QuestionHello and regards from Australia, I hope you can bring some light to my puzzled mind.
I am 37 y.o., no medication, and planning to concieve my first child. I have been suffering from constant fatigue, brain fog, poor vision perception, depression, delayed carcadian phase dissorder, headaches,low BBTs, very low self-esteem and non existent libido (just to name a few )for the past 6 months now. I also found out that i have heavy metal esp.copper overload and my gynecologist told me that I have fibroid. My serum TSH is normal. I was suspecting estrogen dominance. Well did not I get a big surprise when the results of my saliva hormone test came back. My estrogen levels are so low that even post menopausal women would be concerned!...estradiol 1pmol/L (ref.range 6-14) On the other hand my progesterone levels are fine or better to say P4:E2 ratio is 473:1 (ref.range 200-300:1). I am very confused, because I thought that low estrogen is associated with menopause where no more folicles exist to mature, leading to anovulation (therefore low levels of progesterone)... Until now I have been charting my BBT and except that my BBT seemed to be slightly lower in follicular phase ( 35,9 - 36,2 degrees celsius)I seemed to ovulate (beautiful temperature rise to up to 36,5 degree celsius)and my luteal phase lasted up to 14 days. My cycles may vary from 29 to 33 days in length. I thought my problems to concieve may be due to insufficient levels of progesterone. Please could you explain to me what this low estrogen in my case mean? Have I been ovulating or not? Will I ever concieve? Or am I menopausal? By the way yes it is true I have not been able to monitor my cervical mucus very well ( I always been on the dry side girl) and saliva fertility microscope never showed much of ferning either. I have not been able to find any relative information on the internet, so I will really really appreciate your explanation and advice if possible. Thank you for your help in advance. Regards Adriana
AnswerHello,
Some of what you are describing does not jive. If you have normal ovulatory cycles, your estrogen levels should be in the normal range. That would make me suspicious of the saliva test result. I think I would start by checking a cycle day #2 hormone panel blood test. That is the test should check for Estradiol, FSH, LH, Prolactin, TSH on the second or third day of your menstrual cycle. That will tell you what your baseline is and whether your ovaries are functioning correctly. If not, then the reason will have to be determined so that the appropriate treatment can be applied.
One obstacle that you have is your age. Your fertility is significantly decreased due to decreased egg quality as a result of your age. I would recommend that you no longer waste time and go see a fertility specialist. They could determine the proper and quickest course of treatment for you to achieve pregnancy. If you do that, I am confident that you can achieve pregnancy. This year, in our program, we have been achieving an almost 70% pregnancy rate with IVF in your age group.(your natural chances of conceiving are 15% per year).
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
