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Saturday, November 20, 2010

As Expected

Negative.

HCG < 5 (didn't leave the exact value)
E2: 25
P4: 15.3

Values 3 days post transfer:
E2: 360
P4: 47.6

How did my P4 go from 47.6 all the way down to 15? I was taking at least 800mg/day which is a LOT of P4!!

Also, my estrogen went from 360 to 26!? It looks to me as though my numbers all plummeted.

WTF?

They left the message on my blackberry as the battery had died (I didn't think to look) and left the numbers.

Ideas:
Bad suppository batch (inconsistently made)
I just can't absorb it all vaginally
It leaked out most of the time

Not sure what else explains it all.

Do some women just not absorb it or what?

I would love to retest my numbers. I think I have a "open lab slip" somewhere. I think I'll see if I can find a quest labs to knock one out today while I'm still on my progesterone.

Please...any and all ideas about this?

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Comments on "As Expected"

 

Blogger Mad Hatter said ... (4:25 PM) : 

Oh Linda, I'm so sorry. I know you said you expected it, but I was so hoping for you.
I wish I had something to offer on the estrogen and progesterone levels - I don't know what mine were or even what they are supposed to be at each point in the process...perhaps I should know these things!
Thinking of you - do something very kind for yourself and go squeeze those kittycats...
Love,
Maddy

 

Anonymous Anonymous said ... (4:26 PM) : 

Linda, I am so sorry.

What kind of P4 were you taking? I had no problems with P4 on Endometrin. The others have not done as well for me.

I'm wondering of some E2 support might be helpful in the future. My clinic tested my E2 a few days after transfer and when it was around 200 they immediately had me on estrace and the vivelle patch. They said that they wanted to see it over 1000 as that is optimal to sustain a pregnancy.

 

Blogger linda said ... (6:05 PM) : 

@Anonymous:

I was on 400mg of progesterone suppositories twice a day. So 800mg/day in all, though I probably really did close to 1000mg as I had a few smaller capsules that I'd add in when I felt that I may have lost a bit.

1000 for estrogen? Seriously? That's quite high compared to my values. I will ask Dr. Czech to see what he thinks. (I'm inclined to agree with you though!!)

@Maddy: I updated some old posts today that didn't have tags and I think that you noticed (tho no one else seemed to!). I hope that wasn't confusing!! :-))

 

Blogger IVF 40+ said ... (7:29 PM) : 

Sorry to hear you got a BFN. Hope you have something non ivf related planned to look forward to.

 

Blogger linda said ... (8:02 PM) : 

@IVF 40+:
I just posted an ad for a gestational surrogate and then cracked an ridiculously expensive red. I can't tell you how much I've been looking forward to a glass of wine if and when the BFN came through.

I'm feeling more confused than anything. I thought that maybe the progesterone and estrogen nosediving meant something, but Dr. Czech's co-doc said that it's pretty typical to see P4 dip when implantation doesn't happen. I don't know if I believe it.

I spent a few hours cleaning up blog posts that were missing tags, re-reading old posts, and saw that 9 cycles ago I had the same mid 2WW cramps that made me think I had implantation.

They've followed me through nearly every single cycle without fail.

If they're not from the P4, then what?

I'm at such a loss. I hope that finding a GS is the answer as I'm out of ideas.

 

Anonymous Anonymous said ... (9:41 PM) : 

Linda, I think a gestational surrogate is a marvelous idea and may be just what you need.

Yeah, it does seem like a ton of E2! That was my reaction. I took estrace 2mg 3 times a day and had one Vivelle patch which I changed every three days. That sure did it. My E2 was never below 1400 after that.

I don't understand the rationale, but that cycle was the first time I had made it past a chemical pg and now have a second tri pg. I have some anecdotal evidence that women who aren't monitored for E2 more frequently have chemicals, but again, just my observation.

Good luck!

 

Blogger linda said ... (9:48 PM) : 

Dear Anon,

How much was your vivelle patch? After I freeze my next batch of embryos, I may try a "tweaked" protocol. Of course, one that I make myself. :)

Can you please tell me how much P4 and type and also the vivelle amount? When you were taking 2mg of E2, was it EE2 (estinyl estradiol) that you were taking orally? If yes, I've got a bunch of that just laying about. I was actually on it before ER but they took me off of it after that point.

When did you start E2 and P4?

Thanks so much for sharing your information!

And CONGRATS to you for getting a BFP!! :)

 

Blogger Mad Hatter said ... (1:51 PM) : 

Okay, Linda, so I checked on what my levels were when I had my beta, which was techinically 18dpo and 9 days post HCG booster. I was supposed to be taking progesterone 3x/day, but in the last few days only took one or two...I was not taking any estrogen post-ovulation.

My progesterone was higher than 30 nMol/L, which my doctor says was suggestive of good ovulation and my estrogen was in the mid-400s, which my doctor says "we like to see".

I don't know if the expectations around these values are different for IVF versus timed intercourse, but the next time I do a monitored cycle, I'm definitely going to ask about the E2 over 1000 thing. Please let us know what your clinic says, too.

Love,
Maddy

 

Blogger linda said ... (2:28 PM) : 

@Maddy,

Wow, so your P4 and E2 values were much higher than mine. How much P4 did each dose have for you?

Your P4 was twice mine, and your E2 was 1600% higher than mine.

I'm starting to really wonder why no one at my clinic was alarmed about my values?

Thanks for sharing for me.

I am going to go through each of my cycles and chart out when in the 2WW I had cramps, P4 dosages, and such. I think there's a serious pattern to my cramps but I need to prove it graphically.

Love
Linda

 

Anonymous Anonymous said ... (7:59 PM) : 

Linda, I sure wish I had that info for you. They took me off P4 and E2 at 13 weeks and I recycled the containers. I used the Vivelle patch that comes in a small purple box and I'm pretty sure it was estinyl Estradiol which I took 3 times a day at 2mg. For P4 I used 100mg of Endometrin, 3 times a day. It worked well.

When my E2 came back at 200 a few days after transfer (day 8?) they were adamant that I get on E2 support immediately. The clinic had me put on a patch and pop an E2 immediately. The estrogen support products had actually come in my IVF meds box so this must be pretty common at the practice.

 

Blogger linda said ... (8:06 PM) : 

Hi Anon,

Yeah I know that purple box. :) I have the EE2 (estinyl estradiol) here at home. I wonder why they didn't have me take it.

One thing I REALLY DISLIKE about this clinic is that they don't print out a paper calendar for patients. And so there is nothing to reference when you have a late night question and start to panic. Everything is conveyed via a phone call. I am going to demand a calendar next time. If I find out that I was supposed to stay on the EE2 the entire time I will freak out and ask them to refund my cycle. They gave me a bottle with 40 capsules of EE2 and I only used about 10 for this cycle. That worries me a bit: why give me so much for a cycle?

Can I ask which clinic you cycled at? I am curious as to whether I can find anything about their protocols and reasoning online. I just asked Dr. Sher over at SIRM what he thought about my values and whether he would suggest estrogen support. PFC gave me vivelle patches for IVF3, and SIRM NYC gave me suppositories that had P4/EE2 in them. That's it though.

 

Blogger Adele said ... (9:59 PM) : 

Linda, I'm just realizing that the comment I made didn't go up:( Not sure what happened.

I'm really sorry about the negative. REALLY sorry. I don't know about the absorption question but I'd be curious to know. No advice. No suggestions. Just sending you big
hugs.

 

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