Help! Low E2 on day 5


#1

I need some advice. My RE doesn’t usually give out the E2 levels. I’ve done 5 days of stims and the nurse just called with bloodwork results - they cancelled me. She said my E2 was less than 100. I’m at max meds so increasing won’t make a difference. Does this sound like the right thing to do so early? I suppose I should have asked the number…

This is my 4th cycle so I know what stimming “feels” like. This caught me completely by surpirse!


#2

Sorry to hear this, I too have low E2 levels. Mine was at 44 on Day 5. They are increasing my Menopur to 300 already at 300 on follistim. We are going to check again on Friday and see if there has made any changes.


#3

Thanks for the response. I’m just not sure what to do and have to decide within 1/2 hour (they all leave at 3 pm EST). I was a slow responder 3 years ago (stim 12 days) and only got 9 eggs then. I’m sure they’ve considered my age and past response but I can’t help but wonder about one more day. At my age, wouldn’t just half that be an okay response??? I can’t help but feel like the meds the working…hormonal, bloating, side twinges. The nurse actually mentioned micro dose protocol. I did that for my 2nd cycle and had no response - didn’t they even look at me chart??? I’m just so upset. This was our one and only because we’re completely OOP and spent 40K getting my DD and just can’t do it again.


#4

Did they give you an option? Maybe you could keep trying and see what happens? Even if you get a few eggs its better than none? Have you tried menopur? Maybe adding it in on another cycle would be ok, its better to cancel now and then have the money to spend on another try since your only out meds for 5 days at this point?


#5

Thank you so much for your responses and words of encouragement! I did call my nurse and ask her to have the RE re-evaluate my chart. I told her my concerns, i.e. I’m on day 4 of my period still, my age, my slow response in the past, my failure at mirco-dose priming (meaning this is the ONLY protocol that works and the only one we will do), etc. She said she’s confident the RE would agree to two more days of stims and another blood test Friday morning. If for some reason he didn’t, she’d call me back. It’s past the call back time so I guess we’re good to go. I really feel in my gut I’m getting a response…I actually feel like I’m further ahead physiologically - the bloating, twinges, etc. I would be happy with just one perfect embryo. I’ve been on this forum long enough to see lots of successes with just one or two embryos. I just think the RE just looked at the number and made a snap decision without thoroughly reviewing my chart. Oh well, I’ll give up Friday if they say so but feel ton better going a couple more days. Thanks!


#6

Just wanted to give you some words of encouragement. I am an extremely poor responder, this last cycle my E2 was also low, I only had 2 follies that were considered large enough up until day 8 of my stims (we had actually already decided to convert to an iui again). When I went in on day 10 for my bloodwork & ultrasound 2 more follies had grown and we switched back to IVF. At retrieval we ended up only getting 2 eggs but both of them fertilized w/ ICSI and we did a 3dt of both. I’m currently in my 2ww and :pray: for a :bfp:
So please, do NOT give up hope, just like you, I said I’d be happy with 1 embryo to transfer and we were lucky enough to transfer 2!!


#7

Lots of women are slow responders. I can’t believe they wanted to cancel you so soon! Good for you for standing up for yourself and buying yourself an extra two days. You know your body, and if you are feeling signs, that’s great news! :slight_smile:

Did you have any measureable follicles at the appointment?

In general, my E2 is under 100 until something ridiculous like day 15. It takes awhile to take off sometimes!

Hope this is the BFP cycle for you!!


#8

Thank you all so much for the words of encouragement! I can always count on the women here. Jeanne :pray: this is your cycle. I would be thrilled with 2 to transfer. When is your beta?

Francesca I haven’t even had an US yet. That’s what really bugged me too. Why not even take a peek before canceling?

Jenn I’m going to ask about adding menopur tomorrow. I’m taking 1 ui of low does hcg in place of menopur this time. I used menopur on my last successful cycle so I’m not sure why they would change something that worked in the first place.


#9

No U/S - WTH???

I can’t believe they wanted to cancel you before you even had an U/S, when I go in for monitoring they always do bloodwork & an U/S.
Definitely check about the menopur, that’s the only stim drug I used this cycle - my RE thought that I might respond better to it alone than combining it with follistim. I also used HGH which is supposed to help with egg quality.
My beta is on the 26th - thanks for the :pray: 's :slight_smile:


#10

Well the nurse called back this morning and said the RE sees no harm in taking meds again tonight and coming back for more bloodwork on Friday (that would be 7 days of stims). He still recommends canceling and regrouping but willing to go another day - what kind of decision is that?? It’s a $800 expense for me to keep going. I want to but I’m not unreasonable. If this cycle has no chance - tell that to me, explain why, and insist on a cancel. I don’t really care for his “whatever” attitude to the situation. I’m not a difficult patient and this is the first time since 2009 (7 iuis, a lap, an ectopic, 7 IVFs) that I have ever questioned any decision they presented me.

Does anyone know what a good or average E2 number is for day 7 for a slow responder? I stimmed 14 days on my first cycle and 12 on my 3rd.

I’m annoyed that they won’t schedule a US. I have to go there for the BW anyway. It only takes 5 minutes. I keep finding accounts of E2 levels not exactly matching up with follicle #s and growth. When cycle #2 was cancelled they at least did a US - that was after 7 days of stims too.

I asked about adding menopur - which I responded to last time - and she said the low does hcg is suppose to do the same thing. Again, what harm is there is switching it up? DH is just as annoyed. He feels we’re getting crappy service - especially since we know RE didn’t read my chart before suggesting micro flare.


#11

[quote=EmmaL]Well the nurse called back this morning and said the RE sees no harm in taking meds again tonight and coming back for more bloodwork on Friday (that would be 7 days of stims). He still recommends canceling and regrouping but willing to go another day - what kind of decision is that?? It’s a $800 expense for me to keep going. I want to but I’m not unreasonable. If this cycle has no chance - tell that to me, explain why, and insist on a cancel. I don’t really care for his “whatever” attitude to the situation. I’m not a difficult patient and this is the first time since 2009 (7 iuis, a lap, an ectopic, 7 IVFs) that I have ever questioned any decision they presented me.

Does anyone know what a good or average E2 number is for day 7 for a slow responder? I stimmed 14 days on my first cycle and 12 on my 3rd.

I’m annoyed that they won’t schedule a US. I have to go there for the BW anyway. It only takes 5 minutes. I keep finding accounts of E2 levels not exactly matching up with follicle #s and growth. When cycle #2 was cancelled they at least did a US - that was after 7 days of stims too.

I asked about adding menopur - which I responded to last time - and she said the low does hcg is suppose to do the same thing. Again, what harm is there is switching it up? DH is just as annoyed. He feels we’re getting crappy service - especially since we know RE didn’t read my chart before suggesting micro flare.[/quote]

I would throw a fit tomorrow. If they feel they need to cancel, I would make them do an ultrasound and see how many are developing. Rather than cancel, why not switch to an IUI and have them continuing to monitor, might as well not let the whole thing be a waste? You have a right to demand high service and actually have them pay attention to you.

I had to get kind of cranky with my clinic too. I have always been a big proponent of managing my doctors to manage my health. After I had the miscarriage, and went to start my new cycle, they wanted to put ,me on the same protocol which I didn’t respond well to, I threw a fit and said you told me it wasn’t a good one for me, did you actually read my chart? Then I got them to start changing things up and each time I went I asked questions which resulted in adding a few inexpensive things. I am hoping it pays off when I go in for my first monitoring appt. I would definately demand them to do more than just give you that whatever attitude! Good luck!:grr: :grr: :grr:


#12

I’m a slow responder (I have DOR). Here were my E2 levels for my current IUI cycle on 300iu follistim:

Stim day 7: E2 198 & 3 follicles
Stim day 10: E2 383 & 5 follicles
Stim day 12: E2 703 & 4 follicles + 1 smaller one that won’t mature in time.

It looks like E2 should double every 2 days or so, so if you are currently at 100 on day 5 then I’d suspect you’ll be around 200 by day 7. Just don’t count on a large number of follicles…

Best of luck to you!!


#13

Jeanne612- praying for you girl!!! :heart:


#14

I am really surprised at your clinic not doing an ultrasound. I would try your best to get one. I know it is terrible to have a cancelled cycle if you are OOP, I have had a few and am OOP completely. I wonder about the clinics success rates? It just seems so abnormal from the many REs I have been to not to do an ultrasound.


#15

Thanks ladies. Successful IUI is not likely given my “narrow” tubes. I’ve had one ectopic already. I still have no news. My clinic usually calls about 1 pm but always before 3 pm so I’ll know within a half hour. I’m having horrible side effects from the FSH - nothing like I’ve had before. I was dizzy all yesterday evening, double vision, chills, hot flashes, mood swings, cramps, nausea, you name it! So my body is reacting to the drugs but not the right parts LOL. I’m still holding out for lab error. It was really confusing in the office during the blood draw Wed. Maybe there was a mix up. That would be so horrible for the other person but I can’t help but hope. We had a discussion last night about one more attempt at a clinic that has high success rates for women my age - CCRM or RMA. Anybody have any other suggestions. DH is worried about the funds, he believes the country is heading for another finacial collapse this summer…


#16

E2 = 182 on stim day 7. Nurse said to continue at same medications and come in for an US and BW Sunday. I’m so glad I insisted on not being cancelled. For comparision, my last cycle (that resulted in DD) my E2 was at 600 on stim day 8. A logical assumption would be that we’re looking at half the follicles active. That would be 4.5. I would be happy with 2-3 good eggs. I’m going to remain optimistic!

Thanks again for all the encouragement and advice to self advocate!


#17

[QUOTE=luv4rachela]Jeanne612- praying for you girl!!! :heart:[/QUOTE]

Thank you :slight_smile:


#18

[QUOTE=EmmaL]E2 = 182 on stim day 7. Nurse said to continue at same medications and come in for an US and BW Sunday. I’m so glad I insisted on not being cancelled. For comparision, my last cycle (that resulted in DD) my E2 was at 600 on stim day 8. A logical assumption would be that we’re looking at half the follicles active. That would be 4.5. I would be happy with 2-3 good eggs. I’m going to remain optimistic!

Thanks again for all the encouragement and advice to self advocate![/QUOTE]

Glad that they didn’t make you cancel, good luck on Sunday, I still can’t believe you haven’t had an US yet, :cross: that you have lots of small follies!!!


#19

[quote=EmmaL]E2 = 182 on stim day 7. Nurse said to continue at same medications and come in for an US and BW Sunday. I’m so glad I insisted on not being cancelled. For comparision, my last cycle (that resulted in DD) my E2 was at 600 on stim day 8. A logical assumption would be that we’re looking at half the follicles active. That would be 4.5. I would be happy with 2-3 good eggs. I’m going to remain optimistic!

Thanks again for all the encouragement and advice to self advocate![/quote]

I am sooooo glad they didn’t cancel you. I can’t wait to see how many folli’s you have on Sunday - let us know. Your 2 days ahead of me, I am on stim day 5 today. Our DDs are super close in age, so maybe we can end up with our next :bfp: close to each other too! Yeah! I am the same way, older (38 now) and I don’t need a ton of folli’s, I know I won’t get a ton. I would be thrilled if I get 10 this time, I got 7 last time, but I want more than anything to have a few more this time and make it to a 5 day…but I will take what I can get, especially if it ends up in a :bfp: :babydust: :babydust: :babydust:
Talk to you soon and happy stimming!


#20

My clinic does NO monitoring between CD1 and CD9. Then they do an US, no bloodwork unless there is a chance of OHSS. I hear its more common…and I am ok with it as its covered by insurance so less to bill through which means I have more chances paid for…and they still have high success rates (I got :preg: first time, but lost it due to chromosonal ab)!