Monday, April 23, 2007

Day 7 - E2 at 975

All right my resident experts, should I be concerned? My E2 is 975, it is Day 7. I've been directed to bring down the Gonal-f to 37.5 and to come in tomorrow for blood and ultrasound.

Now, the reason I am a little concerned is because when I tried to figure out what that number means. I got this from INCIID:

What should E2 numbers ideally be during an injectables cycle?
You should see 150-200 per mature follicle. (Note: E2 tends to be somewhat lower on pure FSH cycles. You may use this as a guideline, but your physician will be your best guide in this case.) It ideally should be 100 or over after three days of LH-containing injectables. It ideally should be 100 or over after 4-5 days of injectable recombinant FSH. No chart can show ideal E2 levels since E2 varies per number and size of the follicles.

If I am doing my math correctly, that could mean 4.8 to 6 mature follicles. It could mean a whole bunch of immature follicles too and I won't know for sure until the ultrasound. But, either way it explains why my ovaries have been bugging me.

But, I am concerned that if they have too many mature follicles that they will cancel this IUI. I mean four is manageable and to be honest would be the ideal situation. Considering one of those little guys SHOULD get fertilized and maybe just maybe implant. But, SIX, I am not looking for a litter here. Two or three I would welcome in heart beat. But, SIX!

Did I tell you about the nightmare I had when I first started taking clomid. Well, keep in mind that I was also experiencing killer cramps at the time. Basically, I dreamed that I had sextuplets and all I kept on saying "But, I only took clomid." Now, I know that Gonal-f increases the chances of multiples etc. But, for twins and such. Not sextuplets.

Thoughts, experiences, etc. are greatly appreciated. Even if it is, breathe Dianne you will know more tomorrow. But I am all ready repeating that to myself :).

P.S. I also know that I am overreacting. To be honest, writing this has made me feel more in control. Freak out over. But, I would still really like to hear your personal experiences. Thank you!

**UPDATED**

Samantha asked a really good question. The E2 number of 975 was after four days of the G*nalf and I was on CD 7.

Also, did go in for the ultrasound this morning. Turns out that it looked like I have at least three mature follicles and a bunch of little ones. I will post more later once I get the news. But it does seem that the IUI will be happening this week.

Which leaves me pondering whether or not to do our 3rd IUI immediately after. Because we leave for our trip at the end of May. And presuming that if this cycle is over by the 15th, we could do the injectibles and have our 3rd IUI before our trip. But do I really want to be on a 2ww on vacation? And do I want to stress myself out with all of this timing. Considering the IUI would be presumable on the two days before we leave.

OK - praying that this is it and I no longer have to ponder so much. Yes, yes, yes I know that if this is it - then I will only be pondering other things. But those other things seem like green pastures at this point.

9 comments:

Sticky Bun said...

I shamefully really have no idea what the E2 levels are supposed to be, in part because I think it depends on so many things. The nurse always tells me what mine is, and I always have to ask if that's good. And, mine have been all over the place--from 600+ very early on, to just over 200 when I got my +OPK this weekend.

You'll definitely learn more at the u/s tomorrow, and hopefully you'll find that you just have some little ones right now and that at the lower the dose, just one or two will start to emerge as the dominant ones and you'll be fine. :-)

Just a thought. Good luck with the u/s tomorrow--I hope it goes well!

Nicole said...

Sadly, I am absolutely useless as far as all of this stuff goes. But, I hold out the greatest of hopes for you, my friend.

Lee said...

I want to use the forbidden "r" work - oh please forgive me - but relax a fraction. BREATHE!

I went through three IUI cycles and always had between 9-13 mature follicles. I was usually a slow responder to the meds, and then it would happen. From what I understand, the dr.s want that many follicles. The one time I didn't they cancelled the cycle on me. I never looked up the numbers though. It would have tortured me - as it is obviously you ;-)

You are a rational, intelligent,wonderful woman - you know that your dream was a nasty trick on your subconscious.

The hardest part of all of this is we don't have any control. But hang in there
xo

PCOSMama said...

I'm not very knowledgable but I know a little about E2 levels. Even the tiny follicles you have will raise your E2 level so you could only have 3-4 bigger follicles but a bunch of smaller ones. At least that's the way I understand it.

Take this for example - in February, the day I triggered (cd11) my E2 was 708, but I only had 2 mature follicles. 2 around 17mm, 1 around 13.5mm, then many more under 10mm. This last cycle in March I had 7 follicles over 10mm but my E2 level was only around 1000. So really the E2 level alone is hard to tell by. The only way to know for sure is to do an ultrasound - are they planning one soon to see what is going on?

Also, E2 level is often used to determine the risk of OHSS. Every clinic differs on what their cut-off is - my clinic cut-off is around 1000, but for me they will go up to 1500 because the PCOS causes so many smaller follicles that they have to account for that in the E2 level. For whatever reason, a higher E2 level increases your risk of OHSS. That's probably why they are cutting your dose now - to try keep that E2 level from rising much more.

Oh, and every doctor differs on how many mature follicles you can have before they cancel you - my doc told me 5-7 so I was thrilled when we had 7 that were over 10mm. Any more and they would have canceled me!

Hope that helps a little! Good luck!

Samantha said...

Everybody's E2 levels are different. Is that seven days of meds or CD7 and you started your meds some time after CD1? Based on my own personal experience, 975 might be close to what they want for 7 days of meds, but a little high if you've only been only them 4 days (if say, you started CD3). But my estradiol level tends to start slow and then go crazy, whereas other people's may go up fast and then level off. But like other people have said, your ultrasound tomorrow should give you more information about what's going on.

Piccinigirl said...

wow, I'm glad I got here after you updated because I had no idea about E2, only that on Clomid at day 10 I normally had an E2 over 1000 and my dr would smile at me and say "you said Twins were ok, right?" (she said that every cycle so I just got used to knowing that I was producing mutiple follicles)

sounds like things are going well and of course I am wishing you LUCK this cycle and hopeing that you don't need a backup plan at all.

*hug*

The Town Criers said...

Wheeew...three follicles is perfect. Here's hoping that you don't need to think through a "next" cycle because this one is perfect.

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