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General E2 levels reference??

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#1 KennyandFooty

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Posted 04 February 2012 - 04:14 PM

Can anyone suggest a reliable source of information on E2 levels (monitoring) in Canada? I think, from what I've read, that I should can generally use 1000pmol/L PER mature follicle (16+mm)? Is this correct?
(ie. U/S shows 8 follicles over 16mm+ means E2 #s should be +/- 8000pmol, if all are mature)?

Just want to be able to gauge how I'm doing with my E2 levels this time around...as last time they dropped (resulting in a cancelled IVF).

Thanks for any advice!

Me: 33 DH: 31
TTC 4+ years
Asthmatic - Bricanyl & Symbicort daily
Hydrosalpinges --> Bilateral Tubal removal


IVF#1 - September 2011 - Short protocol - Cancelled/Ectopic pregnancy; Tubal removal (October)
IVF#2 - March/April 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
FET#1 - July 2012 - Cancelled; zero survive thaw
IVF#3 - October/November 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
Hysteroscopy and Biopsy February 2013 - All results normal

FET#2 - BFP - March/April 2013 - EDD December 25, 2013

2 frosties waiting

January 1 - Our beautiful baby boy arrived after an emergency induction.  Completely in love! <3


#2 Laura1976

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Posted 04 February 2012 - 06:51 PM

KennyandFooty - I gather that it's about 800 to 1000 per mature follicle.
ME 35 SO 32 TTC #1 since September 2008

See 'About me Page' for more cycle history

November 29/11 - Unexplained IF/Recurrent loss testing

Compliment C3 & C4 below acceptable range
LA Ratio DRVVT above acceptable range
Lupus Inhibitor demonstrated
Antiphospholipid IgG above acceptable range
Antiphospholipid IgM above acceptable range (more than double)


Consultation @ VFC December 10/11

IVF/ICSI #2 (with Intralipid therapy) January/February (Victoria Fertility Clinic)
BCP December 16 -29/11 & January 6 - 28/12
Vitamin D (2000iu daily) and Iron Supplement (Ferrous Gluconate 300mg daily) - Start December 24 until Dr advises otherwise, PregVit 5 (Starting January 12/11), Vitamin E (800iu daily) until Heparin begins (Starting January 14/11) Fish Oil (1200iu daily)
Superfact (0.5mg) - Start January 22/12
Dexamethasone (0.5mg) - Start February 4/12 until beta

After ER - Doxycycline (100mg), Estrance (2mg), Prometrium (200mg 3x day), heparin 5000 units (2x day), calcium (1500mg daily), low dose aspirin (81mg daily)
Intralipids - February 13/12 and day of ET
Neupogen Uterine Flush - Day of ER

February 2/12 - E2 35p/mol
February 4/12 - 300iu Gonal-F & 75iu Repronex
February 9/12 - U/S & E2 - RIGHT- 11, 9, 10, 19, 8, 12, 11, 10, 13, 6 LEFT: 12, 7, 10, 10, 8, 6, 5, 5 E2 2635

February 9/12 Gonal-F lowered to 225iu Repronex remains at 75iu
February 11/12 - U/S & E2 - Right 14, 10, 11, 12, 10, 13, 12, 12, 14, 7 LEFT: 11, 8, 10, 13, 9, 8, 8 E2 5610
February 13/12 - U/S an E2??? & Intralipid Therapy
February 16/12 - E/R 20 eggs, 17 mature and ICSI'ed, 3 left to fertilize by regular IVF
February 17/12 - Fert Report 16 fertilized by ICSI, 1 fertilized by IVF
February 20/12 - Neupogen injection
February 21/12 - Transferred 2 Blastocysts ( 1 x Grade 19 Early Blast, 1 x Grade 19 Expanded Blast) and Intralipid Therapy and Acupuncture

“Here's all you have to know about men and women: women are crazy, men are stupid. And the main reason women are crazy is that men are stupid.” - George Carlin

#3 KennyandFooty

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Posted 04 February 2012 - 09:03 PM

Thanks darlin'! So...if they see...say...10 follicles...but my E2 is at around 4000...could that indicate that I could expect approximately 4 mature eggs retrieved? Just so I understand...

Me: 33 DH: 31
TTC 4+ years
Asthmatic - Bricanyl & Symbicort daily
Hydrosalpinges --> Bilateral Tubal removal


IVF#1 - September 2011 - Short protocol - Cancelled/Ectopic pregnancy; Tubal removal (October)
IVF#2 - March/April 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
FET#1 - July 2012 - Cancelled; zero survive thaw
IVF#3 - October/November 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
Hysteroscopy and Biopsy February 2013 - All results normal

FET#2 - BFP - March/April 2013 - EDD December 25, 2013

2 frosties waiting

January 1 - Our beautiful baby boy arrived after an emergency induction.  Completely in love! <3


#4 Laura1976

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  • My Clinic:Heartland (IVF #1) VFC (IVF #2)

Posted 04 February 2012 - 09:44 PM

I think that the E2 level also says something about the quality of the egg. So with an E2 of 4000 you could have 8 mature eggs, but they may not all be of high quality.

I vaguely remember your stats (follicle info and E2's) from your last cycle, can you either post them or PM them to me? I remember I was perplexed by your E2 and your # of eggs back then.

As you know I don't profess to be a medical professional, I am just an obsessive researcher...
ME 35 SO 32 TTC #1 since September 2008

See 'About me Page' for more cycle history

November 29/11 - Unexplained IF/Recurrent loss testing

Compliment C3 & C4 below acceptable range
LA Ratio DRVVT above acceptable range
Lupus Inhibitor demonstrated
Antiphospholipid IgG above acceptable range
Antiphospholipid IgM above acceptable range (more than double)


Consultation @ VFC December 10/11

IVF/ICSI #2 (with Intralipid therapy) January/February (Victoria Fertility Clinic)
BCP December 16 -29/11 & January 6 - 28/12
Vitamin D (2000iu daily) and Iron Supplement (Ferrous Gluconate 300mg daily) - Start December 24 until Dr advises otherwise, PregVit 5 (Starting January 12/11), Vitamin E (800iu daily) until Heparin begins (Starting January 14/11) Fish Oil (1200iu daily)
Superfact (0.5mg) - Start January 22/12
Dexamethasone (0.5mg) - Start February 4/12 until beta

After ER - Doxycycline (100mg), Estrance (2mg), Prometrium (200mg 3x day), heparin 5000 units (2x day), calcium (1500mg daily), low dose aspirin (81mg daily)
Intralipids - February 13/12 and day of ET
Neupogen Uterine Flush - Day of ER

February 2/12 - E2 35p/mol
February 4/12 - 300iu Gonal-F & 75iu Repronex
February 9/12 - U/S & E2 - RIGHT- 11, 9, 10, 19, 8, 12, 11, 10, 13, 6 LEFT: 12, 7, 10, 10, 8, 6, 5, 5 E2 2635

February 9/12 Gonal-F lowered to 225iu Repronex remains at 75iu
February 11/12 - U/S & E2 - Right 14, 10, 11, 12, 10, 13, 12, 12, 14, 7 LEFT: 11, 8, 10, 13, 9, 8, 8 E2 5610
February 13/12 - U/S an E2??? & Intralipid Therapy
February 16/12 - E/R 20 eggs, 17 mature and ICSI'ed, 3 left to fertilize by regular IVF
February 17/12 - Fert Report 16 fertilized by ICSI, 1 fertilized by IVF
February 20/12 - Neupogen injection
February 21/12 - Transferred 2 Blastocysts ( 1 x Grade 19 Early Blast, 1 x Grade 19 Expanded Blast) and Intralipid Therapy and Acupuncture

“Here's all you have to know about men and women: women are crazy, men are stupid. And the main reason women are crazy is that men are stupid.” - George Carlin

#5 KennyandFooty

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Posted 04 February 2012 - 10:45 PM

It's one of the reasons I'd like to better understand the numbers...because during my last IVF - which was ultimately cancelled after we had only 3 eggs retrieved (and many others that were luteinizing) - with zero fertilization (still don't know if those 3 were mature or not).

My E2 levels at my 2nd U/S (after 7 days of stims) was 5565 (with about 20 follicles between both ovaries) and by my next U/S (9 days of stims), my E2 had dropped to just over 5000 (U/S showed about 14 follicles). During my retrieval, the doctor retrieved about 8 eggs...but only 3 were "viable".

It seems I did not respond to the Orgalutran last time...and ovulated before the retrieval - - which ultimately resulted in my pregnancy (though the timing of everything still seems off to me since we abstained during the entire injection process and didn't resume until 4 days POST ER)! Anyways...I know now the drop in E2 SHOULD have been a red flag to whomever reviewed my files those days leading up to the retrieval (high follies - low E2 - never a great sign in the first place...nevermind the dip!)

After everything happened...it WAS suggested I may have an egg quality issue - but we're hoping it was just a poor response to the meds - and the eggs are fine (afterall...I did get pregnant despite it turning out ectopic). Maybe it's wishful thinking...but I feel that...now that I've started IVF #2...at least if I understand the E2 levels...I might be able to ask more questions before the cycle ends poorly again.

Thanks for any other information you can give. I know you're not a Doctor...but...your knowledge is priceless.

Me: 33 DH: 31
TTC 4+ years
Asthmatic - Bricanyl & Symbicort daily
Hydrosalpinges --> Bilateral Tubal removal


IVF#1 - September 2011 - Short protocol - Cancelled/Ectopic pregnancy; Tubal removal (October)
IVF#2 - March/April 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
FET#1 - July 2012 - Cancelled; zero survive thaw
IVF#3 - October/November 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
Hysteroscopy and Biopsy February 2013 - All results normal

FET#2 - BFP - March/April 2013 - EDD December 25, 2013

2 frosties waiting

January 1 - Our beautiful baby boy arrived after an emergency induction.  Completely in love! <3


#6 Laura1976

Laura1976
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  • 3356 posts
  • Gender:Female
  • Location:Winnipeg
  • Interests:I think right about now all I am interested in is getting PG and staying that way for 9 months!
  • Dx:Immunological
  • My Clinic:Heartland (IVF #1) VFC (IVF #2)

Posted 05 February 2012 - 09:42 AM

Do you remember at what point you had a lead follicle >20mm? Did you have one that reached that before your E2 dropped? Did you have a single/few follicles that were out front ahead of the other ones? What meds were you on last time.

From what I know the trigger shot helps with the last phase of maturation. If you had already ovulated before you received your shot I would think that the remaining eggs (since our bodies will typically only release one egg when ovulating naturally) would not have benefited from the final stage of maturation as your body would have been starting to absorb them. From what I know follicles that do not ovulate are absorbed. So based on that of course the eggs that they did manage to 'rescue' (IMO they didn't really do a retrieval they tried to cover their butts after they missed the boat) wouldn't have been the best quality they could be anymore.

I hope that makes sense...
ME 35 SO 32 TTC #1 since September 2008

See 'About me Page' for more cycle history

November 29/11 - Unexplained IF/Recurrent loss testing

Compliment C3 & C4 below acceptable range
LA Ratio DRVVT above acceptable range
Lupus Inhibitor demonstrated
Antiphospholipid IgG above acceptable range
Antiphospholipid IgM above acceptable range (more than double)


Consultation @ VFC December 10/11

IVF/ICSI #2 (with Intralipid therapy) January/February (Victoria Fertility Clinic)
BCP December 16 -29/11 & January 6 - 28/12
Vitamin D (2000iu daily) and Iron Supplement (Ferrous Gluconate 300mg daily) - Start December 24 until Dr advises otherwise, PregVit 5 (Starting January 12/11), Vitamin E (800iu daily) until Heparin begins (Starting January 14/11) Fish Oil (1200iu daily)
Superfact (0.5mg) - Start January 22/12
Dexamethasone (0.5mg) - Start February 4/12 until beta

After ER - Doxycycline (100mg), Estrance (2mg), Prometrium (200mg 3x day), heparin 5000 units (2x day), calcium (1500mg daily), low dose aspirin (81mg daily)
Intralipids - February 13/12 and day of ET
Neupogen Uterine Flush - Day of ER

February 2/12 - E2 35p/mol
February 4/12 - 300iu Gonal-F & 75iu Repronex
February 9/12 - U/S & E2 - RIGHT- 11, 9, 10, 19, 8, 12, 11, 10, 13, 6 LEFT: 12, 7, 10, 10, 8, 6, 5, 5 E2 2635

February 9/12 Gonal-F lowered to 225iu Repronex remains at 75iu
February 11/12 - U/S & E2 - Right 14, 10, 11, 12, 10, 13, 12, 12, 14, 7 LEFT: 11, 8, 10, 13, 9, 8, 8 E2 5610
February 13/12 - U/S an E2??? & Intralipid Therapy
February 16/12 - E/R 20 eggs, 17 mature and ICSI'ed, 3 left to fertilize by regular IVF
February 17/12 - Fert Report 16 fertilized by ICSI, 1 fertilized by IVF
February 20/12 - Neupogen injection
February 21/12 - Transferred 2 Blastocysts ( 1 x Grade 19 Early Blast, 1 x Grade 19 Expanded Blast) and Intralipid Therapy and Acupuncture

“Here's all you have to know about men and women: women are crazy, men are stupid. And the main reason women are crazy is that men are stupid.” - George Carlin

#7 KennyandFooty

KennyandFooty
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  • Dx:Tubal
  • My Clinic:McGill Reproductive

Posted 05 February 2012 - 10:23 AM

Do you remember at what point you had a lead follicle >20mm? Did you have one that reached that before your E2 dropped? Did you have a single/few follicles that were out front ahead of the other ones? What meds were you on last time.


My clinic triggers when the "lead" follicle is about 16-18mm. I have my history written up in "About Me" on my profile...but I remember having at least two follicles on the right that were nearly 18mm (maybe like 17.5+/-) and one on the left that was around 16. Both of those were measured though, the same day my E2 level came back and had dropped. The rest of the remaining follicles were 14 or smaller (lots smaller) at that last U/S before trigger. My lining was developing nicely...but the follicles were disappearing and the E2 was dropping. I was triggered the next day with 10,000IU of HCG.

The meds I was on were Repronex (7 days), Orgalutran (3 days) and the trigger. I tend to agree with you that there was some kind of "error" that occurred and since then it has been more of a "cover" than anything...but...when I had my follow-up...my doctor told me it was likely egg quality or my body's poor response to the meds that resulted in the poor ER. He said "the drugs are usually quite good".

I feel like...before we went through everything that followed...if whoever WAS monitoring my levels, etc. that day when the E2 OBVIOUSLY dropped...they either should have cancelled the cycle then...or when I asked the question, "Is this normal"? and was told "We like to see that number go up, but we work with what we've got"...there maybe should have been a heads up like...oh...your cycle might be shit now because we missed something! That'll never happen though! I just want to be able to recognize red flags this go around if they present themselves, in the event that someone misses something again!

Thanks for your feedback Laura! :) Means a lot to me!

Me: 33 DH: 31
TTC 4+ years
Asthmatic - Bricanyl & Symbicort daily
Hydrosalpinges --> Bilateral Tubal removal


IVF#1 - September 2011 - Short protocol - Cancelled/Ectopic pregnancy; Tubal removal (October)
IVF#2 - March/April 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
FET#1 - July 2012 - Cancelled; zero survive thaw
IVF#3 - October/November 2012 - Modified Microdose Flare Protocol - BFN - 3 frozen blasts
Hysteroscopy and Biopsy February 2013 - All results normal

FET#2 - BFP - March/April 2013 - EDD December 25, 2013

2 frosties waiting

January 1 - Our beautiful baby boy arrived after an emergency induction.  Completely in love! <3


#8 janaya825

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Posted 08 February 2012 - 03:02 PM

Is estrogen level the same as E2?

Me-42 DH-46TTC-4+ years-

Initially tried on our own and got pregnant but was an ectopic :(Jan 2010-HSG done and showed both tubes open.Feb 2010-Found a clinic called MCF (not Markham) that only did IUIs. Did 3 cycles with clomid and timed intercourse and 1 cycle with IUI. All BFN. Decided that we should go to a Mount Sinai based on a friend's recommendation.
Nov 2010-got in to see Dr at MS. Advised to try IUI with injectables.HSG with the dye came back 'inconclusive' but went a head based on previous test IUI in Feb 2011-BFN /IUI in May 2011-BFN. Decided I didnt like the vibe at MS and felt I was lost in the shuffle over there.
Researched on this forum and others and decided to get a referral to Dr. Virro in Markham April 2011 referral sent to Dr. Virro Nov 2011
Finally got in to see Dr. V Dec 2011-f/up on bw and u/sJan 5th 2012-
start BCP
CD1 Jan 31-2012 U/S on Feb 1-showed a cyst on my right ovary so no meds to start sad.png Feb 2-2012- Dr.V drained my cyst and able to start meds 150 pur/150 menp Feb 7-started Orgalutron Cycle almost cancelled due to not responding well to meds Feb 10-stims started working yay! Feb 19- ER-8 eggs retrieved! Feb 20-got call from lab for report on embies -1 fractured,2 fertilized incorrectly,1 didn't fert at all--other 4 we will have to see. FXd for them to be good quality Feb 21-got embie report 2 have matured and divided as they should. ET scheduled for Feb 23! Feb 23- out of the 4 we have decided to transfer 1 and have 2 more on ice. 1 didn't develop any further Feb 29-started to have crampsMarch 2- AF started sad.pngsad.png
March 8-Follow up with Dr.V FET planned for May 2012 April 30-called in my day 1 May 7- went in for b/wET-May 14 2012
May 25-BFN Waiting for WTH appt in early June

June 11-f/up with Dr. V and have decided to explore immune testingJuly 13- completed all b/w for ABC Aug 17- phone consult with ABC to discuss immune testing results Sept 6- Follow up with D.V to discuss treatment for high NK cells and low LADs. LIT and IVIG recommended Sept 13- first LIT Oct 4- 2nd LIT Oct 29- re-test of LADs and NKsNov 1- ABC cleared me to cycle
Nov 9- F/up with Dr. V- Going to do a natural frozen transfer.Nov 22-day 1/started calcium and lovenox Dec 1- blood work countinued until Dec 5 Dec 4-u/s for lining check Dec 9 -transfer scheduled Dec 21- Beta- positive but low Dec 24-2nd beta-rising (more than doubled) Dec 28- beta rising (# increasing well) Jan 4 2013-beta still rising but not as high as it should be Jan 9-u/s to check viability/rule out ectopic Jan 9-had u/s but couldn't see anything in tubes or uterus. Beta still rising steady. Dr thinks it is too early
Jan 10- had pain and bleeding. Decided to go to the hospital. Got checked out and it is an ectopic in right tube. Jan 11-24-Treated with Methotrexate 2x.Jan 25- emerg surgery to remove baby from tube. Ended up losing right tube sad.png Giving myself time physically/emotionally healing.
In May and June did my immune treatmentsJuly 2013- Fresh IVF cycle-a total of 8 eggs and transferred 1 great blast and 3 frozen. Ended in BFN after 6 days!  We are crushed!
Sept 2013- FET- transferred 2 great blasts and resulted in BFP!! Beta was 1262!
Ended in missed miscarriage on Nov 19,2013- CRUSHED!!!
D & C on Nov 20-going to take time to heal.
Feb 2014 met with Dr. V and he advised we should do PGS testing with a fresh cycle and include the 1 last frozen we have to be tested.
Went ahead with fresh cycle in July and had 5 blasts in total sent off to have PGS testing
Out of 5 only 2 were 'normal' and that included the one from the previous cycle that was frozen.
Did immune re-testing and only need IVIG
Sept 3- FET of 1 3BBO blast
Sept 15-BFP!!! Beta 390!!!
Oct 6-first U/S-everything looks good
Nov 19- 12 week U/S everything looks good smile.png
Jan 06-2015- 20 week scan and everything looks good!!!

 

 

6aFIm5.png


#9 Dr. Kimberly Liu

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Posted 10 February 2012 - 10:39 AM

Generally we expect about 700-1000 per follicle, as suggested above. If levels are lower than expected, it could mean not all of the follicles are good or have eggs inside of them.

Good luck,
Dr. Kim Liu





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