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...

Tips for Living With Menopause

During the time before you’re permanently finished menstruating, you may have to deal with a range of uncomfortable and potentially life-disrupting symptoms. Here are a few tips to help you manage these symptoms.

What You Should Know Before Considering IVF

Have you tried everything to get pregnant? If you’ve had a thorough evaluation, tried other approaches, and still been unable to conceive, you may want to try in vitro fertilization. In fact, sometimes, IVF is the only viable path to conception.

Is There a Way to Prevent Infertility?

Infertility is a more common problem than you may realize, but it’s often treatable. Both men and women can experience issues that lead to infertility, so if you’re trying to become pregnant and struggling, you should see a professional.

My Pap Smear Was Abnormal - Now What?

A Pap smear, or Pap test, is a screening test recommended for women ages 21-65 to detect early signs of cervical cancer. Abnormal results can be scary, but there are a few things you need to know.

5 Common Myths About Infertility

Infertility can send you on a search for answers. Unfortunately, there are a lot of wrong answers out there. This post sets the record straight regarding five common myths about infertility.

Is Preimplantation Genetic Testing?

Couples who have chosen in vitro fertilization are taking a big step toward becoming parents. Preimplantation genetic testing is an important part of the process and can ensure your embryo is healthy before being transferred to the uterus.