Q: What do elevated estradiol levels mean?
A: Cycle day 2-4 estradiol levels are done as an adjunct in evaluating egg quality and chances of getting pregnant. You would normally see on day 3 a low FSH level and a low estradiol level. An elevated FSH level may indicate diminished egg quality. But if the FSH is normal and the estradiol level is elevated, then the elevated estradiol may be artificially suppressing the FSH level to the normal range. An elevated estradiol level on CD 3 potentially indicates diminished egg quality. There are no clearly defined cutoff values for normal and abnormal estradiol values. Most doctors like to see cycle day 3 estradiol of less than about 80 pg/mL, levels of 80-100 pg/mL are borderline, and over 100 pg/mL is abnormal. There is not much data that suggest that an elevated day 3 estradiol is a problem in itself. The problem is more so that it is potentially "masking" the detection of the poor ovarian reserve by suppressing an FSH level that would otherwise be elevated. An elevated estradiol level on CD 3 may also indicate hormonally active ovarian corpus luteum cysts left over from the previous cycles. The corpus luteum (outer "shell") of a follicle remains after an egg is released and for a short time after ovulation and rupture, it continues to produce the hormones needed in the event of a pregnancy. An inappropriately timed hormone production beyond the beginning of the next cycle can interfere with normal growth of the uterine lining and it can also inhibit follicle selection and growth during the next cycle.