Can anyone help analyze my numbers?

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CT_Michele
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Can anyone help analyze my numbers?

Post by CT_Michele » Tue Apr 14, 2009 8:01 pm

I am currently stimming for my second ivf cycle, my first was a success, and I didn't do a lot of questioning the first time around since everything went smoothly and worked.

I was hoping someone here might work in the field or have a lot of experience and be able to help me with my numbers. Even though I have learned a lot about ivf in general, I am still a moron when it comes to the technicalities.

So I am on day 5 of stims. I went for u/s and bw yesterday (day 4) and they saw about 10 follicles (which is what I expected since that is what happened last cycle). When they called with blood results they said to reduce my follistim from 375 to 300, and that they wanted to see me again today instead of my planned appt tomorrow.

So I went today and they now see a total of around 22 follicles, 13mm the biggest, others around 10. When they called with bw, they said to reduce to 250iu and they want to see me tomorrow and bring a dose of ganerelix with me. I asked for my levels, and they said LH was 1.3 and Estrogen was 734.

Although they told me everything looks good and is fine, I am a bit skeptical. Do you think they may be concerned with OHSS? If they were really concerned, would they be cancelling or having me "coast" at this point or would that happen later before trigger? What does the estrogen level mean and is it normal? What does the LH # mean? I am not suprised about the ganerelix, because compared with my last cycle, if they give it to me tomorrow morning, it will be the exact same timing as last time.

Thanks for any help. I am sure I will find out more tomorrow anyone, but I am too impatient and there is too much knowledge here for me not to ask!
Me- 28 DH- 33 Male Factor
1st IVF- 12/07- BFP! Ella Michele was born 8/26/8
2nd IVF- 04/09 - BFN
1st FET- 09/09 - Chemical
3rd IVF - 04/11 - Embies didn't make it to ET
4th IVF - Fall 2011??
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sportsmom
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Post by sportsmom » Tue Apr 14, 2009 8:13 pm

ct michelle I don't have alot of answers but I asked the nurse yesterday at my suppression check if I was at risk for OHSS once I start stims because of my current high possible folly count. She said we are all at risk (safe general answer :roll: ) but I would have to have an extremely high folly count plus my estradiol be at 5,000 + to go into OHSS. She said most people will have one or the other but not both. She said in the many years she's worked at this office she's only seen it twice.

I think maybe they just want to slow you down to a slow stimmer. They don't want to overcook you have you dried out on the outside and undercooked inside. Ya know? :lol:
Cindy
1st IVF -May 11=BFN
FET-Aug 11: BFP!
edd: April 27, 2010
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to_have_fun08
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Post by to_have_fun08 » Tue Apr 14, 2009 8:18 pm

Michelle,
You are responding quickly so I would think they are just trying to slow you down. Once you add in the ganirlix, things should slow up. 22 follicles are a lot so I would take precautions for OHSS. Drink lots of water and eat protein. Good luck!!



Chris
Chris 40- DH 41
6 IVFs Cycles - BFN's
DE Cycle 2/2011 -BFP Jacob born 11/11/11

FET 7/2012 - BFP - Kaylee due 4/3/13

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baylorbear33
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Post by baylorbear33 » Tue Apr 14, 2009 9:11 pm

In comparing your numbers to mine during my fresh cycle, I would say that you are still in good shape. My E2 did get up to 5000 at the end of my stimming. In fact, they only gave me a half-dose of HCG to trigger because of this. They retrieved 41 eggs from me. Even with all of this, I may have experienced very light symptoms of OHSS, but I was still fine. I drank lots of gatorade and had lots of salty foods. Seems counter intuitive, but it worked. Best of luck to you with your cycle.
Age 39, DH 37
1st IVF 5/08-Lost Twin Girls @ 19 wks
FET 4/09-M/C @ 5 1/2 weeks
FET 6/09-BFP
Owen Robert born 3/3/2010, 10 lbs 4 oz
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CT_Michele
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Post by CT_Michele » Tue Apr 14, 2009 9:26 pm

Thank you all for the replies, even if my clinic thinks I am headed towards possible ohss, I think they are staying on top of it.

Baylor, that's interesting about the salty foods...did someone tell you to do that? I have been eating a low sodium diet for quite some time to try and keep my blood pressure down. Just curious about why you did that??
Me- 28 DH- 33 Male Factor
1st IVF- 12/07- BFP! Ella Michele was born 8/26/8
2nd IVF- 04/09 - BFN
1st FET- 09/09 - Chemical
3rd IVF - 04/11 - Embies didn't make it to ET
4th IVF - Fall 2011??
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baylorbear33
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Post by baylorbear33 » Tue Apr 14, 2009 9:44 pm

Yes, RE's office told me to drink the gatorade because of the salt content and to eat the salty foods such as chips & salsa. It has something to do with keeping the excess fluid of OHSS at bay. My ovaries both approached the size of tennis balls, so most of my discomfort was purely due to the size of my ovaries.
Age 39, DH 37
1st IVF 5/08-Lost Twin Girls @ 19 wks
FET 4/09-M/C @ 5 1/2 weeks
FET 6/09-BFP
Owen Robert born 3/3/2010, 10 lbs 4 oz
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cymplicity27
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Post by cymplicity27 » Wed Apr 15, 2009 12:36 am

Hey Michele! Just wanted to echo what everyone else was saying. My estradiol peaked over 5,000 just before I triggered and that was when my RE started to really talk about OHSS. (sounds like 5000 is the magic number) I was actually given the option at that point to coast or continue to retrieval. I wasn't at a point where they were going to cancel yet so it was up to me. The risk was if I reported symptoms of OHSS within the 2 days before ER, they could still do the retrieval but would have to freeze my eggs and do a FET weeks later when OHSS symptoms subsided. Of course I went full steam ahead and everything worked out fine in he end! I was also instructed to drink gatorade for the sodium and Ensure for protein. Didn't get an LH number. Oh good, I just found my numbers from all my stimming b/w. Here they are:

Day 5 - 478
Day 7 - 1101
Day 9 - 2583
Day 11 - over 5000, didn't write the number down on this pad but remember it being over 5000; this was the night I triggered.
Cynthia - 31, blocked tubes, DH - 26, perfect
1st IVF - 3/2009, ER - 3/26, ET - 3/29 BFP!!

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Ghost
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Re: Can anyone help analyze my numbers?

Post by Ghost » Wed Apr 15, 2009 4:00 am

CT_Michele wrote: So I went today and they now see a total of around 22 follicles, 13mm the biggest, others around 10. When they called with bw, they said to reduce to 250iu and they want to see me tomorrow and bring a dose of ganerelix with me. I asked for my levels, and they said LH was 1.3 and Estrogen was 734.
Some risk there, but not extreme, if you are triggered with hCG.

Since you are taking ganirelix (not Lupron), you have the option of being triggered with Lupron instead of hCG. This would cause a surge of natural LH from your pituitary, the same hormone that matures the eggs in a natural cycle. The nice thing about LH is that it is short-lived. Matures the eggs and then it's gone (unlike hCG). This makes significant OHSS almost impossible.

You could ask your doctor about this option.

However, the luteal support is tricky if they are doing a fresh transfer after a Lupron trigger. They should follow the protocol published by the University of Connecticut (Engmann et al).

jennywit
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Post by jennywit » Wed Apr 15, 2009 10:05 am

Ct-Michele-I don't know much about the numbers-since like you-it just worked the 1st time. But I can tell you that I had over 28 mature follies & Dr. levi was concerned about OHSS so I remember that I did like half of the HCG shot and he administered Lupron to me at his office the day before retrevial beacause he said it would reduce the chance of any "pain" I'm guessing he meant OHSS-Like I said-I didn't know much to ask much back then. Anyway, I can tell you it seems as though he stays on top of it. GOOD LUCK!!!!!! Jennifer
DS#1-Stephen-born 8/05- (natural)then TTC 2 1/2 yrs- IVF#1w/ICSI-07/08-BFP! DS#2-Matthew- born 04/03/09!

CT_Michele
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Post by CT_Michele » Wed Apr 15, 2009 1:23 pm

Thank you all,

Jenny- I am glad to hear from you as we have the same doc. It is good to know that you had even more follies with me and still made it through just fine. I figured dr levi would stay right on top of it. It is interesting about the half hcg/half lupron, I guess I will have to wait and see what happens.

Ghost- Thank you again for your valued info. I thought I would be triggering with hcg only, but since Jenny used the same doc as me and was in a similar situation, I guess it is possible he will use half or all lupron in office. I am going to the clinic in an hour or so for another scan and bw, I might ask them if they are concerned or not.
Me- 28 DH- 33 Male Factor
1st IVF- 12/07- BFP! Ella Michele was born 8/26/8
2nd IVF- 04/09 - BFN
1st FET- 09/09 - Chemical
3rd IVF - 04/11 - Embies didn't make it to ET
4th IVF - Fall 2011??
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estrellita
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Post by estrellita » Wed Apr 15, 2009 1:36 pm

Hi guys! Michele good luck I hope everything goes ok with your cycle.
I know nothing about OHSS, but now reading all this I'm a little worried because when I was on clomid it was too painful and when I started all this IVF my RE did a u/s because she said that because of the dates I got my last af I should be ovulating that day. She was :shock: when she did it and said that I produced many follies w/o medications so that when I start stims she wont give me a big amount because I could be in pain and she would have to be checking me very close. So now I think she was worried about "OHSS" with me :roll: lets see how it goes.
Me: 28, DH: 31

1st IVF 04/09 = BFN
3 frozen embies

08/09 = BFP (Natural)

jennywit
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Post by jennywit » Wed Apr 15, 2009 3:33 pm

Michele-good luck today, let us know how you made out. Jennifer :D
DS#1-Stephen-born 8/05- (natural)then TTC 2 1/2 yrs- IVF#1w/ICSI-07/08-BFP! DS#2-Matthew- born 04/03/09!

to_have_fun08
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Post by to_have_fun08 » Wed Apr 15, 2009 10:03 pm

Michelle - Just checking to see how your are doing. Hope your appointment went OK.



Chris

CT_Michele
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Post by CT_Michele » Wed Apr 15, 2009 10:50 pm

Thanks for checking on me guys! Appt was good, same amount of follies, just bigger now. They gave me ganerelix today which I have to take each morning now to prevent ovulation. When they called with bw results they said to keep my doses the same as yesterday so I am guessing everything looked good if they decided not to adjust. They do want to see me back again tomorrow though. I have had a scan everyday since stim day 4! The dr said I am on the frequent flyer program, as I will probably be there everyday this week and maybe everyday up until trigger.

I did ask him straight out if he was concerned about ohss, and he said concerned was the wrong word, that they were just watching carefully. He said if I stayed at the orginal high dose, he would have been worried about it, but that is why they monitor carefully and adjust accordingly. I feel better that today there were no reductions in dose, it makes me think they are less concerned about hyperstimulation. I think we are gearing up for ER on tuesday...so keep your fingers crossed for me!
Me- 28 DH- 33 Male Factor
1st IVF- 12/07- BFP! Ella Michele was born 8/26/8
2nd IVF- 04/09 - BFN
1st FET- 09/09 - Chemical
3rd IVF - 04/11 - Embies didn't make it to ET
4th IVF - Fall 2011??
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jennywit
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Post by jennywit » Wed Apr 15, 2009 11:59 pm

Glad to hear the good news Michele! I will keep my fingers crossed for you!
DS#1-Stephen-born 8/05- (natural)then TTC 2 1/2 yrs- IVF#1w/ICSI-07/08-BFP! DS#2-Matthew- born 04/03/09!

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