OB GYN

Ob-Gyn questions? Ask a gynecologist online.

Ask a Doctor,
Get an Answer ASAP!

OB GYN

I'm currently doing an agonist IVF cycle. After 9 days of

Customer Question
stims (300IU Gonal F +...
I'm currently doing an agonist IVF cycle. After 9 days of stims (300IU Gonal F + Synarel Spray twice a day) a scan on Friday revealed 5 follicles 13-15mm and Oestrogen 500 pmol/L (approx 1360 pg/ml). A further scan & blood test 3 days later on the Monday (after 12 days stims) showed follicles: [email protected], [email protected], [email protected] and [email protected], Oestrogen was 10,740 pmol/L (approx 2925pg/ml) Progesterone 4.2 nmol/L & LH 1.7 iu/L. I was triggered with Ovidrel (half of a 250mcg syringe) on that Monday evening (I took no more Synarel or Gonal F that day). I had an egg retrieval 36 hours later on Wednesday and got 6 mature eggs, 4 of which fertilised normally by ICSI. My primary concern is that I felt the effects of progesterone (tender breasts/headcahes/mood changes/slight temp increase) creeping in on the Saturday/Sunday prior to my trigger on Monday night and am worried I triggered a bit too late and that the rise in progesterone reflects this? What causes the rise, I thought it only rose AFTER ovulation? There seems to be an awful lot of articles about how elevated progesterone levels on trigger day can be detrimental to final IVF outcome and also affect endometrial receptivity causing it to become out of sync. I think I should have been triggered on Sunday due to my v high Oestrogen level and that Progesterone had started to rise (Oestrogen was over 10,000pmol/L on morning of trigger day which seemed very high for only 6 mature eggs? Also Progesterone at trigger day at 4.2 nmol/L seems high? I would have expected not to feel the effects of progesterone - i almost felt how I feel at a normal ovulation/one day after, but I still hadn't taken the trigger at that point so it seemed odd to me. I'd like to know if the elevated progesterone is a concern and whether I should contemplate freezing any embryos and transferring in a natural cycle instead, also thoughts as to whether you think the oestrogen level was too high for 6 mature eggs and I should've triggered a day earlier (Sun) and whether the endometrium will have been affected by this rise in progesterone prior to trigger and hence endometrial receptivity and pregnancy rate affected. I'd really appreciate someone's feedback as I didn't get the opportunity to speak to my doctor properly. Thank you for your time.
Submitted: 1 year ago.Category: OB GYN
Show More
Show Less
Ask Your Own OB GYN Question
Answered in 11 minutes by:
7/14/2016
OB GYN Doctor: Dr. SH, Doctor replied 1 year ago
Dr. SH
Dr. SH, Doctor
Category: OB GYN
Satisfied Customers: 8,789
Experience: Board Certified MD
Verified

Thank you for your question.

The most important thing to consider when a lady is having the IVF procedure is to see whether she is having mature eggs that can be used for excellent fertilization to happen with ICSI, which I think has happened in your case.

The symptoms that you mention i.e. tender breasts, headaches and mood changes are nonspecific changes and can happen very commonly in any lady who is undergoing treatment for IVF or going through the process.

Actually, you cannot compare normal fertility process with an artificial fertility process like IVF. Hormone levels can go up. Progesterone going up or being high does not at all indicate that you would be having reduced chances of fertility or anything.

I think that you should be okay and your endometrium should be as receptive as any lady who is having IVF.

I can also tell you this from my personal experience as well, as my wife had IVF and was blessed with twins, a boy and a girl.

Her hormone levels were also like yours.

So I would not worry whatsoever.

Let me know if you have more questions.

Please submit a rating when you are done.

Kindest regards

Ask Your Own OB GYN Question
OB GYN Doctor: Dr. SH, Doctor replied 1 year ago

I have referred your next question to a fertility expert who may take sometime to respond.

I would appreciate a rating on this thread, if that is okay with you.

Kindest regards

Ask Your Own OB GYN Question
OB GYN Doctor: Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered. replied 1 year ago
Dr Chaithanya
Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered.
Category: OB GYN
Satisfied Customers: 798
Experience: General Physician, Family medicine, Internal medicine, all age groups.
Verified

Hello

I'm Dr Chaithanya attending you

Thanks for requesting a new expert

I'm typing your answer[please wait]

Ask Your Own OB GYN Question
OB GYN Doctor: Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered. replied 1 year ago

Thanks for waiting

I have seen similar cases

Progesterone and Estrogen levels slightly fluctuation doesn't really matter much

Though there can be lot of internal factors playing and it is all individual variations how the body perceives to hormones at the receptor level

So, don't get worried

You will have high chances of positive results if everything goes well, irrespective of slight hormonal fluctuations

Hope this helps

Please leave a positive rating at the top right corner of the page, the only way we experts are compensated for answering you

Follow up questions can be asked even after the positive rating

You can get back to me any time here, http://www.justanswer.com/medical/expert-dr-chaithanya/

Any bonus is welcome and appreciated

Best Regards

Dr Chaithanya

Ask Your Own OB GYN Question
Customer reply replied 1 year ago
Are you a specific fertility expert? I've already had to pay to receive a vague response to my question and you have replied very quickly and it covered all my points. I requested last time that I'd prefer to have an experienced fertility specialist answer my question who can specifically refer to IVF results from my many patients. Thank you.
OB GYN Doctor: Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered. replied 1 year ago

Yes, I have worked very closely with IVF treatments.

What is your specific question bothering you? please ask

Ask Your Own OB GYN Question
OB GYN Doctor: Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered. replied 1 year ago

Also, request to leave a positive rating. Any follow up questions can be asked after the rating

Ask Your Own OB GYN Question
Customer reply replied 1 year ago
Your answer is a bit too generic for what I was asking as I covered a lot in my question. I would ideally like to hear a fertiflity expert's thoughts on the issue of potential premature leutinisation/at what level of progesterone that can be seen to kick in at/what ng/ml of progesterone points to premature leutinisation/if my particular elevated level of progesterone is of a concern as some trials have indicated a level of over 0.8ng/ml can be too high. There is a huge amount about this online and I'd like an expert's view if possible. I'd be also interested to hear an expert's thoughts on whether retrieving slightly early than normal may help IVF success rate in women over 40 as I believe some new research last year has perhaps shown this due to the existence of increased progesterone which can be detrimental to the egg's granulosa cells, by retrieving eggs earlier this can potentially be avoided. So I was looking for feedback on my individual circumstances - your thoughts on my trigger day, if it was a little too late & thoughts on my individual results, not just a generic answer if possible. This site seems to be vague and a great rush shown in you wanting a rating so you get paid, but I need more detailed answers and am only too happy to pay when I feel an expert with in depth knowledge of IVF answers at a level of detail. Thanks
OB GYN Doctor: Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered. replied 1 year ago

I really understand your concern

I'm a medical researcher as well

The answer what I have given is based on overall view that I got from seeing success and failure rates of different individuals who have undergone IVF

Now, as you want to have a specific answer, let me work out on it with your case, and based on your levels

This takes little time

I'm a medical researcher from 10 years, and I ahve access to various journals as well

Let me work out on it

Would you mind accepting a premium offer for medical research, it takes 1 to 2 hrs work for me

Thanks.

Ask Your Own OB GYN Question
Customer reply replied 1 year ago
I'm sorry I don't think this is for me, I either feel pushed into quickly rating a response so a doctor gets paid or pushed into paying even more for research which I don't even believe would be helpful for me. Seeing as there seems to be no attempt at any answers to any of my particular questions from 2 doctors who have replied so far, I'd rather leave it there thank you as the site is giving me what I hoped for. Thank you for your time.
OB GYN Doctor: Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered. replied 1 year ago

Ok, Please leave a positive rating at the top right corner, for the time I spent here. That is fine if you don't want to accept premium service offer. Only that way my answer counts here. Thanks a lot! Good luck to you!

Ask Your Own OB GYN Question
Ask Dr Chaithanya Your Own Question
Dr Chaithanya
Dr Chaithanya
Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered.
Category: OB GYN
Satisfied Customers: 798
798 Satisfied Customers
Experience: General Physician, Family medicine, Internal medicine, all age groups.

Dr Chaithanya is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me.

Susan O.USA

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

< Previous | Next >

Meet the Experts:

Dr. C.

Dr. C.

Board Certified

2,537 satisfied customers

30 years of experience and an award-winning educator.

Monika Hearne, M.D.

Monika Hearne, M.D.

Board Certified OB/GYN

5,752 satisfied customers

With experience and compassion, I treat my patients like family.

Dr. Charles

Dr. Charles

OB/GYN (Doctor)

141 satisfied customers

Board Certified. Solo practice for 8 years; delivered more than 1300 infants and performed more than 800 surgeries.

Dr. K.

Dr. K.

MD

2,298 satisfied customers

Board certified OB/GYN with 20 years of experience.

DR PRABIR KUMAR DAS

DR PRABIR KUMAR DAS

CONSULTANT GYNAECOLOGIST

1,651 satisfied customers

MBBS(CAL)MD(G&O)

Dr.JBB

Dr.JBB

Board Certified OB/GYN

1,293 satisfied customers

15 yrs experience in Women's Health, Pelvic reconstruction and Incontinence

Dr. Lawrence

Dr. Lawrence

OB/GYN

822 satisfied customers

Board Certified OB/GYN and accomplished educator

< Previous | Next >

Related OB GYN Questions
I have been ovulating the last few days along with spotting
I have been ovulating the last few days along with spotting very light on and off is that ok?… read more
Dr. Chip
Dr. Chip
M.D.
12,933 satisfied customers
Is their an early pregnancy after 3 days of unprotected Sex
Is their an early pregnancy after 3 days of unprotected Sex you can take I was ovulating at the time… read more
Dr. K.
Dr. K.
MD
2,298 satisfied customers
I'm taking letrozole to help with ovulation. Is is normal to
I'm taking letrozole to help with ovulation. Is is normal to have shorter periods on it? When off of it I bleed 5-7 days. On the letrozole I bleed 3-4 days.… read more
Dr Josh
Dr Josh
Doctor
B.A.M.S.
5,921 satisfied customers
I am taking Prozac with -est 60/40 progesterone. Is there
I am taking Prozac with bi-est 60/40 progesterone. Is there any interaction I have been feeling weird … read more
Dr. Arun Phophalia
Dr. Arun Phophalia
Consultant Surgeon and Sports Medicine
Post-Doctoral Degree
32,396 satisfied customers
If a patient is ovulating and ovary age/bloodwork and
Hi if a patient is ovulating and ovary age/bloodwork and everything looks great, why would an ob/gyn recommend femara? The patient is taking vivance during this trying to get pregnant stage. I get it … read more
Dr. Juran
Dr. Juran
Physician, Partner
Doctoral Degree
193 satisfied customers
I have a question regarding ovulation, yes I'm 22 weeks
I have a question regarding ovulation JA: Have you seen a doctor about this yet? What medications are you taking? Customer: yes I'm 22 weeks pregnant and none JA: Have you been keeping a personal medi… read more
Dr Anil Kumar
Dr Anil Kumar
M.B.B.S
2,714 satisfied customers
Ovulation kit I was taking ovulation test and shows I
Ovulation kit I was taking ovulation test and shows I ovulated around 9th-12th. I didn't have a previous period. Could they have picked up I was pregnant or would they work similar to a pregnancy test… read more
Dr Ted Manos
Dr Ted Manos
Self Employed
MD
744 satisfied customers
I did an ovulation kit which was positive on oct 8, next
Hi I did an ovulation kit which was positive on oct 8, next cycle due oct 23rd, tried oct 8th and 9th. How soon will a blood test show if I am pregnant?… read more
Dr. K.
Dr. K.
MD
2,298 satisfied customers
Trying to see if estrogen stop your period trying not to get
Trying to see if estrogen stop your period trying not to get one this month … read more
Dr. David
Dr. David
Radiation Oncology Attending Director
Post-Doctoral Degree
13,043 satisfied customers
I've been having more uncomfortable ovulation pain these
Hello! I've been having more uncomfortable ovulation pain these past few months-only on my left side. This time it has hung around for longer than usual and has been more intense. I have had pain duri… read more
Dr Uzair
Dr Uzair
FCPS (R) General Surgery
M.B.,B.S. FCPS
3,660 satisfied customers
Can this liquid estrogen same as a1.25mg estrogen pill, I am
can this liquid estrogen same as a1.25mg estrogen pill … read more
Dr.Saleem
Dr.Saleem
Consultant Cardiologist
Doctoral Degree
729 satisfied customers
What does weakly proliferative endometrium mean, my pap was
my pap was good clinical history is abnormal uterine bleeding … read more
Dr. Thomas, MD
Dr. Thomas, MD
2,227 satisfied customers
Is it possible to have a false negative on a pregnancy test
Is it possible to have a false negative on a pregnancy test 30,32,36, and 37 days after sex?… read more
Dr. Juran
Dr. Juran
Physician, Partner
Doctoral Degree
193 satisfied customers
Is it possible to ovulate with hcg levels at 500 and empty
Is it possible to ovulate with hcg levels at 500 and empty gestational sac (blight ovum) that hasn't passed (i.e. Concern of pregnancy from unprotected sex).… read more
Dr. Norm S.
Dr. Norm S.
Doctoral Degree
8,182 satisfied customers
I had a 3 day embryo transfer 9 days ago, and today I had
Hi, I had a 3 day embryo transfer 9 days ago, and today I had some heavier cramping and some bleeding(menstrual like). I called my clinic but the dr is gone for the day, the nurse said to continue med… read more
Dr Uzair
Dr Uzair
FCPS (R) General Surgery
M.B.,B.S. FCPS
3,660 satisfied customers
If taking progesterone to start a late period and it starts
if taking progesterone to start a late period and it starts one day after you begin the first dose of progesterone 400mg, a heavy flow, should you stop or continue the progesterone for the 6 more days… read more
The Physician
The Physician
Emergency Room Physician
MSc. Pediatric Emergency Medicine, MD.
939 satisfied customers
I had 3 positive pregnancy test and started on progesterone
Hi I had 3 positive pregnancy test and started on progesterone and took a another pregnancy test and it looks negative does this mean I'm having another miscarriage … read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,622 satisfied customers
What is the most likely treatment for endometrium showing
What is the most likely treatment for endometrium showing hemorrhage and stromal with glandular breakdown? I went into premature menopause at 29 years old which completely stopped my all of my cycles.… read more
Dr. Norm S.
Dr. Norm S.
Doctoral Degree
8,182 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x