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Infertility/Fertility/antagonist protocol, low e2


Hi doc, I am undergoing antagonist cycle...when e2 was 515, cetrotide .25 was added on day 7 of stims(menotrophin 300iu)  And now on day 10 of stims e2 is still 605 whereas Ultrasound shows growing follicles 5 of size 15 and 5 around 10mm in size. Now the doctor wants to cancel the cycle due to low e2, I am very disappointed
Pls suggest doc... My AMH is also good with good AFC.

Hello Ric from India,

Your doctor may not be familiar with the antagonist protocol.  It is not based on E2 levels but on the size of the leading follicles.  In general, the antagonist should not be started until at least 1/3 of the follicles are at 16 mms.  If it is started sooner, the follicles will be suppressed and not grow, as in your case.  This certainly makes me wonder about the expertise and competency of your doctor.

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.  I now provide personalized fee for service consultations/advice/direction via email and payable via Pay Pal.  If interested, contact me via my email at  This service will allow you to have your own personal on-demand infertility expert.  


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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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