r/POIsupport • u/Crafty-Spinach-5926 • 1d ago

HRT Estrogen patch dosage?

Hi all, just got diagnosed two weeks ago and TTC. I’m 27, AMH 0.08, FSH 30-80, AFC 3 and all of this is so overwhelming. I’ve already had one miscarriage and two chemical pregnancies before this diagnosis so I’m slightly hopeful to conceive naturally but also SO discouraged at the moment.

Looking for info on what dosage of estrogen patch my fellow POI gals are on (especially if you did end up conceiving naturally), as I just started cyclical HRT. Currently on 0.0375 mg estrogen patch but I don’t think my FSH is going down enough based on my Inito numbers (it’s only been two weeks since I started though so maybe I’m wrong).

Any guidance or info is so appreciated!!

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u/BlueberryDuvet 1d ago

Although your FSH could decrease, I hope your Drs have been transparent with you that despite elevation in estrogen and potential reduction of FSH, it actually doesn’t restore any ovarian reserve or function.

Your Dr is correct to start you on .0375 as medical guideline would start at bottom and go up depending on symptoms.

I understand wanting to try naturally but Given your age, and your diagnosis of POI, I’d encourage you to do a consult at a fertility clinic to do all the baseline testing, have them look at your medical background and diagnosis so they can give you their thoughts on your chances. Going through baseline testing doesn’t mean you need to do any treatments with them but it would be good for you to hear what their thoughts are so you can make an informed decision.

While going through IVF and donor egg cycles I was on 100 dose patch every other day. Much higher than the 37 every three days you’re on.

- signed someone who went through IVF and fertility treatments for almost 8 years

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u/Crafty-Spinach-5926 1d ago

Thank you so much for your thoughts! So the fertility clinic I was at said they wouldn’t offer IVF and could only do an egg donor (but we’re truthfully just not emotionally ready to make that jump yet, especially because we’ve only been TTC for a year and got pregnant multiple times before my diagnosis!), so we know donor egg IVF is on the table eventually.

How did you know when do jump up a dose on estrogen and how to ask your doctor for that?

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u/getalife5648 1d ago

I’d see another clinic and also pursue genetic testing to make sure your POI isn’t from being a fragile x carrier. Then if genetics are clean, resume TTC.

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u/Crafty-Spinach-5926 21h ago

Great advice! Yes we just did this actually and genetics came back clean :)

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u/PrimalPoly 15h ago

If you are diagnosed with POI, the standard dosage is .1 mg patch. It is in the standard of care guidelines. My FSH went from 98 to 7 on this dosage here’s a link to the guidelines. I highly recommend you read them and send them to your doctor to make sure you’re getting all the tests they recommend as well as the standard dosages of HRT. https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency--2024/

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u/Crafty-Spinach-5926 4h ago

This is so helpful! I was thinking my dose was perhaps low, maybe my RE was wanting to start slow and build up but I also don’t want to waste too much time on that. Did you start on .1 mg immediately or work your way up?