Suggest Remedy For Dropping E2 Levels When Having PCOS

Posted on Sat, 17 Jan 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 17 Jan 2015 Answered on

Mon, 16 Feb 2015 Last reviewed on

Question : I have pcos and have just had my first ivf cycle cancelled cause my E2 level dropped from 8600 to 4900 overnight. I was on 150 menopur for 5 nites then it was decreased to 75 and them e2 dropped. What could be the cause I am so worried. I am 32

Answered by Dr. Manisha Jain (37 minutes later)

Brief Answer:
GnRH agonist in next cycle

Detailed Answer:
Hello dear, I understand your anxiety.
E2 levels declined after decreasing the dose of FSH, suggests that the follicular growth ceased and thus they became atretic without releasing the eggs.
It is less common but a known entity in patients with PCOD.
In my opinion you will need GnRH agonist protocol in your next IVF cycle along with ovulation induction.
In case you have any questions I will be happy to help.
Regards
Dr Manisha

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (4 minutes later)

Thank u doctor. Whats involved in the GnRH agonist protocol? What will happen all the follicles i had growing this cycle, will they reabsorb? When should i be able start ivf again? Any questions u think i should have ready for my Re?? Thank you

Answered by Dr. Manisha Jain (6 minutes later)

Brief Answer:
wait for 1 month

Detailed Answer:
Welcome dear.
Agonist protocol is started on day 21of the cycle and then FSH is given for ovulation induction in next cycle so that there are good hormones in body and also removes unwanted hormones from acting during the growth phase of follicles.
You need to take rest for another month and then start a fresh cycle.
The follicles of this cycle will be reabsorbed and won't be of any problem in future.
Hope for the best.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Jain (9 minutes later)

Thank u doctor. Seen as i dont get my period ever should i ask the clinic about taking something to bring it on? Is it common with pcos to have the first cycle cancelled? Is the first cycle really a trial run or will i ever have a baby. Im so sad right now

Answered by Dr. Manisha Jain (7 hours later)

Brief Answer:
tablet duphaston advised

Detailed Answer:
I understand the sadness part.
It is not common for first cycle to be canceled in PCOD at all.
The cycle was never a trial run and thus it was just a mere bad luck playing its part.
You need to be prepared for your next cycle which will be more customized for your body due to the better assessment of dose and type of protocols needed for your induction (from the experience gained from previous cancelled cycle).
At times things happen for your own good only in the long run and this canceled cycle will most likely give your doctor a better insight and thus help him to give you better results.
Don't feel disheartened and god will definitely bless you with a healthy baby soon.
As per periods are concerned you will get them once you will leave progesterone (given after embryo transfer).
For next cycle take tablet duphaston 10 mg twice a day from day 16-25 of cycle (for ten days)
And after leaving it you will get your periods.
Take duphaston in every cycle till you are ready mentally for next cycle.
All the best.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar