Question for expert level IVFers re:E2 levels

BzeetyD

I'm triggering tonight for my 2nd IVF. Protocol for both in my siggy.

This morning according to measurements I have 15 follicles that are mature (15mm or bigger). But my Estradiol is 1539, which would likely mean only 7 mature.

Last time they got 21 eggs (I had 14 at 14mm, so they were on the edge) and only 7 were mature, but those 7 good ones matched my estradiol level (1600+) at the time of trigger).

  Both times my E2 has plateaued around the same place 1500-1600.

This is day 9 of stims for me. 

What does this mean? What do flat levels indicate? Is there any meds that help to get around this?

How many mature eggs did you get and what was your E2 level?

Thanks. 

Mrkyrain

If I remember correctly, usually an E2 level of around 200 per mature follicle is average.  You didn't say how big your largest follicles are but I am guessing that your clinic is deciding to trigger you based on the fact that you have a good number that are ready to go.  If you wait too long, the larger ones also wont be any good.  If you are planning on doing future cycles, you could talk to your RE about changing your protocol to a slower burn.  There are drugs (ganerelix, lupron) that may help slow down the larger follicles and give the smaller ones time to catch up.  Having said all of this, try to focus on this cycle. Going in with 7 or 8 mature eggs is not a bad thing.  There were cycles that I went with 3 or 4 or didn't make it at all.  Best of luck to you.

Edwina.McDunnough

People here have mentioned that Ganirelix can suppress your E2 but I've never discussed this with my RE. Plateaus aren't great but they're not necessarily bad. You don't want a dip or long plateaus. For comparison for my IUIs they were 912 (day before trigger) and 1031. Unless noted all values are the day of trigger.

1636? 9R, 6 fert, 5 normally

1800?10R, 7 fert, 4 normally (lead follies this time)

1592?13R, 8 fert normally

1496?13R, 12 fert normally (better clinic, better stim)

457?converted to IUI

1096?cancelled

BzeetyD

Thanks Edwina! That's just the kind of info I needed. I forgot about Ganirelix suppressing E2 #'s. that kind of makes sense because I had huge growth over just 24 hours - going from 6 "mature" on Friday to 15 today.

I knew I could count on you for a good answer.

Ps- recently watched Raising Arizona again. Good stuff!

vanessagorc

For antagonist and antagonist w epp, it was closer too 100 per mature egg for me.

My 2nd cycle, i triggered around 1100, and got 12 of 13 mature eggs.  I wasn't sure how it would turn out bc my e2 was much lower than it was on long lupron, but it was a better cycle for me.  Good luck.

genmalone

My E2 was just under 3,000 and I had 27 eggs retrieved, 27 were mature, and 23 fertilized.  So, my E2 wasn't 200 per egg.  Also, I did 5 or 6 days of Ganirelix (not sure if that matters).

Good luck with your ER!