Can anyone help me understand Day 3 blood test results?

[SquillosMum]

I had FSH, LH and oestradiol tested on cycle day 3, results were:
FSH 6.4 iu/L
LH 3.2 iu/L
Oestradiol 135 pmol/L

My GP (who is not a fertility expert!) says that the FSH and LH are fine, but the range for Oestradiol should be 200 - 2000, so mine is very low. He didn't seem to know why this would be, given that the FSH and LH were fine.

Can anyone shed any light? We're due to see the fertility consultant in May for donor insemination treatment, but that seems ages to wait! I have already conceived using donor insemination with stimulated ovulation (have lovely 2 yr old DS).

Thanks.

Hi SquillosMum - I'm only a layman ... but just had a day 2/3 test - and I think you results are good!
Found this on the net... it may help:

"A day 3 FSH and/or Oestradial test is one which measures the hormones which occur on day 3 of a menstrual cycle. This should fall within certain parameters, and if the result is outside these parameters, then the diagnosis will be poor.

FSH is one of the most important hormones involved in the menstrual cycle, and the main hormone involved in producing eggs. If a test done shows an elevated level of FSH, even when the woman is relatively young, it shows that the body has entered premature menopause and would find it very difficult to conceive a baby.

'When a woman goes into menopause she is essentially running out of eggs in her ovaries. The brain senses that there is a low estrogen environment and more FSH is released from the pituitary gland in an attempt to stimulate the ovaries enough to produce a good follicle and estrogen.

By measuring a baseline FSH on day 3 of the cycle, one can often get an indication that the women is closer to menopause and has relatively less "ovarian reserve". Another way of saying this is that if the baseline FSH is elevated the ovarian reserve (how many eggs are left) is reduced and sometimes also the egg quality is reduced. In other words, an elevated FSH represents a reduced egg supply (in numbers of eggs remaining) and it might also reflect a compromise of egg quality.

A blood oestradiol level on day 3 of the menstrual cycle is a way to potentially discover some of those women with a normal day 3 FSH that may in fact have decreased egg quantity and quality. Ideally on day three there is a low FSH level in conjunction with a low oestradiol level. If the FSH is normal but the oestradiol level is elevated, the elevated oestradiol may be artificially suppressing the FSH level in to the normal range.

The idea of using day 3 oestradiol levels as an adjunct in evaluating egg quantity and quality is relatively new. Clearly defined cutoff values for normal and abnormal are not well defined and are also lab-dependent. There is not much data that suggests that an elevated day 3 oestradiol is a problem in itself. The problem is more so that it is potentially "masking" the detection of the poor ovarian reserve by suppressing an FSH level that would otherwise be elevated"

Thanks for that info, seems the GP knows too little to be of much use - good job I've already got an appt with a specialist!

My gp states that oestradiol below 100 would be too low. My consultant at fertility clinic states that below 180 would be normal and anything above that would be worrying...so two very different opinions.

Chocolatedays - can I just say that elevated FSH does not signify premature menopause. It signifies perimenopause which is the 10 years or so leading up to menopause.

I have had day 2 hormone levels and to this day I am still confused. FSH is elevated, last time it was 13.6, oestradial was 127 and lh was around 2.0. Although I know I am in the perimenopause stage of my life (and am only 38!) I have no idea how bad my situation is.

My consultant paints a bleak picture and my gp just says I am not menopausal.

I honestly beleive that although hormonal imbalances are a problem, the medical people have no real idea of how it affects reproduction. They say no chance of conceiving if high FSH but you hear of women having healthy babies with FSH of 40!

Don't let them fob you off squillosmum.

chocolatedays - what website did you get your information from. I would be interested to read that and find out how low is normal for oestradiol.

At my highest FSH my oestradial was 83 which I know is too low.

this is where I found the quote

BTW on my last day 2/3 bld test my results were FSH 5.1, Oestrodiol 44, LH 3.2. I think they are pretty good (I'm 37) - howver I didn't think the levels could be too low?? If I am wrong I'd really like to know!

have to admit, still don't get it chocolate days.

The higher my fsh, the lower my oestrogen level seems to go. I wonder why my gp states that oestradial should be over 100. BTW I have always had blood tests done on day 2

Can I ask what your consultants opinion was of your results. The website you directed me to does say that fsh and oestradial should be quite low but why do the medical opinions I have had say different.

I am going to have another day 2 done at beginning of next cycle to see what the state of play is now.

Hi Dizzy
I have seen you've posted on this - I'm interested in what replies you get, I feel a bit confused too now!

I have Zita West's book in front of me now. It says:
FSH (in mlU/ml)less than 6 is excellent, 6-8 good, 9-10 fair, 11-13 diminished reserve.
Oestradiol (in pg/ml) 25-75
LH ( in nlU/ml) less than 7

I also have these tested on day 2.

Are you on any other chat rooms (eg fertility friends .co.uk) as it may be more likely to answer the q's you have.

Try not to worry. When do you next see your consultant (rather than GP?).

I am having IVF v. soon and that is why I've had the recent bld test. The clinic were fine with the levels.

Diz - if you still want an answer it might be worth starting a thread specifically for Atillathemeercat. She is the guru of all things sciency to do with fertility / hormones etc.

I last saw my consultant last August when he told me to not bother with anymore treatment as my FSH was consistently over 12 each time tested....basically wrote me off! 'go and enjoy the one you've got' he said!

Although I am interested in medical opinion I don't think they should act like God and my consultant was, well either that or a psychic who could predict my future.

I admit my chances of conceiving are significantly reduced but its not impossible so I still have hope. I still ovulate every month which suggests that I still have an ok supply of eggs. the lack of conception does suggest that my egg quality may be reduced though which is a worry.

think I will put put out a thread for atillathemeerkat as she does seem to know whats shes talking about and explains things a lot better than the doctors

thanks chocolatedays