Does anyone have ideas about this protocol?

Does anyone have ideas about this protocol?

SillyPuppy
SillyPuppy

March 20th, 2012, 12:24 pm #1

Hi there.

I am very new to this experience and I wonder what my doctor has in store for me.

I had the pharmacy call me with information about the prescription for a stimming cycle and these are the medications:

femara 2.5 mg

prometrium 200mg

menopur 75 unit vials (injectible) 20 vials

HCG 10,000 units (trigger)

I have not gotten my flow sheet and I have an appt with the RE to discuss all of this next week.

Can anyone tell me what they could imagine this protocol is for stimulation? (high stim, low stim, total waste of time stim, what is she thinking stim?)

I am not doing IVF but will be doing IUI (because RE says it will put sperm closer to cervix if nothing else) I feel like I am flying blind a little bit.

FWIW I am newly 45, TTC 2 mos (in 2WW of month 2) Just had a hysteroscopy with a two tiny (total size 1 cm) uterine polyps removed and my cycle continued as it does with ovulation etc. I still ovulate and have 27 day cycles.

I have a CD 1 FSH of 10.5 and and CD3 of 13 and an AMH of .55 . My AFC is 8 and my LH is 3.9 My estradiol is really low and that is bugging me a lot but it doesn't seem to bother my RE. She measured it at CD1 at 21 and my ob measured it at 12 on cd3. Testosterone is 35 and that seems low too. My TSH numbers are all fine.

I have no real symptoms that would correlate with these low estradiol numbers. Nothing.

Also, my RE said that she questioned the test of estradiol given by my ob as she said by her lab values those levels are not even measurable and invalid? Her lab is part of a teaching university hospital so I imagine it is a better source of lab values but still have NO idea what she means.

Any thoughts you all can share would be so great. Sorry for the book I have written above^

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Joined: April 19th, 2004, 2:36 am

March 22nd, 2012, 3:03 pm #2

Femara isn't as commonly used, but there have been a few ladies on here in the past who used it, usually with good results. But with the number of vials of menopur, I'm assuming she is planning on 75-150 IU per day, which is low stim. But that is just a guess based on the number of vials that she ordered.

As far as the RE questioning the other lab's E2 test, different labs have different lower limit levels that they test. I know Cooper will go down to 10, my local teaching hospital only goes down to 20, and the LabCorp goes down to 5. So, she is wrong that the level isn't measurable at 12. That's acutally a little ignorant (I think) on her part. Now as to whether the OB's lab is good, that is an unknown. She may know that the OB's lab isn't that accurate. But for her to say that levels that low aren't measurable is just wrong.

If the OB's lab is okay, I would ordinarily be a little concerned that your E2 is dipping from CD1 to CD3 to such a low level. BUT, since you are ovulating regularly, I wouldn't worry about it. As long as your body responds to your own FSH and produces estrogen and ovulates, it really isn't something to worry about.
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Joined: April 19th, 2004, 2:36 am

March 22nd, 2012, 3:03 pm #3

Hi there.

I am very new to this experience and I wonder what my doctor has in store for me.

I had the pharmacy call me with information about the prescription for a stimming cycle and these are the medications:

femara 2.5 mg

prometrium 200mg

menopur 75 unit vials (injectible) 20 vials

HCG 10,000 units (trigger)

I have not gotten my flow sheet and I have an appt with the RE to discuss all of this next week.

Can anyone tell me what they could imagine this protocol is for stimulation? (high stim, low stim, total waste of time stim, what is she thinking stim?)

I am not doing IVF but will be doing IUI (because RE says it will put sperm closer to cervix if nothing else) I feel like I am flying blind a little bit.

FWIW I am newly 45, TTC 2 mos (in 2WW of month 2) Just had a hysteroscopy with a two tiny (total size 1 cm) uterine polyps removed and my cycle continued as it does with ovulation etc. I still ovulate and have 27 day cycles.

I have a CD 1 FSH of 10.5 and and CD3 of 13 and an AMH of .55 . My AFC is 8 and my LH is 3.9 My estradiol is really low and that is bugging me a lot but it doesn't seem to bother my RE. She measured it at CD1 at 21 and my ob measured it at 12 on cd3. Testosterone is 35 and that seems low too. My TSH numbers are all fine.

I have no real symptoms that would correlate with these low estradiol numbers. Nothing.

Also, my RE said that she questioned the test of estradiol given by my ob as she said by her lab values those levels are not even measurable and invalid? Her lab is part of a teaching university hospital so I imagine it is a better source of lab values but still have NO idea what she means.

Any thoughts you all can share would be so great. Sorry for the book I have written above^
-
Last edited by krgh on March 22nd, 2012, 3:04 pm, edited 1 time in total.
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SillyPuppy
SillyPuppy

March 22nd, 2012, 3:32 pm #4

Femara isn't as commonly used, but there have been a few ladies on here in the past who used it, usually with good results. But with the number of vials of menopur, I'm assuming she is planning on 75-150 IU per day, which is low stim. But that is just a guess based on the number of vials that she ordered.

As far as the RE questioning the other lab's E2 test, different labs have different lower limit levels that they test. I know Cooper will go down to 10, my local teaching hospital only goes down to 20, and the LabCorp goes down to 5. So, she is wrong that the level isn't measurable at 12. That's acutally a little ignorant (I think) on her part. Now as to whether the OB's lab is good, that is an unknown. She may know that the OB's lab isn't that accurate. But for her to say that levels that low aren't measurable is just wrong.

If the OB's lab is okay, I would ordinarily be a little concerned that your E2 is dipping from CD1 to CD3 to such a low level. BUT, since you are ovulating regularly, I wouldn't worry about it. As long as your body responds to your own FSH and produces estrogen and ovulates, it really isn't something to worry about.
Hey there

Thanks SO much for answering. I think I need to call the actual lab that did the testing. They can probably tell me what their ranges are and then when I see the next RE I can explain the standards. And yes that is kind of ignorant for someone at a major teaching hospital.

As for the low estrogen, this is my second month of temping and using a Clear Blue Fertility Monitor. So far I am terrible at temping as I am (and have always been a light sleeper) so I do the best I can to consistently temp but so far it shows the temp dipping and rise that would indicate ovulation and the pattern after two mos is fairly consistent.

The Clear Blue Fertility Monitor coupled with cross checking using the Clear Blue Digital tests are what I am REALLY counting on for checking. So far they both show ovulation. I have had high days (4 and then the peak two months in a row now) You use first morning urine with the monitor and afternoon urine with the digital tests and those too have shown the surge. Of course they say with a surge you don't necessarily have to ovulate.

I guess I could asks for further bloodwork to confirm that O occurred but I am really not sure how the RE would feel about it? Why should I care? I am paying for it. I am going to probably do testing on my own to check to be sure.

I REALLY appreciate your feedback.

I have NO symptoms of low estradiol otherwise to indicate that I am menopausal. Nothing.
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