Dear doctor

I went through first unsuccessful IVF treatment.
The second time my IVF doctor even wont to start because my blood result, he ask me to come back next month.
My blood result was:
FSH 11.1
Oestradiol on day 1-93, on day 2-146 and on day 3-299.
Please could you tell me if I will be able to start the treatment next time if the blood gets better.

Hello Ewelina from Poland,

You don't mention if your doctor did an ultrasound, but with an elevated Estradiol level on CD#2 (146) we don't usually start the IVF cycle.  The reason is because often this means that there is an ovarian cyst present that is producing the estradiol and this will prevent the ovaries from responding properly.  In addition, this means that the ovaries are not completely suppressed, which also is important for stimulating the ovaries properly.  So, in most cases the patient is either given some sort of suppression, such as the birth control pill or lupron or ganerelix and the estradiol followed.  Once the estradiol goes below 100, then the cycle can be started.

In my case, I would do the same as your doctor.  I would postpone the cycle but place you on the birth control pill to suppress the ovaries for one month.  Then you can usually start the cycle after completing the birth control pill.  In my program I do this with all my patients before they start an IVF cycle just to make sure.  I usually won't use a natural cycle to precede the IVF cycle for this very reason.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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