Monday, June 11, 2012

Part II: All about the hormones (updated at the end)

Again, it does not *look* like a super pretty cycle that I am trying in. Its CD15 today.  I'm coming up to a surge possibly tomorrow. I picked this cycle because my Clear Blue Easy fertility monitor(CBEFM) switched to 'high' fertility a possible 4 days before ovulation, which is not too shabby.  To try to understand what that meant, I read the original studies looking up how the monitor works: There are 3 forms of estrogen: estradiol (strongest), estrone (middle strength) and estriol (weakest). The CBEFM measures the levels of a Estrone metabolite, which correlates very well to blood estradiol levels.  At some point, when the estrone levels increase past a certain threshold, the monitor changes from 'low' to 'high' fertility.

The good news, I've had 'high' fertility for around 3 days now, but the bad news is I have not seen a peep of the egg white CM yet.Apparently, estradiol (the strongest estrogen) drives the cervical mucous production. So when that gets super high, you get all that goopy stuff. It should be straightforward (lots of estradiol = lots of CM), but I have to wonder. Here is a question for you IVF ladies: There are times your estradiol levels must have gone through the roof, given the multiple maturing follicles: Do you always see the fertile CM during this time?

Because I've seen no CM yet, I was hoping  that ovulation would be delayed a day past CD17, but no dice, I've been monitoring my LH for the past 2 days, its on the rise and I think I should be in full surge by tomorrow (CD16). Which means the IUI is dayafter. ULP.

I am going in for hormonal monitoring and a U/S tomorrow. I have a feeling my stats (hormone levels, follicle sizes etc) are going to be very similar to my last cycles, and are considered bang normal by any RE, so my nitpicking and worry, is really for nothing. Something I cannot put my finger on is the problem.

In the last cycle, which was a BFN, I had a lot more 'symptoms' in the luteal phase which could
a) have been the result of a hypersensitive, far too imaginative psyche because absolutely nothing happened
b) been indicative of an embryo that probably bounced around for a few days, produced a smidgeon of HCG, before dying out because it could not implant, either due to uterine issues or because it was itself crappy quality and ran out of steam. Yeah- this covers most bases.

CD16 Testing and monitoring update:
EWCM made its exuberant entrance this morning (It always makes me SO happy to see it, yeah, I'm a little nuts but I blame this process :-))
U/S Monitoring:  The action is all in the left ovary (UGH- I have a hate-hate relationship with the left side of my body, will explain why sometime). Lining = 8.6 mm and 'beautiful'; Follicle = 17 mm (almost exactly the same as the last 2 times, albeit those measurements were on the day of ovulation, not from the day before).
Estrogen = 221 pg/ml-- normal for a single follicle,  I'm hoping it will be up a little tomorrow.

LH test results:
9 am blood work shows LH = 13. ie, looks like the surge is starting, but not there yet. 
2 pm check by OPK: Surge still not underway,  test line lighter than control.
7 pm check by OPK: LH surge is here. Test line now as dark as control.

IUI will be tomorrow. While I can apparently take a lot of shit and keep on going with barely a hitch in my stride, here is hoping the universe hands me something good instead.


  1. Fascinating about the CBEFM. I've long tried to understand how it works and that clears up a lot. I always thought that it was a fancified LH strip test...didn't realize it clues into the estrogen like that (and, obviously, you can't see it by eyeballing the sticks...which they tell you in the directions but which I've always tried to do:).

    In terms of IVF and high estradiol, and the effect on EWCM...if there was an increase it was slight (in my case). But my response to stims was always pretty modest, and that may be one reason.

  2. They are absolutely right when they tell you not to eyeball it- the estrogen part is actually a competition assay, the higher the levels, the lighter the line ( I could not figure out which one) gets apparently, and the monitor calculates it, feeds it into an algorithm and spits out the interpretation.

  3. Good news about the EWCM!  I think we are all super-tuned in to our bodies/signs around this process - I know I am!  It's frustrating getting lots of signs and then a BFN.  I bet you're right that something was happening in there.  Fingers crossed for you.  We're cycle sisters on about the same timeline looks like!

  4. How exciting!  I am the same way about the EWCM - so excited to see it!  On unmedicated cycles, I usually only see it once, but it's thrilling to see.  And yes, when I did IVF and my estradiol levels were sky high, I saw buckets of the stuff - was fascinating, really.  Good luck!!!

  5. Excited for you!  We'll be cycling pretty close to the same time.  My CBEFM has been "high" the past 2 mornings.  I am doing my first unmedicated cycle this cycle. Only because I couldn't schedule a medicated with school and work.  On medicated cycles I don't have those "high" days before the surge and I wonder if that means my eggs don't have the proper opportunity to mature. 

    Sounds like your eggs are maturing nicely.  I wish you the best this cycle.

  6. Did not know that about the monitor. I have some high hopes for you on this cycle. Everything crossed.

  7. Come on Universe! Thinking of you today Jay!!