COVID19 Safety Alert

What Kind Of Estrogen For Endometrin Priming & Luteal Phase Support?

Question:

Hi there, I'm in Ireland and having egg donation treatment in Spain. I've had several unsuccessful cycles and am now finding that my endometrium is not as thick as it used to be. When my period begins, I take 6mg of Meriestra orally. I was interested to read an earlier answer of yours to question "thin endometrium causing ivf failure" that said "Vaginal is better because the hormone goes directly to the endometrium without having to go through the liver first (first pass), where most of the estrogen is removed, when taken orally."

Should i go back to my clinic and question the oral administration of the drug? In earlier cycles I was applying patches to my body.

Thanks in advance for any guidance you can offer and I understand it would be general advice rather than a medical opinion.

Best Regards, A. from Ireland

Answer:

Hello A. from Ireland,

Thank you for reading some of my previous answers. Multiple studies have shown that oral estrogen for endometrial priming and luteal phase support are the least effective method. For that reason, it has become the standard of care to use either injectables, patches, vaginal gels or vaginal tablets. I think this is something you should query your doctors about. If your lining is not developing adequately in an egg donor cycle, it may be because you are not getting adequate estrogen.

Your doctors should be evaluating this thickness prior to deciding whether or not to proceed with the transfer. If you were my patient, I would not do the transfer if your endometrial lining was inadequate. In that situation, I would freeze the embryos and plan a frozen embryo transfer at a later date, in a cycle where the lining is adequate.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG

Executive Medical Director

The Fertility and Gynecology Center

Monterey Bay IVF Program

www.montereybayivf.com

Monterey, California, U.S.A.

You Might Also Enjoy...

The Importance of Wellness Exams

Protecting your health is protecting your fertility. Choosing to get regular check-ups can protect you from issues later down the line, or prepare you for any possible issues. Read on to learn more about the importance of wellness exams.

The Difference Between Perimenopause and Menopause

Are your hot flashes connected to menopause δΈ€ or perimenopause? Is there even a difference? In this blog, we explain the difference between perimenopause and menopause and how you can get relief from your less-than-pleasant symptoms.

How Age Affects a Woman’s Fertility

One thing to know about starting a family is that you have a limited amount of time when you’ll be most fertile. Learn more about how your fertility changes with age.

Understanding the IVF Process

In-vitro fertilization is a confusing or sensitive topic for some people. Understanding how the process works removes the mystery surrounding it and clarifies how IVF can help you.