Experience with high E2 Levels

Today I am on Day 9 of stimming.

My protocol has been:
.5 mg dexamethasone
75 iu menopur
0-150 iu Gonal F - changed based on E2 levels
5 iu Lupron

On day 4, my E2 levels were 219 (gonal f - 150). On day 7, my E2 levels were 1038 (gonal f - 75). On day 8, they were 1686 (gonal f - 37.5). And then today they decided to explode: 3791 (no gonal f). Needless to say, I am VERY concerned about OHSS. As of right now, I have about 20 measurable follicles all more or less the same size (12-15).

Anyone have any experience with high E2 levels? The nurse who called told me they are usually concerned when they get to be over 6000, which is a number mine are quickly approaching....

Re: Experience with high E2 Levels

mine were over 6000. we retrieved 18 eggs, all were mature. i def had mild OHSS symptoms after ER but they still allowed me to transfer. when i got my BFP, 2 days later the symptoms came back with a vengence and i gained 9lbs of fluid in about 48 hours. it sucked but i was so happy to have a BFP that i dealt with it. theres really nothing they can do for it unless its so bad that they drain the fluid.

sometimes to avoid OHSS they will trigger with lupron but since you are on it as part of your protocol you might not be able to. if you use HCG to trigger the chance of OHSS is higher. i would guess that your RE will coast you (no more stim) until the rest of the follies mature for ER. if you do develop OHSS post-ER they might freeze your embies and do an FET if the symptoms are too bad to transfer.

also, studies have shown that e2 over 5000 at transfer time has resulted in lower implantation rates. i still transferred 2 and both implanted, only one became a baby. the reason my symptoms were bad post-BFP were because both implanted. the more HCG = the worse the OHSS. how many are you planning on transferring?

Re: Experience with high E2 Levels

Thank you for the response!

I am planning on transferring 2 just in case. This morning I have another monitoring appointment so hopefully my levels have leveled off. I am keeping my fingers crossed. And yes, I am suppose to trigger with a HCG, which I have read may lead to OHSS. I guess at this point, there is nothing I can really do to prevent it. I plan on drinking fluids and trying to stay hydrated.

Re: Experience with high E2 Levels

You're still below the 6,000 and your follies are almost at the mature size. Remember, you'll trigger 36 hours before ER and your follies will continue to grow those 2 days. I think you're probably pretty close!