getting at, even if I haven't been in your situation.  Good luck!