What do these results suggest may happen next?

[Minnie74]

Hi. Just looking for a little advice about test results. Not sure what to expect from my doctor. I'm 39 and have been ttc2 for 9 months. (Took 2 years for ds1) My cycles have been very irregular for the last two years (23-30 days and a couple of 14 days) so I have been having acupuncture which has resulted in two 26 day cycles.
I'm using a cbfm and have only had a peak ovulation day once in 6 months (after my 3rd session of acupuncture). Nothing this month.
Anyway I've just finished all the initial fertility tests and got the following results:
FSH 5.3
LH 4.7
Progesterone 56
Estrodial 212
The nurse who read me the results says all are fine just the estrodial is on the low side of normal.
The thing is the progesterone is from the fluky cycle I ovulated on the monitor while the rest are from this cycle with no ovulation. Does this skew results? Should they all be from the same cycle? Is the estrodial level critical?
Really sorry for this major post. Just getting fed up about the continual highs on the monitor and no peaks. Thanks in anticipation of anyone actually making it through this post of rambling! X

[Shellster52]

You are certainly not rambling at all. With my current predicament I could ramble away a lot more than that so I know how nice it is to get it off your chest.

I am in Australia and I think we use different units of measurement to England. Do you know what days of your cycle the tests were performed on and what unit of measurement they are measured in, as this makes a difference.

I am no expert so I quote from a fertility book written by Dr Sandra CABOT:
Test FSH on day 2 or 3 of cycle. Normal range 2-20 U/L. The ratio of FSH to LH should be close to 1:1.
Test oestradiol (E2) on day 2 or 3 of cycle. Normal range 100-200 pmol/L.
Test LH on day 2 or 3 of cycle. Normal range: Less than 7 U/L.

When your nurse says your E2 was on the low side, I assume then this is not a day 2 / 3 test? Again, I am no expert, so here is a tidbit I found on the net about estrogen levels and egg quality:

Get estrogen blood test just before ovulation. Peak estradiol is between 500 and 1000 pmol/litre per healthy follicle. When cycle monitoring, ask your clinical team what your peak estrogen was: bigger numbers are better. If the level is towards 500 (or lower) per mature follicle, then egg quality may be a concern.
www.fertility.ca/2008/06/how-your-menstrual-cycle-reflects-your-egg-quality/.

I suppose you could look all this info up for yourself if you want with good old Dr Google, so I am sorry to quote you a bunch of statistics if this is not what you are after, but rather just want to vent.

I too am no spring chicken and am about to embark on a 4th IVF cycle, so I know the frustration. Time gets away from us doesn't it. You don't expect it to take so long to conceive number one and then by the time you go through pregnany and breastfeeding, our time is just about up and number two doesn't happen as easily as we would like.

So you are starting with medical assistance. What is your next step from here?

[Minnie74]

Thanks for the reply Shellster52 the estrogen test was a day 3 test so I'm not sure the level being low then is a problem having done a bit more dr googling! Im not sure what they were measured in but the range she gave as normal was 200-2000! so 212 is pretty low. It's just so frustrating that the cycle they checked progesterone was the one time I actually ovulated when I'm 99% sure I haven't any other month!
I'm going back to my doctors in a week to discuss the results and hopefully be given some advice other than keep having regular sex! I hate being back in this POS cycle. The cbfm worked first time last time and I sort of assumed it would again. Clearly not as we're now on the 6th month of it.
I wondered about Angus castus to help ovulation.
Good luck with your next ivf cycle that must be a pretty stressful time for you. Fingers crossed.
X

[AttilaTheMeerkat]

Do not use Agnus Castus as this can make some underlying hormonal problems worse. If you did want to use something like this (and I suggest you do not initially) then I would seek the advice of a properly qualified medical herbalist beforehand.

You need a diagnosis first and foremost and both of you should be under the care of a gynae at a subfertility unit. Your man should be tested as well, subfertility is not the sole preserve of the woman. I'd be asking now for a referral to such a person.

[Minnie74]

Thanks attilathemeerkat I guess I'm just floundering around at the moment. I'm hoping to get a referral when I see my own doctor again in a couple of weeks.
On the partner side he's being an arse about getting tested. We don't have the same doctor so he has to go to his surgery and ask for tests which he keeps 'forgetting' to do. It's beginning to cause arguments as I hardly enjoyed the tests I've had. He just seems to think that it's bound to be me as the cbfm hasn't being picking up any ovulation. Men!!!!

[Shellster52]

Mmm, that all sounds a bit weird that the normal estrogen range is 200 - 2000! And as you say, low is normal at the start of a cycle as you don't have a growing follicle producing estrogen. Mine was high on day 2-3 for a few cycles when I had a large follicle that hadn't ruptured from the previous cycle (it was after IVF and my hormones were out of whack).

Must be frustrating that they classified you as fine when you are sure that you don't usually ovulate and had the prog test in the one cycle where you did! I hope your doctor doesn't fob you off and give you the 'keep having sex' line.

You are very reassuring to me that I am not alone when it comes to our men! My husband had the sperm test done (much to his disgust) and it came back at 100% abnormal. So I am going through the drama of IVF and all the drugs I am injecting into myself without putting any blame on him. But then he has the nerve to tell me the reason it all isn't working is because I am thinking about it! Like he is in denial about his sperm.

[Minnie74]

Argh men *shellster52'! It's never their problem is it?! My dh has finally booked a gp appointment for next thurs. What will become of that we will see.
Good luck with the IVF xx