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Ganirilex Effect on E2

September 6 2008 at 12:23 PM
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Nancy  (Login NancyKC)

 
The uncertainty of this cycle is killing me. I was (and am still hoping) to do my 1st IVF, I finally have enough follies (7 ranging from 10 - 18) after a very high stim cycleDay 13, continuing with meds to try to grow the smaller ones. RE just called and said that my estrogen may be leveling out, yesterday it was 720 now its 730, and she said this is not good. She's not sure if its a resulf of having the Ganirilex/Antagon in my system or if its bec I'm starting to ovulate?

She doesnt want me to do the trigger shot tonight with ER on Monday bec she wants the smaller follies, (3 10's and an 11) to grow bigger or she said it wouldnt be a good enuf IVF cycle with just 3-4 good size/maturing follies. I was told to take the Antagon shot again today, continue with Follistim tonight and to come in for U/S tomorrow, blood work tomorrow am. I'd like to still think I can do trigger shot tomorrow nite with ER on Tues bec I dont usually have this many follies and have been really hoping to try the IVF cycle after many failed IUI's.

But I could tell by her voice that she was disappointed with my E2 levels today, so I'm afraid she's not optimistic about my chance for IVF.

Was wondering if anyone had any insight re: my E2 and if you think my prognosis may be ok for ER on Tues or am I looking at another round of IUI's?

Thanks.
Nancy

 
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cbsgirl
(no login)

e2 and ganirelix

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September 6 2008, 3:15 PM 

Nancy -

Ganirelix definitely slows down the e2 rise. On my last 2 cycles, my RE automatically upped my Menopur by 75iu when ganirelix was added to help ensure e2 continued to rise. On my 1st cycle, the menopur did the trick and there was no slowdown in e2. For my last cycle, the menopur alone was not enough to compensate and more gonal-F was added to get my e2 moving again. Ironically, my e2 stalled right about 720 and only increased by about 10-15 for a couple of days until the extra stims kicked in. It then took off again and I ended up with e2 in the 12-1300 range with 4 follies at retrieval. Others on the board have had a similar problem and a common resolution is an increase in stims.

Are you on Follistim only or are you also taking Menopur or Bravelle? Also, how many ius of Follistim are you taking now? And, did your RE adjust your stims when the ganirelix was added? You could ask your RE her thoughts on upping your stims for the next couple of days to address the e2 or whether she thinks adding Menopur or Bravelle (which are a mix of FSH and LH) could help.

You definitely seem to be headed in the right direction for a good IVF cycle, so don't give up hope yet!!!

cbsgirl

 
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summerwind03
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Re: Ganirilex Effect on E2

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September 6 2008, 3:47 PM 

Did you just add the ganirelex yesterday? If so, that likely is the cause of the slowdown in e2. I also upped my Menopur by 75 IU the day I added ganirelex and by my next bw 2 days later, my e2 had still increased reasonably. I wouldn't give up yet, but you do want to keep an eye on those bigger ones, so make sure you go back for monitoring tomorrow. Even on ganirelex, my 18 went to 28 in 2 days! So I think I lost two follies that got too big.

 
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Nancy
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Ganirilex Effect on E2

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September 6 2008, 4:09 PM 

Thanks Ladies. I feel better...I've been on Ganilirex since Tues and my estrogen has been rising since then, so I guess that is why my RE didnt have me increase my meds. Today, after we realized it's stalling, she told me to increase my Follistim dose tonight from 225 to 300 (Im taking 225 Follistim in the am too). I'm also taking Repronex (same as Menopur), 225 IU's per day and she didnt tell me to take any more of that tomorrow am, so hopefully increasing just the Follistim will work.

She acknowledged that we might lose the follie that is 18 but its would be worth it to get the 5 or 6 that are smaller and closer in range.

One day at a time, I keep telling myself.

Thank you for responding!

 
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Hope
(Login Hoping45)

Explain about losing bigger follicle to get smaller ones?

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September 6 2008, 11:59 PM 

How does it get lost? Does it ovulate before the others, but you keep stimming til the others get big enough and then trigger shot? Or, does it ovulate with the others when they are finally ready, but because it has become so big, that particular egg is no longer fertilizable?

 
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NancyKC
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Losing Big Follicles

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September 7 2008, 10:19 AM 

I believe it is the latter, that the biggest follicle may be too "mature" to fertilize, so we risk losing that one by having me continue stimming to help the smaller ones catch up so that I have more (close in size) to choose from at the time of retrieval.

 
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Hope
(Login Hoping45)

thanks, had similar IVF experience

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September 7 2008, 2:07 PM 

That is, I had one lead of 18, and about three 10's and 11's at day 12, despite the Ganerilix. They chose to trigger me early to not lose the 18; I see now that they could have (maybe should have) sacrificed that one to keep stimming the others, with more Ganerilix and higher stim numbers, so that I might have had those three to choose from instead of that one.

So interesting! If this happens again I will ask the RE to try this other course of action.

 
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