Are estrogen levels supposed go up during stims?
Are estrogen levels supposed go up during stims?
Wasn't sure and my nurse hasn't called me back with an explanation. Does anyone know the answer to this? Thanks very much.
Follicles produce estradiol. As they grow, and as more of them grow, your levels will rise. If your levels do not rise, it can mean your follicles are not developing.
If you are stimulating with an aromatase inhibitor, like Letrozole or Anastrozole, then your levels might not rise, or not as much.
Sorry to disagree with Kelley here, but I've not seen a protocol for triggering based on estradiol levels. It's almost always based on follicular development (often the size of the lead follicle, such as when it reaches 17mm or 18mm), and once in a while a protocol will specify triggering based on progesterone levels (progesterone starts to be produced once the follicle is mature, as a signal to the endometrium to get ready for implantation).
Whether a clinic backs off when estradiol climbs is up to the clinic. One way to reduce the risk of OHSS is to "coast" (stop stimming for awhile) and let estradiol levels drop. Many clinics do that, but not all, and there are much more reliable ways than coasting to avoid OHSS that don't compromise egg quality. We never coast, not even when estradiol gets well above 10,000 mIU/ml.
If you are stimulating with an aromatase inhibitor, like Letrozole or Anastrozole, then your levels might not rise, or not as much.
Sorry to disagree with Kelley here, but I've not seen a protocol for triggering based on estradiol levels. It's almost always based on follicular development (often the size of the lead follicle, such as when it reaches 17mm or 18mm), and once in a while a protocol will specify triggering based on progesterone levels (progesterone starts to be produced once the follicle is mature, as a signal to the endometrium to get ready for implantation).
Whether a clinic backs off when estradiol climbs is up to the clinic. One way to reduce the risk of OHSS is to "coast" (stop stimming for awhile) and let estradiol levels drop. Many clinics do that, but not all, and there are much more reliable ways than coasting to avoid OHSS that don't compromise egg quality. We never coast, not even when estradiol gets well above 10,000 mIU/ml.
Ghost - you mention lead follicle at 17 or 18mm - is that also a variable based on your clinic? My clinic likes to see a lead follie at 20mm...
right now I have 13 follicles ranging from 14mm to 21mm and as of yesterday my E2 level was over 1400..??
right now I have 13 follicles ranging from 14mm to 21mm and as of yesterday my E2 level was over 1400..??
TTC #1 16 mos.
Me 34 DH 34 normal
Endo stage I/II - laparscopy in 1997/Nov 2007
IVF #1 Feb/March - BFN
IVF#2 May/June BFP
Beta 149 6/15
Beta 602 6/18
Me 34 DH 34 normal
Endo stage I/II - laparscopy in 1997/Nov 2007
IVF #1 Feb/March - BFN
IVF#2 May/June BFP
Beta 149 6/15
Beta 602 6/18
I've seen many publications describing the triggering point as "when the lead follicle reached 18mm".IrishHope wrote:Ghost - you mention lead follicle at 17 or 18mm - is that also a variable based on your clinic? My clinic likes to see a lead follie at 20mm...
right now I have 13 follicles ranging from 14mm to 21mm and as of yesterday my E2 level was over 1400..??
20mm sounds better to me.
My clinic uses a formula based on all of the follicles, not just the lead follicle.