Question about E2 numbers

jenn0620 · July 2013

Hi Ladies! I went in today to have blood drawn and my E2 came back at 475 and a doctor I don't usually work with, but the only one avaliable, said to drop my Menopur and Folistim in half. Does that seem reasonable? I am on day 4 of stims, I don't remember what my numbers were the last 2 cycles so I can't really compare.
TIA for the help!

shell3879 · July 2013

On Monday I was 3 days of stims in, and mine was 127 I think. I stayed at the same dosages of Menopur & Follistim (150 each).

ld08271 · July 2013

How big are your follicles? Are you doing TI, IUI, or IVF? I think if your doing TI or IUI the rational is that if your follicles are still on the small side, then your E2 will only continue to increase and they don't want to risk hyperstimulation. I'm currently dealing with some mild hyperstimulation after IUI and it's no fun.

Good luck!

jenn0620 · July 2013

ld08271:
How big are your follicles? Are you doing TI, IUI, or IVF? I think if your doing TI or IUI the rational is that if your follicles are still on the small side, then your E2 will only continue to increase and they don't want to risk hyperstimulation. I'm currently dealing with some mild hyperstimulation after IUI and it's no fun. : Good luck! nbsp;

I'm doing IVF, the nurse called me back and did say its just a little high and I'm moving faster then expected that's why they're lowering both meds to half of what I was taking,

rrdiva1 · July 2013

Hey there! It is completely normal for them to tweak meds as you go in any cycle. They don't e2 getting to high to quick because they want follies to be uniform, and all have good quality mature eggs. You are good hang in there, I go for my e2 Fri.

LeggyJeggy · July 2013

Definitely normal to tweak, I had the opposite problem, I was like 33 at that point so I doubled my dose.

RosyGlow · July 2013

Hey there, Jenn! I think you are doing great. The drop in meds is probably a good idea if you are on Day 4. Here's the deal: your numbers should double (your E2) ideally every other day. So then, if they kept your meds the same, then when you go in on D6, you could expect 800 something. On D8, 1600 something, on D10, 3200, and D12, 6400. Anything above, say, 3000, is considered pretty darn high, and getting closer to the risk of OHSS. Everyone is different, though. For my IVFs, and in general, the E2 on the day of trigger is an indicator of egg maturity. Each mature egg will put out around 200 in estrogen at time of trigger/retrieval. For me, this was true (first IVF, my e2 was 2000 at trigger, and I got 12 mature eggs). Second IVF, my e2 was 6200 at trigger, and I got 21 mature eggs. Of course, any other "little" follicles in there that don't have a mature egg inside also put out a bit of estrogen, so the correlation is there, but it's not a perfect science. They will watch your follicle size to compare and trigger you at the right time. BTW, my E2 was REALLY high on day of trigger for my second IVF, but I didn't get OHSS either time.

I hope this helps! How many follicles did they count today?

jenn0620 · July 2013

RosyGlow:
Hey there, Jenn! I think you are doing great. The drop in meds is probably a good idea if you are on Day 4. Here's the deal: your numbers should double your E2 ideally every other day. So then, if they kept your meds the same, then when you go in on D6, you could expect 800 something. On D8, 1600 something, on D10, 3200, and D12, 6400. Anything above, say, 3000, is considered pretty darn high, and getting closer to the risk of OHSS. Everyone is different, though. For my IVFs, and in general, the E2 on the day of trigger is an indicator of egg maturity. Each mature egg will put out around 200 in estrogen at time of trigger/retrieval. For me, this was true first IVF, my e2 was 2000 at trigger, and I got 12 mature eggs. Second IVF, my e2 was 6200 at trigger, and I got 21 mature eggs. Of course, any other "little" follicles in there that don't have a mature egg inside also put out a bit of estrogen, so the correlation is there, but it's not a perfect science. They will watch your follicle size to compare and trigger you at the right time. BTW, my E2 was REALLY high on day of trigger for my second IVF, but I didn't get OHSS either time.nbsp;I hope this helps! How many follicles did they count today? nbsp;

Thanks Rosy! They didn't measure follies today just blood work. I guess I'm a fast responder she said. You definitely explained this better for me!

Thanks everyone for your responses, I feel better about what's going on!

RosyGlow · July 2013

jenn0620:
RosyGlow:
Hey there, Jenn! I think you are doing great. The drop in meds is probably a good idea if you are on Day 4. Here's the deal: your numbers should double your E2 ideally every other day. So then, if they kept your meds the same, then when you go in on D6, you could expect 800 something. On D8, 1600 something, on D10, 3200, and D12, 6400. Anything above, say, 3000, is considered pretty darn high, and getting closer to the risk of OHSS. Everyone is different, though. For my IVFs, and in general, the E2 on the day of trigger is an indicator of egg maturity. Each mature egg will put out around 200 in estrogen at time of trigger/retrieval. For me, this was true first IVF, my e2 was 2000 at trigger, and I got 12 mature eggs. Second IVF, my e2 was 6200 at trigger, and I got 21 mature eggs. Of course, any other "little" follicles in there that don't have a mature egg inside also put out a bit of estrogen, so the correlation is there, but it's not a perfect science. They will watch your follicle size to compare and trigger you at the right time. BTW, my E2 was REALLY high on day of trigger for my second IVF, but I didn't get OHSS either time.nbsp;I hope this helps! How many follicles did they count today? nbsp;
Thanks Rosy! They didn't measure follies today just blood work. I guess I'm a fast responder she said. You definitely explained this better for me! Thanks everyone for your responses, I feel better about what's going on!

Glad it helped - I hope you continue progressing well! One more addition to my above guidelines, if you are on an antagonist protocol, that will skew your estrogen to mature-follicle correlation just a bit. I was on antagonist for my first IVF, so it made my e2 a LOT lower than the overall number of eggs retrieved and also lower than the number of mature follicles. Glad you're feeling better. Have a great day!

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