QuestionDear Dr. Ramirez,
Well I start my IVF cycle this month and i have been using BCP's since last month..
since my last recorded estradiol levels were very high (185) my RE has put me on a pretty high dose of lupron-5mg/ml as opposed to 50 microgram/0.2ml that i was supposed to take earlier. I will be using 20 units followed by 10 units 2 weeks before i actually start my cycle.
My IUI history shows that i have never had more than 1 or 2 eggs...do u think we are trying to maximize? I am worried about hyperstimulation as the kowest dose of clomid has caused me a blighted ovum..
also i was wondering if i would have more severe side effects than most women bcoz of the high dose (also i am very petite 5 feet and weigh less than 100 lbs)
AnswerDear Marusha,
Thank you for your question. My worry is that your ovary will be too suppressed. Lupron is a medication that suppressed the ovary. If too high a dose is given, the ovary will be suppressed and not respond well to the fertility medications to grow follicles. In that case your yield will be low or none. If the estradiol was elevated previously, it was for some reason. Usually, it is because of a corpus luteum cyst. This cyst is suppressed with birth control pills so we usually will just postpone the cycle until the cyst resolves and the estradiol returns to normal. Or if the patient is already on Lupron, then we just wait a little longer to start the fertility medications until the levels come down.
From your history, it doesn't sound like you would be at risk for hyperstimulation, but you won't know that for sure until you take the medications and see. In terms of side effects, most women don't have any problems with the fertility medications. The lupron, yes. Because it suppresses the natural hormones, some women do have side effects.
I hope this answers your questions.
Sincerely,
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
