My CCRM IVF Journey

Our successful journey through IVF #2 at one of the world's top fertility clinics

Surrey Chat

Posted by auntiem10 on August 12, 2010

Yesterday I requested a quick chat with Dr. Surrey so that I could gauge his take on my high estradiol level. He called at 5:00 p.m. Mountain Time, and we spoke for about 10 minutes. It was a good conversation, and I feel more optimistic!

He said at CCRM, they see these high estradiol levels all the time. It just means that the BCP/Lupron combo hasn’t suppressed me enough yet. I asked him if there is much of a chance that the level will have dropped significantly by tomorrow, and he said sure, they see that all the time. He can’t promise that it will drop, but it is definitely a possibility that we will be given the green light tomorrow to start stims on Saturday.

In the event that the estradiol level is still above their threshold of 50, here is the game plan:

Plan A) If the level is around 60, we will proceed. I’ll start stims on Saturday and travel to Denver on Wednesday.

Plan B) If the level has dropped but is hovering around 80 or so, I’ll stay on Lupron for up to another week, and then get rechecked. This will continue until the level is around 60, and then I’ll start stims the next day.

Plan C) If the level has stayed the same or gone up, I’ll have to go on BCPs for a month, and then start all over with Lupron. He rarely experiences a high estradiol level the month after this treatment, but if it remains high after a month, he will change my protocol from standard Lupron to GnRH antagonist and proceed from there.

I asked how confident he is that the mass seen on u/s is an endometrioma. He said given my history of stage IV endo and multiple nasty endometriomas, he’s of the opinion that if it “looks like a duck and sounds like a duck, it’s probably a duck.” (He has said this phrase to me during each of our conversations, LOL.) It’s slightly possible that it could be a hemorrhagic ovarian cyst, but it is more than likely an endometrioma. He is pleased that it’s actually reduced in size since my ODWU in April. He mentioned that there is probably a functioning corpus luteum somewhere near my ovaries producing estrogen. There is not necessarily a correlation between size and estrogen production when it comes to cysts, so it’s possible that the cyst is invisible on u/s but still producing tons of estrogen.

He doesn’t think surgery is necessary, so we will just see what tomorrow brings. I’m done sulking and will just accept whatever plan we have to follow. : )

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6 Responses to “Surrey Chat”

  1. Jen said

    Glad to hear he made you feel better. He was the doctor who checked on me after we discovered my ectopic and reassured me when I was feeling very low. all the best!

  2. LisainSK said

    Sounds like Dr. Surrey is a very compassionate doctor. And got to love it how they can just “manipulate” our estradiol to hold off for a week if need be. Sounds very, very promising. I’m optimistic you won’t get delayed…thanks for the update. Very educational indeed!

  3. I’m glad you have a plan!
    That’s funny about him repeating the ‘duck’ example. I do the same thing with my patients–use the same phrases over and over, sometimes I get sick of myself 🙂

  4. LC1 said

    Sounds really promising that you won’t have much of a delay! Hang in there!

  5. R said

    Glad you have a plan. Hopefully your number will have gone down and you won’t need to worry about the other plans.

  6. Hi, I just found your blog. I am sorry that you’ve gone through so much already to get to this point. Good luck with your estradiol level – I hope it comes down soon. I’m a few days behind you (but on another continent) – I have my suppression check next week. Here’s hoping your time in Colorado is as productive as possible.

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