Estrogen measurements during an FET

We all know that estrogen can be an issue in fresh cycles because your body is making so many follicles and saturating your body with estrogen.  (Estrogen measurements can be related to the number of mature follicles—lots of follicles equals lots of estrogen.  http://3yearwait.blogspot.com/2015/02/what-do-all-of-those-measurements.html)  Ovarian hyper simulation syndrome can be a risk (http://3yearwait.blogspot.com/2011/05/ivf-side-effects.html), and high estrogen can have a detrimental effect on chances of pregnancy success.  (http://www.ncbi.nlm.nih.gov/pubmed/24757341)

But what about estrogen in a frozen embryo transfer?  Does it even matter?  I mean, they measure it for some reason….

Six days before one of my scheduled FETs, I had an estrogen measurement of 231.  Another time it was 265.  Are those good?  Bad?

Not much appears to be written about this.

In the past, I’ve read e2 should be around 200 per mature follicle.  (That’s why estrogen can be so high on an egg retrieval cycle—lots of follicles.)  Reading non-medical sources, it appears some clinics want at least an e2 measurement of 300 to do a transfer, and prefer 500-1000, with 800 being the ideal.  My clinic looked for anything above 200, although it was not clear to me that they would not do a cycle on less than that.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2467429/

Here’s more regarding e2 measurements for a retrieval cycle:

http://paperity.org/p/73970726/the-association-of-serum-estradiol-level-with-outcomes-of-clomiphene-citrate-human

Also, here’s something that discusses estrogen:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230061/?_sm_au_=iVVRLsPQQNDHb7WD

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2467429/

And estrogen monitoring:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2467429/

Decrease in e2 after HCG shot is bad:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415290/

Info on estrogen:

http://www.yourivfjourney.com/estrogen-why-do-fertility-patients-need-it/

More links on neural tube defects

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825100/ (“Inositol for the prevention of neural tube defects: a pilot randomised controlled trial”)

http://hmg.oxfordjournals.org/content/18/R2/R113.full

https://academic.oup.com/hmg/article-abstract/18/R2/R113/604196/Genetics-of-human-neural-tube-defects?redirectedFrom=fulltext (“Genetics of human neural tube defects”)

More links on IVF

http://download.springer.com/static/pdf/674/art%253A10.1186%252F1477-7827-10-107.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1186%2F1477-7827-10-107&token2=exp=1461867487~acl=%2Fstatic%2Fpdf%2F674%2Fart%25253A10.1186%25252F1477-7827-10-107.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1186%252F1477-7827-10-107*~hmac=26ec86ddb2d451ab460ea8c636c67a42e59302dfb23574ddbf65440ed82923fc (“The optimal duration of progesterone supplementation in pregnant women after IVF/ICSI: a meta-analysis”)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341449/ (“Serum biomarkers for predicting pregnancy outcome in women undergoing IVF: human chorionic gonadotropin, progesterone, and inhibin A level at 11 days post-ET”)

http://fertilityfile.com/2008/03/25/everything-you-need-to-know-about-embryo-transfers/ (“Everything you need to know about Embryo Transfers”)

http://www.huffingtonpost.com/tina-donvito/why-i-did-7-rounds-of-ivf_b_7101700.html (“Why I Did 7 Rounds of IVF”)

http://www.ncbi.nlm.nih.gov/pubmed/25007008 (“Alcohol consumption and in vitro fertilization: a review of the literature.”)

More links on miscarriages/recurrent pregnancy loss/birth defects

https://www.ncbi.nlm.nih.gov/pubmed/8290380 (“Recurrent pregnancy loss as an indicator for increased risk of birth defects: a population-based case-control study”)

http://www.news-medical.net/health/Multifactorial-And-Polygenic-(Complex)-Genetic-Disorder.aspx(“Multifactorial And Polygenic (Complex) Genetic Disorder”)

http://www.glowm.com/section_view/heading/Genetic%20and%20Nongenetic%20Causes%20of%20Pregnancy%20Loss/item/318 (“Genetic and Nongenetic Causes of Pregnancy Loss”)

http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/content/tags/genetics/do-genetic-factors-explain-recurrent-pregnancy-loss?page=full  (“Do genetic factors explain recurrent pregnancy loss?”)

http://www.fasebj.org/content/30/1_Supplement/151.6.long?related-urls=yes&legid=fasebj;30/1_Supplement/151.6 (“Maternal plasma folate, vitamin B12 levels and multivitamin supplementation during pregnancy and risk of Autism Spectrum Disorder in the Boston Birth Cohort”)

http://humrep.oxfordjournals.org/content/26/5/1259.full (“SYCP3 mutation may not be associated with recurrent miscarriage caused by aneuploidy”)

http://perspectivesinmedicine.cshlp.org/content/5/3/a023119.full (“Genetic Considerations in Recurrent Pregnancy Loss”)

http://humrep.oxfordjournals.org/content/17/2/446.full.pdf (“Cytogenic analysis of miscarriages from couples with recurrent miscarriage: a case-control study”)

http://expectingscience.com/2015/08/26/lies-damned-lies-and-miscarriage-statistics/ (“Miscarriage statistics”)

https://sites.google.com/site/miscarriageresearch/miscarriage-general (“Miscarriage Statistics”)

http://spacefem.com/pregnant/mc.php?m=02&d=01&y=16 (“Daily odds of pregnancy miscarriage”)

Association between family history of hernia and omphalocele?

I think I’ve mentioned in the past I had double-hernia surgery when I was just one month old.  Other women in my family (grandma, cousin) have also had hernias (and repair surgery).  So, for some reason, hernias run in our family.

Well, this article notes a baby with omphalocele and then notes that its dad and paternal grandma both had hernias:

http://www.americanjournalofsurgery.com/article/0002-9610(57)90092-2/pdf

“It will be interesting to know what the male sons of this boy will show from the standpoint of omphalocele and hernia in the future.”

Maybe there’s an association?

More links on omphalocele

General information:

http://www.chw.org/medical-care/fetal-concerns-center/conditions/infant-complications/omphalocele/

http://coloradofetalcarecenter.childrenscolorado.org/conditions/abdominal-wall-defects/omphalocele

Diagnosis:

http://www.fetalsono.com/teachfiles/bowelher.lasso

Stories/outcomes:

http://www.parentingbanter.com/showthread.php?t=31427

http://www.themotherbabycenter.org/blog/2014/10/ians-story-treating-an-omphalocele-at-the-midwest-fetal-care-center/

http://www.lifewithoutacompass.com/eulogy-elizabeth-cathryn-foster-8111-10813/#more-574

http://www.chop.edu/stories/giant-omphalocele-jacksons-story#.VxvASYo8LCQ

http://onlinelibrary.wiley.com/doi/10.1002/uog.1978/full

http://www.rcst.or.th/ejournal/files/Vol31_No2_48.pdf (“Clinical Outcomes of Omphalocele:

An Analysis of 124 Patients”)

Decisions about termination:

http://rockymountainjewess.blogspot.com/2012/08/talking-about-abortion.html?m=1

http://community.babycenter.com/post/a38047033/termination_due_to_giant_omphalocele

http://community.babycenter.com/post/a30390827/omphalocele?cpg=5

Misc:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809310/pdf/pjms-29-866.pdf (“Omphalomesenteric duct cyst in an omphalocele: A rare association”)

http://medicaljournal.in/2014/Volume2/Issue2/AMJI-02-web-case-report-giant-omphalocele-congenital-anomaly-containing-bowel-loops.pdf (A minor omphalocoele occurs when the defect is 4 cm or less (at birth), major or giant omphalocoele has 5 cm or larger defect.  It may include sac may contain small and large bowel, stomach, liver, spleen, urinary bladder, uterus and ovaries.  In some omphoceles, the sac ruptures.)

http://omphalocele.net/wordpress/wp-content/uploads/2010/03/omphalocele_article1.pdf (“Caring for the Newborn with an Omphalocele”)

http://medicaljournal.in/2014/Volume2/Issue2/AMJI-02-web-case-report-giant-omphalocele-congenital-anomaly-containing-bowel-loops.pdf (“Giant Omphalocele: A Congenital Anomaly Containing Bowel Loops”) 

Questions after a diagnosis of omphalocele and treatment options

As previously discussed, after the diagnosis of omphalocele, understanding more about the omphalocele (and potential associated issues) is pretty important to knowing what your prognosis is going to be.  (http://3yearwait.blogspot.com/2016/04/looking-for-sliver-of-hope.html;http://3yearwait.blogspot.com/2016/04/omphalocele-outcomes.html;http://3yearwait.blogspot.com/2016/04/diagnosing-omphalocele.html)  Here is a list of questions I prepared for our follow-up ultrasound and genetic counselor session after our omphalocele diagnosis (which I never got a chance to ask because she had passed away by our follow-up appointment):

Genetic Testing Questions

What does CVS test for that could be the cause/association with omphalocele?

·       Trisomy 13/18/21

·       Trisomy 14, 15, 16, 17?

·       Beckman Weiderman Syndrome (11^th Chromosome?)

·       What else?

How accurate is the CVS test?

·       Specifically for Beckman Weiderman Syndrome

When will we have results?

Omphalocele/Spine Questions

How big is the omphalocele?

What organs are in it?

·       Small / large bowel?

·       Stomach?

·       Liver?

·       Spleen?

·       Urinary bladder?

·       Uterus?

·       Ovaries?

Where is it located?

·       Above/below/at the umbilical cord?

Are there any other abnormalities?

·       Brain / head issues that suggest spina bifida?

·       Anything else wrong with the skeleton?  (Short / deformed limbs? Clubfoot?)

·       Heart abnormalities?  (Do we need fetal echocardiogram/other testing?)

Treatment options

This article goes into great detail about all of the treatment options:

http://medcraveonline.com/JPNC/JPNC-01-00024.php

(The authors even provide a flow chart! http://medcraveonline.com/JPNC/images/JPNC-01-00024-g001.png)