IVF & high E2 levels??

ccam

Just got a call from my RE's office to drop my Follistim yet again tonight (3rd time this cycle).  I am on stim day #8 and my E2 was 2900 per my b/w this morning.  I asked the nurse if the drop in my stims is a bad thing, she said they are just trying to make sure that I don't end up with OHSS, which I understand.  She said there is always a chance that a cycle can be canceled.

I'm so nervous that my cycle is going to be canceled.  Has anyone had any experience with high E2 levels and what was the outcome?  TIA

hootie123

How big/how many follicles do you have?   I know my office prefers if your E2 is not above 4000 at trigger.  But I know someone who just had success with an E2 at 5000 (she got lots of eggs!).   I know sometimes they also have you 'coast' (no meds) for a bit before trigger and that helps level out the estrogen.  

The other option is that you get to ER but not ET b/c the estrogen and risk of OHSS is too high.

Good luck - you are so close!!!

limpetfan

How close are you to trigger at this point? 

I was told during both my IVF cycles that they don't cancel due to OHSS risk unless E2 is ~5000 or higher.  Also, even if your E2 is getting higher than they'd like, there are other things they can do to prevent OHSS, like using a half-dose hcg trigger, or using a Lupron trigger.  

FWIW, my E2 was well over 2000 when I was told to trigger for both my IVF cycles, and by the day after my trigger it was >5000.  I didn't have any issues with OHSS the first time (14 eggs retrieved), and I had very mild OHSS the second time (15 eggs retrieved). 

On a positive note, high E2 often means you have a good number of maturing follicles, which is great!  Try not to get too nervous yet -- good luck  

Tracyc617

My cycle was cancelled last month because my E2 level was too low.  I hope that doesn't happen to you.  It sounds like they are taking precautions so it wont.  GL!!!

ccam

hootie123:

How big/how many follicles do you have?   I know my office prefers if your E2 is not above 4000 at trigger.  But I know someone who just had success with an E2 at 5000 (she got lots of eggs!).   I know sometimes they also have you 'coast' (no meds) for a bit before trigger and that helps level out the estrogen.  

The other option is that you get to ER but not ET b/c the estrogen and risk of OHSS is too high.

Good luck - you are so close!!!

In total, I had something like 41 follicles, but I would say half of them were at or under 10 and the other half were between 11 and 14mm (this was at my u/s yesterday).  So it kind of makes sense that my E2 was high with all of those follicles, but I'm just waiting for them to tell me that they cancel above a certain E2 no matter what.  I'm always thinking the worst!! 

ccam

limpetfan:

How close are you to trigger at this point? 

I was told during both my IVF cycles that they don't cancel due to OHSS risk unless E2 is ~5000 or higher.  Also, even if your E2 is getting higher than they'd like, there are other things they can do to prevent OHSS, like using a half-dose hcg trigger, or using a Lupron trigger.  

FWIW, my E2 was well over 2000 when I was told to trigger for both my IVF cycles, and by the day after my trigger it was >5000.  I didn't have any issues with OHSS the first time (14 eggs retrieved), and I had very mild OHSS the second time (15 eggs retrieved). 

On a positive note, high E2 often means you have a good number of maturing follicles, which is great!  Try not to get too nervous yet -- good luck  

Thanks!

My nurse doesn't know exactly, but she is thinking I may trigger tomorrow or Thursday depending on my u/s.  She called in a Lupron trigger just in case, so that I'll be prepared for whatever the doctor wants to do.  Looks like tomorrow is going to be the important u/s!

MsGMChick

Just wanted to say good luck and it sounds like you're going to have a great ER!

mdiblasi10

Good luck, hon!! I am rooting for you!!!

mdluv21

My E2 was almost 10k when I triggered. I dropped my meds after stimming for 7 days and then at my 9 day check...he had me stop all together and coast for either 2 or 3 days until I triggered.

Being on VERY strict fluid restriction saved me from developing severe OHSS and I was able to transer my embies as scheduled.  (They retrieved 25 eggs)

I highly recommend you stop drinking water and limited yourself to one 32 ounce gatorade a day to help avoid OHSS.

ccam

Thanks ladies!