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Low Estradiol and Infertility

04/08/2010

Question:

Dear Doctor I am a 37 year old single woman . About a year ago,shortly after a death in the family, a very stressful phase, I noticed a reduction in the duration of menstrual flow from 4 days to 2 days and also reduction in amount of flow. Also a gradual increase in hair growth on the thighs and vaginal dryness.My cycles continued to be regular at 27-30 days . I got my hormone levels checked last may- my thyroid profile was normal,FSH 6.7,LH 8.7,prolactin 15.7, progesterone 5.22nmol/l ,estradiol 66pmol/l,testosterone 0.6nmol/l,,s.cortisol 195 nmol/l. The normal reference range given by the lab for estradiol in follicular phase was 97-592pmol/l and for progesterone as 0.44-6.4nml/l. A pelvis ultrasound showed bilateral polycystic pattern, One ovary 3 by 2 cm, other 4 by 2cm.

Checked again last week and the results are thyroid profile normal,FSH 6.6,LH 5.9,prolactin 23, progesterone 3,0nmol/l ,estradiol 51.2 pmol/l,testosterone 0.8nmol/l,,s.cortisol 301 nmol/l.DHEAS is 144.

I am distressed by the very low estradiol level of 51.2 pmol/l, , The normal reference range given by the lab for estradiol in follicular phase was 97-592pmol/l. They seem low even for the post menopausal reference range of 19-141…does this indicate perimenopause.or that menopause will occur very soon. Is there is a possibility of conceiving naturally and a successful pregnancy with such levels. My gynac has suggested I start Metformin,but from what I could gather from the internet, Im not sure I qualify as PCOD.

I am likely to get married quite soon and would like to discuss with my partner beforehand my chances of conceiving if any.

Answer:

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