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Drop in E2 between CD5 - CD 7 - Good or Bad?

May 9 2011 at 2:34 PM
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Need help figuring out these numbers...

I'm an OOT patient with Dr. Check. Lab didn't report my Saturday B/W results to Dr. Check until this morning. GRRR!!! I thought I was on track until I saw my E2 (and FSH) drop between CD5 & CD7. Is this good or bad?? They want me to do 75 units of Bravelle tonight and go back again tomorrow.

I ovulated at CD8-CD9 last month, but I'm wondering if I've already ovulated over the weekend. This is driving me nuts. sad.gif

Day 2
E2 - 46
FSH - 9
Progesterone - 1.7
LH - 3

Day 5
E2 - 95
FSH - 7
Progesterone - .7
LH - 6

Day 7
E2 - 56
FSH - 5
Progesterone - 1.5
LH - 5

 
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Anonymous
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Re: Drop in E2 between CD5 - CD 7 - Good or Bad?

May 9 2011, 4:11 PM 

Dr. Check doesn't think a drop means a lot, as far as I know, but Dr. Cho does think it means a drop in egg quality. It does look like from your P4 that ovulation will be soon, but not enough rise in your LH yet. Good luck.

 
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Am wondering why he didn't put me on Centrotide...

May 9 2011, 4:51 PM 

Thanks for the info. I am wondering the same thing about the drop in egg quality. Also wondering why he put me on Bravelle and not Cetrotide. Or maybe because it's too late in the cycle for Cetrotide??



 
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Mrs. A
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Bravelle and Cetrotide are 2 different meds, doing 2 different things

May 9 2011, 5:43 PM 

they are not interchangeable.

Bravelle is to grow the follies and Cetrotide is to control the LH surge. Cooper normally introduces Cetrotide when the lead follie reaches 14MM in an IVF cycle.

I'm not sure why/if they would use an antagonist in a natural *timed intercourse* cycle since you're not looking to time things for an egg retrieval and are not looking to hold off a lead so other follies can grow.

 
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Yeah, I know... but I had a bunch of follicles in the running...or so I thought....

May 9 2011, 5:53 PM 

I had about five follicles worth measuring this morning - all over 10 mm, I believe - one about 13 mm, if I remember correctly...

I thought he would put me on Cetrotide to prevent the surge - since I ovulate early (between CD8-10) and give me Bravelle to allow the follicles to grow...

I thought that was the plan?? Maybe that's why they want me to come in tomorrow - to see if the lead follicle is at least 14 mm...

Was telling DH that we definitely need to make an appointment with Dr. Check...

The E2 drop is really bothering me, though... sad.gif

 
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Mrs. A
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not sure

May 9 2011, 5:55 PM 

why the E2 drop. The LH values do not seem to indicate a surge. Yes, the P4 looks like it's creeping up as if a surge is on its way but with an LH of 5 on CD 7 doesn't seem likely especially considering that your CD 2 LH was 3.

As for thinking that maybe you ovulated on Sunday, between the Saturday and Monday results, given the drop in E2...I'm inclined to say not likely because there's not enough of an LH drop. Basically your LH didn't even move. Normally it takes a slower drive down.

I think the best you can do is just what Cooper is instructing, which is continue the boost and see what the next monitoring shows.

Btw, are you on estinyl? Your CD2 E2/FSH numbers look good!

 
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I was going to post about that....

May 9 2011, 6:05 PM 

No - I'm not estinyl.

Last September or October - with RE #3 - my FSH measured at 20. (I promise - I saw the paperwork!!) Got the you-know-what speech.

Last four months of monitoring with Dr. Check - my FSH has averaged 7-9 with E2 ranging from 45-79. This was the best month - I thought - so I had hopes. Was shocked to see that my E2 dropped - just like two months ago.

I've been wondering if progesterone can help normalize cycles??? Or if RE #3 simply inflated my numbers because he didn't want to work with me.

 
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Mrs. A
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keep up the good work!

May 9 2011, 6:12 PM 

If you have the patience (I know it's HARD as all heck!) see what comes of this. Don't lose hope. It seems like your numbers have been under control the past few cycles without needing any meds so that is very positive! Now it's just a matter of growing a good follie or 2 and getting it to stick. Definitely schedule a callback with Dr. Check to do a re-assessment.

 
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Thanks for the encouragement... :-)

May 9 2011, 6:18 PM 

Was feeling pretty bummed tonight... this stuff is hard... sad.gif

Definitely need to talk to Dr. Check. We saw him in February...and I feel like we're in a TOTALLY different place than we were back then....


 
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While I'm still here... any thoughts about one ovary producing better eggs than the other?

May 9 2011, 6:13 PM 

Last month - I had pretty good numbers with a lead follicle coming from my left ovary.

This month - it seems that the follicles on my right ovary are fighting to become the lead follicle - with sucky numbers (my words - I know...).

In my case - there seems to be a pattern - alternating between good numbers and bad numbers.

Wondering if I should scrap this cycle and try again next month with the left/better ovary. I've already taken the Bravelle and will see what they say tomorrow.

BLAH!!! It's one of those nights! sad.gif


 
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Mrs. A
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good ovary vs. bad ovary (PG ment)

May 9 2011, 6:37 PM 

When I first got on this TTC journey my RE discovered I had a bad ovary, my right. Proclaimed "bad" because it had an endometrioma (i.e. chocolate cyst). I had it removed (along with other endometriosis).

Fast forward to my consult with Check and he said he could live with the fact that the endometrioma was removed but that in his opinion he would have left it as is. His opinion was that it's existence would not have harmed anything but that it's removal could have further compromised DOR.

Fast forward to my BFP cycle...that tinkered-with ovary, which started the cycle with a an AFC of 0-2 (more like big fat zero) was the one that popped the follie with the golden egg!

You never know what ovary is going to be the one that sprouts the elusive egg.

I know that some ladies here have tagged their ovaries as good and bad. I think Jaime may be one of them. For me, I seemed to have about an even response with both ovaries, depsite the right one being considered the "bad" one.

Don't make any decisions until you see what the next monitoring brings! Chin up!! happy.gif

 
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Sara H.
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I don't know but have wondered the same...

May 9 2011, 6:42 PM 

Looking back on all my charts it seems the right never does anything. In all the times I was monitored I have never had a follicle on the right, but it's size is all right...

Weird, right?

I don't have an answer for you but it is interesting!

Hang in there,

Sara H.

 
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(Login Bestbehavior)

Re: Drop in E2 between CD5 - CD 7 - Good or Bad?

May 9 2011, 7:21 PM 

I have no idea on your results or why the E2 would have dropped. Doesn't look like near a surge though (LH). LOL I go to Melrose Park for b/w and u/s tomorrow. Which means I have to leave my house at 7:30am Oi! I find the Melrose Park place can be finicky. Sort of like an episode from Seinfeld with the soup guy. There are no seats except the one or two in the "foyer" so you sort of move along as it's your turn down the long narrow "hallway." Can you tell this used to be a house? Or it still is - not sure. I have my fingers crossed as always but I still am not sure this round is a winner . . . I think I need to take the E2 a few days before AF. I am off my own protocal right now with the natural progesterone but figured we'll see what the results from tomorrow are. Am leaving for Fla next Tues so the cycle will end either way with that! Good Luck tomorrow! Grow follie grow!

 
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MargieD
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QUICK UPDATE.... talked to local nurse today....

May 10 2011, 7:29 AM 

Quick update since I have to run...

Talked to the nurse today at the local RE. She says that the drop in E2 happens sometimes and the RE usually gives patients (more) meds - usually Follistim and Bravelle to jump start the numbers and a lot of times it works. She was really candid about it - like it was no big deal...

And oh... practically all of my follicles on my right ovaries grew about 1 mm each which is not bad(??) for 12 hours on 75 units on Bravelle... the follicles on my left - however - fizzled... no growth - nothing... (maybe leading to the drop in E2??)

Waiting to talk to Cooper nurse today... but at least that talk with the local nurse made me feel a bit better... for now... happy.gif


 
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MargieD
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P.S. I only have one right ovary... heehee...

May 10 2011, 7:30 AM 

Saw that I typed "ovaries" for my right ovary... I only have one..... happy.gif

 
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Mrs. A
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sounds good then!

May 10 2011, 9:30 AM 

glad to hear the nurse eased your mind some! Keep us posted.

 
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E2 BOUNCED BACK UP! :-) HSG tomorrow!!

May 10 2011, 12:57 PM 

E2 bounced back up to 95. YEAH!

They've increased Bravelle to 150 units. No Cetrotide... but I go back AGAIN tomorrow for another u/s & b/w reading... so maybe tomorrow...

I also have a HSG scheduled at 7 am as well.

What fun!! happy.gif


 
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(Login krgh)

That's great!

May 11 2011, 11:57 AM 

It does sound like maybe a leftover cyst fizzled out. Good luck with the HSG!

 
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(Login krgh)

Could just be a bobble

May 10 2011, 10:25 AM 

in E2 from a leftover estrogen-producing cyst fizzling out. That can be pretty common.

Is there any chance the local lab could have mis-reported the E2 level? Just a thought. Did your local clinic do it or did you get it at another lab? This isn't likely, but is always a slight possibility.

 
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Went to different lab since it was a Saturday....

May 10 2011, 12:54 PM 

I would be suspicious of FSH numbers being tested in different labs, but I would think that E2 wouldn't matter as much. I don't know if this thinking makes any sense...

Since I don't release, I think you're right - that the E2 might be a left over estrogen-producing cyst fizzling out....


 
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(Login krgh)

Yes, I understand what you mean.

May 10 2011, 2:25 PM 

And I would normally trust highly most lab results for E2. But I still believe my local "fertility" clinic made an error one time with one of my tests at a critical point. I actually called and questioned it and was told it was reported correctly. I later found out that another patient doing treatment at the local clinic had a mistake in her E2 level at the same time. They changed her meds because of the level, then her u/s the next day didn't seem to match and so they re-tested her blood (saved from the previous day) and the E2 level was dramatically different. I'm still convinced they screwed up her cycle by dramatically changing her meds. And I believe they messed up mine because Cooper changed my meds based on what they reported and things went badly. I never knew for certain what the problem was, but I do know something was wrong those couple of days. So, though it is unusual to have a lab error, it can happen.

Anyway, I don't think you are at a critical point yet, so you should be fine regardless. But I just wanted to throw that question out there. I hate to make anyone second-guess lab results, but once in a blue moon there are errors.

 
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MargieD
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I talked with the local nurse...

May 10 2011, 6:17 PM 

About all of this... and she recommended that I'd go to the main lab and come to find out - it's not that far from where I get the u/s...

The other idea is to have my readings done on Friday "just in case" there's a mix up on the weekend...

So...I'm definitely going to consider those if I have to do it again over the weekend...

Monitoring stinks!! sad.gif

 
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