Thursday, November 5, 2009

Day 34 - Questions Answered

OK, so since I left the doctor's yesterday without all the knowledge I'd hoped to acquire, I came home and started in on some research. Then this morning I called one of my IVF nurses (since obviously my doctor is WAY to busy to speak with me) to make sure that the info I found online was correct and to get the results from my blood work yesterday. (I told you I was serious about knowing what all this stuff means! So here goes...hope it isn't too tedious for you!)

The hormones they were measuring yesterday was E2(estrogen/estradiol) and LH (luteinizing hormone). My results were good. (E2:42 & LH: 1.5). Here's what that means....

What is E2?
Estradiol (or estrogen) is a hormone that stimulates the lining of the uterus, causing the lining to grow, and to make itself ready for embryo arrival. (This is not estradiol's only function, but for me, it's the important one). When I begin the stimulation injections my developing follicles (eggs) will contain 'granulosa cells'. These granulosa cells make estradiol and release it into my blood stream. That means that more follicles produce more estradiol. This helps measure how many follicles will be actively developing. As they develop, the level of E2 continues to rise. This rise can further indicate when the follicles are reaching their maturity. (It can also indicate if there is a risk of OHSS, Ovarian Hyperstimulation Syndrome. OHSS can be very painful, and in rare cases, be life threatening, but for now I'm at NO RISK at all since I'm down-regulated....more on this later when my levels start to rise when I'm using the stims. Just keep in mind that levels of 4000 are considered dangerous. In my last cycle I topped out at only 1500, so my doc doesn't think that I need to be concerned about it. But with different drugs anything is possible so that's why they will keep my E2 levels closely monitored throughout. I'm in good hands, even if he is super busy.)

In down-regulation (which is where I am now from the Lupron) my doctor expects low levels of estradiol: below 60 pg/ml. (If levels are not this low, this suggests that my ovaries are not yet suppressed, and that the down-regulation should continue a little longer, until they actually are suppressed.) I am at 42, so that is considered "quiet ovaries" and ready to roll with the soon as I'm taken off "hold"! That's tomorrow, so it's all good!!

What is LH?
Luteinizing hormone levels can predict when ovulation is about to occur. In IVF you really DON'T want to ovulate because then you will loose all the eggs you've just grown and you wont have any left to work with in the lab. (After all, Ben and I are doing IVF because my eggs and his sperm are incapable of joining on their own, so loosing the eggs would be really bad!) When LH is between 9 and 10 that's when spontaneous ovulation can occur. My level is 1.5 now, so we have worries at this point.

The main goal of this, and all IVF treatments, is to grow as many mature, healthy eggs as possible (monitoring them each step of the way) and then harvest them just prior to natural ovulation so they can be fertilized in a petri dish in the lab. Sounds pretty simple right??

Thank goodness for this medical advancement and my busy doctor because we would not be able to have our own baby (our genetics) without this science and his incredible skill.

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