Missing One Evening Dose of Estradiol During IVF Pregnancy
Missing a single 3 mg evening dose of estradiol at 4 weeks 5 days pregnant is not a huge problem—take the missed dose as soon as you remember, even if it means taking two doses in the same day, and continue your regular schedule. 1
Immediate Action Required
- Take the missed 3 mg dose immediately upon remembering, even if this means taking it close to your next scheduled morning dose 1
- Continue with your regular dosing schedule (3 mg morning and 3 mg evening) starting tomorrow 1
- No additional monitoring or intervention is needed after a single missed dose 1
Why This Is Not a Major Concern
- Since less than 24 hours have elapsed, this is technically considered a "late" dose rather than a completely "missed" dose, which minimizes potential risks 1
- The protocol for managing late or missed hormonal medications (established by the CDC) indicates that taking the dose as soon as possible maintains adequate hormone levels 2, 1
- One case report documented a successful twin pregnancy in an IVF patient who inadvertently used oral estradiol vaginally (a much more significant deviation from protocol), demonstrating the robustness of estrogen supplementation during early pregnancy 3
Important Caveats
- If you vomit within 2 hours of taking an oral estrogen dose, treat it as a missed dose and follow the same protocol (take another dose) 1
- If you miss multiple consecutive doses (≥48 hours without estrogen), contact your reproductive endocrinologist or obstetrician promptly 1
- If you experience unusual symptoms after missing a dose—such as vaginal bleeding or cramping—contact your healthcare provider immediately 1