February 25, 2011
Hello! So I have PCOS and did my first cycle of Femara this past month (5mg 3-7). I got a great 23mm follicle, but cycle was cancelled due to estradiol being low at 110. So, I have a few questions:
1. My doctor has increased my dose for this coming cycle to 7.5mg in hopes of it helping to increase my estradiol level. Won't increasing my dosage just lower my estrogen level even more as that is what Femara does? My doctor said that increasing the dose would increase my estrogen, but did not explain how so I am very confused?
2. While everything that I have read since having my cycle cancelled, states that it is completley normal and expected for E2 to be low on Femara - my doctor will not hear of it! He says that a low E2 level leads to a low chance of pregnancy and if you do conceive, a higher chance of miscarriage. I would like to note though that my RE's office has very limited experience prescribing Femara. They did not even offer it to me - I had to ask so I'm thinking they just don't know as much about it as other doctors that use it more regulary. My question is, does the low E2 = low pg rate/high miscarriage rate also hold true on a Femara cycle or are pregnancy rates just as high on a Femara cyle when E2 is low as they are with other medicated cycles when E2 is at the correct level?
3. I do have a high LH/FSH ratio, but I don't know the exact lab values anymore. On cd 16 of this past cycle when I had my u/s to measure my 23mm follicle, my bloodwork that day showed my LH level at 21.2. I know this is normally considered a "surge" level, but could that not be the case for me since I normally have a higher LH level anyway? Meaning, could my body need my LH level to reach a much higher level for it to surge enough to trigger ovulation? I'm just trying to figure out if I O'd the follicle I had or not. I never did get a + OPK, even when I did the OPK the same day my bloodwork showed my LH level at 21.2???
My RE says that if increasing my dose to 7.5mg does not increase my E2 level to the 200mg/pl per mature follicle level, then we have to move onto something more aggressive. I am devastated because I feel like I could definitley conceive on Femara if he would give my body the chance! The fact that I got a great follicle with a great lining, and bloodwork looked great except for the lower E2 (which is obviously normal according to every other doctor but mine) tells me that my body responds well to this and it is not fair to make me stop taking it as I feel so sure that I can concieve on this "miracle medicine"!
Thank you in advance for your help - I really hope you get the chance to answer my questions as talking to my RE is getting a bit frustrating for me at the moment!
1. My doctor has increased my dose for this coming cycle to 7.5mg in hopes of it helping to increase my estradiol level. Won't increasing my dosage just lower my estrogen level even more as that is what Femara does? My doctor said that increasing the dose would increase my estrogen, but did not explain how so I am very confused?
2. While everything that I have read since having my cycle cancelled, states that it is completley normal and expected for E2 to be low on Femara - my doctor will not hear of it! He says that a low E2 level leads to a low chance of pregnancy and if you do conceive, a higher chance of miscarriage. I would like to note though that my RE's office has very limited experience prescribing Femara. They did not even offer it to me - I had to ask so I'm thinking they just don't know as much about it as other doctors that use it more regulary. My question is, does the low E2 = low pg rate/high miscarriage rate also hold true on a Femara cycle or are pregnancy rates just as high on a Femara cyle when E2 is low as they are with other medicated cycles when E2 is at the correct level?
3. I do have a high LH/FSH ratio, but I don't know the exact lab values anymore. On cd 16 of this past cycle when I had my u/s to measure my 23mm follicle, my bloodwork that day showed my LH level at 21.2. I know this is normally considered a "surge" level, but could that not be the case for me since I normally have a higher LH level anyway? Meaning, could my body need my LH level to reach a much higher level for it to surge enough to trigger ovulation? I'm just trying to figure out if I O'd the follicle I had or not. I never did get a + OPK, even when I did the OPK the same day my bloodwork showed my LH level at 21.2???
My RE says that if increasing my dose to 7.5mg does not increase my E2 level to the 200mg/pl per mature follicle level, then we have to move onto something more aggressive. I am devastated because I feel like I could definitley conceive on Femara if he would give my body the chance! The fact that I got a great follicle with a great lining, and bloodwork looked great except for the lower E2 (which is obviously normal according to every other doctor but mine) tells me that my body responds well to this and it is not fair to make me stop taking it as I feel so sure that I can concieve on this "miracle medicine"!
Thank you in advance for your help - I really hope you get the chance to answer my questions as talking to my RE is getting a bit frustrating for me at the moment!
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