Ghost estradiol 6000 and cancelled ivf

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Klm
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Joined: Mon Jun 07, 2010 1:30 am

Ghost estradiol 6000 and cancelled ivf

Post by Klm » Mon Jul 19, 2010 1:50 am

I've written before about my struggles with too high estradiol levels. With just bcp and lupron I once went as high as 220, got cancelled, but then got down to 22 eventually and was at 96 when I got the go ahead to start stims. After six days of stims (2 days of 2 75 ml viles of bravelle and 2 menopur, then 4 days of 2 bravelle and 1 menopur), I was at 1300 so they knocked me down to just 1 menopur. Two days later I was at 3000, did one more day of just menopur and was at 6000 so I got cancelled. I am bummed because each u/s yielded great results with 13 follies on day six and 23 the next two days. The last u/s had one of the follies measuring 20, a couple 19s, some 18 and 17 and the rest smaller. My first question is what will happen to those 23 eggs now that I'm supposed to just wait and call with my period? What do you predict my RE will do next time? I'm sure lower the meds but I'm afraid I wont make big enough eggs. Do you think there is hope for my crazy high levels? I will meet with him soon, but these are questions that have been running through my head this weekend. Thanks.
Me-30 PCOS, Mild Endo
DH-31, male factor
1st IVF-July 2010, Cancelled due to OHSS Risk
Labrascopy Oct. 2010, Found 15 spots of endo,ovarian diathermy
2nd IVF-Dec 2010, ER-11/29 4 of 9 fertilized, mild OHSS, Day 5 ET 2 blasts
BFP! beta 15 dpo 80, 17dpo 229

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kizmet
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Joined: Wed Jan 27, 2010 11:04 pm
Location: Australia

Re: Ghost estradiol 6000 and cancelled ivf

Post by kizmet » Mon Jul 19, 2010 2:35 am

Hey Kim,

I can only imagine they've cancelled because they are concerned about OHSS? Having been their recently I can assure you that avoiding OHSS, is well worth the effort. I ended up with it and only two frozen embies to show from it with very similar numbers to yours, but having spent 6 nights in hospital including ICU, I'd do anything to avoid going through that again. I know in the end it might be worth it, but I certainly couldn't have gone through with a transfer and risk things getting worse. I would have much rathered that my cycle was cancelled before ER given just how sick I got.

I believe that the eggs that you have now will just go through a similar process to when you normally ovulate and don't get pregnant. I'd imagine your RE will reduce the dosage of hormones from the start of your cycle next time round. Don't be discouraged, you obviously respond well to the meds and I think from what I understand, that less meds doesn't necessarily mean less follicles/eggs on subsequent rounds.

Good luck
KIz

Ghost
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Re: Ghost estradiol 6000 and cancelled ivf

Post by Ghost » Mon Jul 19, 2010 4:05 am

Klm wrote:I've written before about my struggles with too high estradiol levels. With just bcp and lupron I once went as high as 220, got cancelled, but then got down to 22 eventually and was at 96 when I got the go ahead to start stims. After six days of stims (2 days of 2 75 ml viles of bravelle and 2 menopur, then 4 days of 2 bravelle and 1 menopur), I was at 1300 so they knocked me down to just 1 menopur. Two days later I was at 3000, did one more day of just menopur and was at 6000 so I got cancelled. I am bummed because each u/s yielded great results with 13 follies on day six and 23 the next two days. The last u/s had one of the follies measuring 20, a couple 19s, some 18 and 17 and the rest smaller. My first question is what will happen to those 23 eggs now that I'm supposed to just wait and call with my period? What do you predict my RE will do next time? I'm sure lower the meds but I'm afraid I wont make big enough eggs. Do you think there is hope for my crazy high levels? I will meet with him soon, but these are questions that have been running through my head this weekend. Thanks.
The eggs will ovulate, perhaps in several days when the Lupron wears off and your LH levels can rise.

I don't know what your RE will do, but we would not put you on a Lupron cycle. We'd put you on an antagonist cycle (like ganirelix or Cetrotide) and then we could use Lupron for the trigger. With a Lupron trigger, there is almost no risk of OHSS regardless of how many follicles you develop or how high your estradiol levels go. That's because it produces a brief LH surge (LH is the hormone that matures the eggs in natural cycles), and the LH is gone by about the time we retrieve the eggs. It does not linger for many days like hCG does. Any developing OHSS symptoms quickly fade away. No need to cancel any cycles for OHSS risk.

If you do a fresh transfer after a Lupron trigger, it seems the luteal support protocol published by University of Connecticut is a must. The usual luteal support protocols do not work well because the corpus luteum dies quickly (recall that rapid decline in LH I mentioned?) and suddenly stops making estradiol and progesterone. Or you can just freeze all the embryos, and do a routine FET cycle like many clinics do.
Last edited by Ghost on Mon Jul 19, 2010 2:37 pm, edited 1 time in total.
Avoid IVF and surrogacy in Ukraine. Ukrainian centers pay shills to post here under numerous sock accounts pretending to be patients in Ukraine. Centers using such deceptive advertising cannot be trusted and should be avoided.

leorira11
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Posts: 1275
Joined: Fri Mar 19, 2010 12:09 pm
Location: Jerusalem, Israel

Re: Ghost estradiol 6000 and cancelled ivf

Post by leorira11 » Mon Jul 19, 2010 6:39 am

Ghost -

I had a near OHSS cycle last year so this cycle, we are doing things nice and slow. I appear to have avoided the OHSS risk (CD16, day 13 of stimming and my estrogen is only around 900) but the Lupron trigger was suggested as an option (I will hopefully trigger today or tomorrow, so I'll find out soon enough!)

What is the UCONN lutal phase support protocol?
8 IVF+6 FET=6 BFN+8 BFP =

-b/g twins 22w (12.09)
-mc 10w (9.10)
-Micha (7.19-24.11) & Asaf (7.19-28.11) born at 24w
-mc 5wk (2.12)
-no HB at 18w (10.12)
-BO (4.13)-
-mc 6wk (9.13)

last attempt - donor sperm - baby girl born healthy July 2014

Ghost
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Re: Ghost estradiol 6000 and cancelled ivf

Post by Ghost » Mon Jul 19, 2010 2:44 pm

leorira11 wrote:Ghost -

I had a near OHSS cycle last year so this cycle, we are doing things nice and slow. I appear to have avoided the OHSS risk (CD16, day 13 of stimming and my estrogen is only around 900) but the Lupron trigger was suggested as an option (I will hopefully trigger today or tomorrow, so I'll find out soon enough!)

What is the UCONN lutal phase support protocol?
Their protocol is IM progesterone and 3x0.1 mg estradiol patches every other day starting the day after retrieval and continued for 10 weeks.

You probably have no need for a Lupron trigger with an E2 of 900, but of course that's up to your doctor to decide based on the whole picture.
Avoid IVF and surrogacy in Ukraine. Ukrainian centers pay shills to post here under numerous sock accounts pretending to be patients in Ukraine. Centers using such deceptive advertising cannot be trusted and should be avoided.

leorira11
Valued Contributor
Posts: 1275
Joined: Fri Mar 19, 2010 12:09 pm
Location: Jerusalem, Israel

Re: Ghost estradiol 6000 and cancelled ivf

Post by leorira11 » Tue Jul 20, 2010 7:20 am

Ghost - thanks for your answer. Luckily - E2 stayed below 1000, so I am using a regular Hcg trigger (tonight! yay!)

Kim - how is your cycle going? did you end up canceling?
8 IVF+6 FET=6 BFN+8 BFP =

-b/g twins 22w (12.09)
-mc 10w (9.10)
-Micha (7.19-24.11) & Asaf (7.19-28.11) born at 24w
-mc 5wk (2.12)
-no HB at 18w (10.12)
-BO (4.13)-
-mc 6wk (9.13)

last attempt - donor sperm - baby girl born healthy July 2014

Klm
Newbie
Posts: 27
Joined: Mon Jun 07, 2010 1:30 am

Re: Ghost estradiol 6000 and cancelled ivf

Post by Klm » Tue Jul 20, 2010 8:31 pm

That's good news leorira! Good luck with your retrieval! Yes, I did get cancelled because of risk for OHSS. My doctor called me yesterday and put me on a pill for 10 days that will make me start my period. We go in on Thursday to talk about a new plan. He said he knows what to do so that was encouraging. However, he said he's never had a case like this before where my estradiol went so high, but I responded so well to the meds by making so many follicles. I am eager to see what the new protocol is and how soon we can start it!
Me-30 PCOS, Mild Endo
DH-31, male factor
1st IVF-July 2010, Cancelled due to OHSS Risk
Labrascopy Oct. 2010, Found 15 spots of endo,ovarian diathermy
2nd IVF-Dec 2010, ER-11/29 4 of 9 fertilized, mild OHSS, Day 5 ET 2 blasts
BFP! beta 15 dpo 80, 17dpo 229

leorira11
Valued Contributor
Posts: 1275
Joined: Fri Mar 19, 2010 12:09 pm
Location: Jerusalem, Israel

Re: Ghost estradiol 6000 and cancelled ivf

Post by leorira11 » Wed Jul 21, 2010 6:02 am

Kim -

I'm so sorry - a canceled cycle is one of my WORST nightmares...

best of luck with the next one

Leora
8 IVF+6 FET=6 BFN+8 BFP =

-b/g twins 22w (12.09)
-mc 10w (9.10)
-Micha (7.19-24.11) & Asaf (7.19-28.11) born at 24w
-mc 5wk (2.12)
-no HB at 18w (10.12)
-BO (4.13)-
-mc 6wk (9.13)

last attempt - donor sperm - baby girl born healthy July 2014

Ghost
Board Veteran
Posts: 4150
Joined: Mon May 29, 2006 5:01 pm

Re: Ghost estradiol 6000 and cancelled ivf

Post by Ghost » Wed Jul 21, 2010 2:14 pm

Klm wrote:That's good news leorira! Good luck with your retrieval! Yes, I did get cancelled because of risk for OHSS. My doctor called me yesterday and put me on a pill for 10 days that will make me start my period. We go in on Thursday to talk about a new plan. He said he knows what to do so that was encouraging. However, he said he's never had a case like this before where my estradiol went so high, but I responded so well to the meds by making so many follicles. I am eager to see what the new protocol is and how soon we can start it!
I'm not sure why he said that. Your ovarian response (estradiol level of 6000 and 23 follicles) is actually pretty common in your age group. We get them like that all the time.
Avoid IVF and surrogacy in Ukraine. Ukrainian centers pay shills to post here under numerous sock accounts pretending to be patients in Ukraine. Centers using such deceptive advertising cannot be trusted and should be avoided.

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