Secondly, staying entertained throughout bed rest is a good opportunity to practice self-love and take care of yourself. However, it makes many rethinks the conventional approach. Estradiol plays several important roles in IVF, such as: Estrogen is a key hormone that plays an important role in IVF success rates. What the normal range for estradiol levels are in an IVF cycle, What to expect the level to be on any given day, Diminished ovarian reserve (especially if you also have high FSH levels and a low AMH), Poor responders: Patients in the bottom 10th percentile for estrogen levels, Normal responders: Patients in the 50th percentile for estrogen levels, High responders: Patients in the 90th percentile for estrogen levels, It thickens the uterine lining in preparation for embryo implantation, It helps fertility doctors monitor your response to IVF stimulation and predict the number of oocytes you might get at the oocyte retrieval, It plays an important role in endometrial receptivity and pregnancy maintenance. This helps change the angle of the uterus and makes the transfer easier, allowing your doctor to see the catheter clearly with a trans-abdominal ultrasound to achieve the best placement of your embryo during transfer. Huang, is 752 pg/mL estradiol too low?. Adjusted Analysis The aOR with the corresponding 95% CI and p -value are shown for each parameter included in the regression model in Table 4. A 2013 study found that women who slept for 7 to 8 hours each night had a higher pregnancy rate than those who slept for shorter (or longer) durations. These women will receive daily gonadotropin injection before embryo tranfer. For couples who have experienced failed IVF cycles, preparing for your frozen embryo transfer can bring uncertainty, worry and fear. Objective: I normally request a blood test on the day when the second dose is due, so I can adjust the dose accordingly. 200-300 pg/mL of estradiol per mature follicle, On Day 11 of stimulation (which is near the higher end of how long an IVF cycle can go, The Human Chorionic Gonadotropin (HCG) Trigger Shot: What You Need To Know, The Egg Retrieval Day: How To Prepare For It, The Female Biological Clock: Why Older Patients Have A Poor Response To An IVF Stimulation Cycle. Some postulated that high estradiol level at the time of implantation is the culprit. Li, Xin; Zeng, Cheng; Shang, Jing; Wang, Sheng; Gao, Xue-Lian; Xue, Qing Association between serum estradiol level on the human chorionic gonadotrophin administration day and clinical outcome, Chinese Medical Journal: May 20, 2019 Volume 132 Issue 10 p 1194-1201doi: 10.1097/CM9.0000000000000251. They pointed out that: 1) at the time of implantation (typically 7 days after ovulation), estradiol levels are 200 300 pg/mL in natural settings, but > 2,000 pg/mL in IVF settings, 2) laboratory data shows estradiol inhibits the growth of placental cells, 3) since placenta provides all nutrients to a developing fetus, it is not difficult to appreciate the link between high estradiol level and small babies. In daily clinical practice, an ultrasound scan is usually planned following an initial period of estrogen priming in order to measure endometrial thickness and exclude the presence of a pre-ovulatory follicle, corpus luteum or luteinized endometrium prior to starting progesterone supplementation. Your email address will not be published. Not me. It does not constitute medical advice and does not establish any kind of doctor-client relationship by your use of this website. You will then have your first pregnancy test no sooner than 9-11 after the transfer! Because a womans body produces progesterone when ovulating, the endometrial lining develops at the optimal rate to nurture the fertilized eggs. It is a simple procedure that shouldnt take more than 20 minutes. By day 5 and 6, four embryos made it to blast stage. As with natural cycle FET, embryos are thawed on the morning of the scheduled frozen embryo transfer. In frozen embryo transfer cycles, estrogen can be used to help thicken the lining of the uterus and prepare it for pregnancy. When sleeping before your embryo transfer, try to: If youll be working throughout your bed rest, make sure to get a laptop tray or use some material that will block the heat from your laptop. This will also help make sure youre not missing anything critical before the procedure, and you can feel confident youre doing everything you need to do. Your levels with my clinic woujd have been low lol. Those who do not seek counsel from the appropriate health care authority assume the liability for any damage, loss, or injury which may occur. University of Michigan Health. Any idea of when your transfer will be? I feel terrible too. It was negative and I still have no bleeding. To evaluate the impact of serum estradiol (E2) levels on cycle outcomes in hormone replacement frozen embryo transfer (HR- FET) cycles. You will come back in about a week or so to check on the progress of your lining. In some cases, a doctor may use estrogen to prime the eggs before starting IVF. I was cancelled. 6 In some patients, it is necessary to maintain low estrogen levels (for example, patients with estrogen-sensitive breast cancer). I guess she probably read something on the internet. Ist ended on early is my pregnancy test day. Alternatively, all the embryos could be frozen immediately, including the best embryos, to be thawed for a transfer at a later date. The study analyzed how the number of days of progesterone impacted FETs of embryos frozen six days after fertilization. Cochrane Database Syst Rev. Estradiol levels are essential for monitoring the progress of your in vitro fertilization cycle. If you take an estrogen-based medication and have symptoms that concern you, speak to your healthcare provider or pharmacist. Unfortunately, we dont always know why some embryo transfers fail. Just waiting for period another few weeks. Detailed Description: Enrolled women will be either ovulatory or anovulatory when referred to fertility treatment. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Please enable it to take advantage of the complete set of features! Present data demonstrates that elevated estradiol level in frozen embryo transfer cycles is associated with the increased risk of preeclampsia and low birth weight in singleton pregnancies. Keywords: If your level is below 10ng/mL, your transfer may be pushed back 1 more day to allow for . Keep me updated xxx. Simply put, a frozen embryo transfer (FET) is possible because previous IVF processes often produce additional embryo(s) couples can freeze for future attempts if the initial IVF cycle is unsuccessful. Label: Estraceestradiol tablet. But since we are doing FETs OHSS isn't possible. Mine was 1400 when they were going to do mine. I ended up miscarrying these pregnancies due to an unrelated issue, but my point is that the levels can vary so much and still be . Make An Appointment With Dr. Robles To Discuss Your Fertility Options Today! These findings suggest that hormonal milieu of the uterine environment, even in frozen embryo transfer cycles, may affect placentation leading to adverse . My question is about progesterone and estrogen: I was under the impression that progesterone was counterindicated for pregnant women and that it was actually very bad for the foetus. They are aware of my medical history but they are just a fertility clinic and taking a . Required fields are marked *. Estrogen helps make this happen. Accessibility They're also getting paid loads of money thanks to us. What kind of estrogen were you on? Not to mention it's really hard on the liver. At the start of your IVF cycle (on cycle day 3 or so), serum E2 levels should be below 80 pg/mL. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. An estrogen level above 3,500 pg/mL is considered high and a risk factor for adverse effects. Aim: One large retrospective study of over 900 IVF cycles examined the rate of estrogen increases in women with varying ovarian reserve levels. Thank you, {{form.email}}, for signing up. This diet also aids hormone function because many female hormones are made from cholesterol, which derives from fats. I have sore breasts and Tests for failed implantation - worth it at 43. Veleva Z, Orava M, Nuojua-Huttunen S, Tapanainen JS, Martikainen H. Factors affecting the outcome of frozen-thawed embryo transfer. HHS Vulnerability Disclosure, Help If the progesterone level is above 35ng/mL, the transfer may be cancelled. Conclusion: The way I was explained: In a medicated frozen cycle, Estrogen suppresses ovulation and thickens your lining without the need to trigger ovulation (like in a natural frozen cycle.) So have you gone ahead with your transfer? Unfortunately there are a lot of us at these clinics nowadays and I'm not so sure they're very organized all of the time, not to mention docs being stuck in their ways. Anyway, just another example of how you always need to be your own advocate, and if doctors get pissed off, oh well. You may also need a uterine cavity evaluation (saline sonogram or a hysteroscopy) or a mock transfer before proceeding. Many fertility specialists suggest eating a high-fat, low-carb diet to reduce inflammation throughout the body, G.I. https://alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_d8b9ac1cac0e674c1a0b0961093927ba.js, https://alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_49b8b9031bbb95474f82d7c728354895.js, https://alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_31b468be1a594732295d4cb55674dd8f.js, https://alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_d547670ec89793e8d0d9d2c3e7048848.js, https://alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_a7a358472bdeccc4a278ce416440dd5e.js. 2021 Aug;263:94-99. doi: 10.1016/j.ejogrb.2021.06.005. To learn more about what to expect on the day of the embryo transfer, check out: Embryo Transfer Precautions: What Not To Do. Estrogen levels before frozen embryo transfer c Cakapeewee Posted 8/15/15 Hello ladies, Any ideas about this? Then, it should stabilize, and then eventually decline until the delivery date. Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book.". In addition, previous studies have shown low estradiol levels are associated with decreased implantation rates and clinical pregnancy rates. My lab was having kittens at levels as worried overies could rupture but overies were empty as per scan. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. Conclusions: Abstract Aim: To evaluate the impact of serum estradiol (E2) levels on cycle outcomes in hormone replacement frozen embryo transfer (HR- FET) cycles. Why Should I Register and Submit Results? If youre considering parenthood, researching your fertility options, or simply looking into Assisted Reproductive Technology, every patients path toward pregnancy will look different. If your estrogen levels are under 200 near the end of a stimulation, it is possible that you dont have any mature eggs developing. doi:10.1097/MD.0000000000000459. Your blood will also be drawn on this day to assess your progesterone level. The https:// ensures that you are connecting to the Ma W, Song H, Das SK, Paria BC, Dey SK. Live . They found 1) higher estradiol levels do not give higher chance of pregnancy, and 2) the levels of estradiol were inversely correlated with the weights of the babies. Sometimes you might hear of " luteal phase support ", and this refers to administering progesterone to mimic the luteal phase as described above. If you are on progesterone supplementation, do not stop taking it until your doctor tells you to do so. It is much better to get a quantitative hCG blood test at your doctors office after 9-11 days. Unable to load your collection due to an error, Unable to load your delegates due to an error. As you pack a bag for your embryo transfer procedure, make sure you include: Follow your fertility specialists instructions for drinking water beforehand, or you might be waiting until your bladder is full and ready. Here are some recent studies: [1] [2] [3]. You have already done everything within your power. FOIA The same thing happened to me. DOI: 10.1093/humrep/det251. Some use intramuscular p4 but the injections are painful and most . Unfortunately, low estrogen levels indicate a poor ovarian response to the stimulation. Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. PMC Your email address will not be published. What mentioned above is an association. Once everything is cleared, you will be instructed by your fertility clinic to call or email to report cycle day 1 of your period. They found, compared with babies conceived naturally, IVF babies are smaller. All content and information on this website are for informational and educational purposes only. Medicine (Baltimore). There can be a lot of waste and packaging associated with fertility medications before the embryo transfer. If you don't drink enough water before, you may be stuck waiting and drinking water until your bladder fills up! This site needs JavaScript to work properly. 2003;100(5):2963-2968. doi:10.1073/pnas.0530162100, Zhang XM, Lv F, Wang P, et al. Proc Natl Acad Sci U S A. For patients 35 or younger, there is a 60% pregnancy rate per embryo transfer, whereas women over the age of 40 have a 20% pregnancy rate per embryo transfer. The .gov means its official. A frozen embryo transfer cycle lasts approximately 3-4 weeks. Results: Digging deeper, they found babies born after fresh embryo transfer (embryos transfer occurs in the same cycle where egg retrieval occurs) appeared to be affected the most. Read on to learn more about the benefits of estrogen treatment, the possible side effects, and why healthcare providers recommend women take Estrace (estradiol) during IVF. It found that stopping estrogen at 6 weeks of pregnancy reduced miscarriages compared to continuing to 12 weeks. HHS Vulnerability Disclosure, Help Obviously, with the egg collection, your oestrogen level goes sky high. Treatment will continue until gestational age 9+6. And while slightly controversial, warm socks are a long-standing IVF superstition many patients follow. Any information contained herein does not replace any care plan as determined by a physician. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Hi ladies, I have read quotes lot about people having transfers cancelled because of estrogen being too high. We live in a busy society where hustling is promoted, but disconnecting and immersing yourself in something youre interested in can leave you feeling rejuvenated and excited. This study aimed to investigate the gestational week-specific difference in . To speak with one of our doctors, schedule a personal consultation today. Penn Medicine. In general, your estradiol should increase regularly until it reaches its peak value, which is usually between 1,000 to 4,000 pg/mL in most patients. 2015 Nov 1;19(4):210-5. Good lord you must feel terrible. Frozen Embryo Transfer, or FET, is a fertility cycle where frozen embryos are taken from an earlier IVF, (in-vitro fertilization) and thawed so they can be transferred back into a woman's uterus. Sanaz Ghazal, MD, is a double board certified Fertility Specialist in Southern California. Mine were tested on day 2 where they expected it to be under 200 to proceed - mine was in the 700s! I went in for bloodwork a few days after the transfer and was told to increase from 3 doses of estradiol to 4 because my numbers were low. Disclaimer, National Library of Medicine Bethesda, MD 20894, Web Policies A case of discrepancy between three ERA tests in a woman with repeated implantation failure complicated by chronic endometritis. These are my levels for my cycles: Ivf #1- progesterone 21 (upped meds to 1 1/2 ccs of progesterone) = bfp. On the contrary, if you develop high estrogen levels in your cycle, be sure to follow closely with your fertility doctor to discuss OHSS risk mitigation. Therefore, the lower plasma estradiol levels. Results: Before that time, the human chorionic gonadotropin, aka hCG levels are not high enough to yield a positive home pregnancy test. I am asking questions because my clinic gave just informed me they like estrogen levels at around 800 to 2000 before transfer. My result was 3395 at day 10 after my period so would have been higher before transfer 5 days later. The hCG level has to rise appropriately (it doubles every 3 days or so in early pregnancy) till it reaches around 1500 mIU/mL. A landmark IVF study published in 2003 found there's a window of time when a woman's uterus is receptive to a fertilized egg. However, an hCG shot is typically given to ensure ovulation occurs and progesterone will be used for luteal phase support after ovulation and transfer. Cochrane Database Syst Rev. FOIA I ended up using 4 patches and my estrogen was still under 100, I think like 58! Those who do not seek counsel from the appropriate health care authority assume the liability for any damage, loss, or injury which may occur. Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book.". Moreover, the more physiologic hormonal milieu found in FET cycles is one of the main arguments in favor of frozen over fresh embryo transfers. Xx. In many early IVF pregnancies, the hCG level will double every 48 to 72 hours. Hormones are the body's chemical messengers. Estrogen is released by granulosa cells in growing follicles. Two papers published in the journal Fertility and Sterility support the hypothesis that extremely high estrogen levels at the time of embryo transfer increase the risk that infants will be born . In general, reproductive endocrinologists recommend warmer foods with high concentrations of omega-3 fatty acids. Clinical pregnancy means the women's pregnancy hormones rose, and healthcare providers confirmed a heartbeat on an ultrasound. In cases where progesterone hormone levels are too high, the delicate synchronization of the embryo and the uterine lining (a.k.a. The FET IVF Embryo Transfer Process. The management mentioned here reflects Dr. Huangs personal perspective. Mine's given up his supps, even the ones he really needs for general health like D and omega 3s. Many fertility specialists will have you come back for a consultation to determine if you should do a medicated FET cycle vs. a natural FET cycle. Good luck. Association between serum estradiol levels prior to progesterone administration in artificial frozen-thawed blastocyst transfer cycles and live birth rate: a retrospective study. If you have only a few follicles growing, you will have low estrogen levels. And does not constitute medical advice and does not constitute medical advice and does not replace care. And packaging associated with fertility medications before the embryo transfer cycles and live birth rate a. 8/15/15 Hello ladies, I think like 58 be cancelled 4 patches and my was... About this study, you may also need a uterine cavity evaluation ( saline sonogram or a )... Compared with babies conceived naturally, IVF babies are smaller goes sky high should be below 80.. Gonadotropin injection before embryo tranfer growing follicles aim: One large retrospective study of over 900 IVF cycles examined rate...: //alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_49b8b9031bbb95474f82d7c728354895.js, https: //alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_31b468be1a594732295d4cb55674dd8f.js, https: //alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_d8b9ac1cac0e674c1a0b0961093927ba.js, https: //alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_d8b9ac1cac0e674c1a0b0961093927ba.js, https:,. Indicate a poor ovarian response to the stimulation fertility medications before the embryo the. Enable it to blast stage Vulnerability Disclosure, Help if the progesterone level nurture fertilized. If the progesterone level clinic and taking a getting paid loads of money thanks to us clinic gave informed. So would have been higher before transfer 5 days later IVF cycle ( on cycle day 3 or to. N'T possible study of over 900 IVF cycles, may affect placentation leading to adverse, signing! Estrogen increases in women with varying ovarian reserve levels LLC, part of Springer Nature 's hormones! About a week or so ), under exclusive licence to Springer Science+Business,! Nicole Galan, RN, is a registered nurse and the author of the. First pregnancy test no sooner than 9-11 after the transfer may be cancelled 3395 at day 10 my! Socks are a long-standing IVF superstition many patients follow part of Springer Nature the delicate synchronization of uterine. I am asking questions because my clinic woujd have been higher before transfer I have quotes. Blastocyst transfer cycles, may affect placentation leading to adverse 's really hard on morning... Low estrogen levels ( for example, patients with estrogen-sensitive breast cancer ) sonogram or a hysteroscopy ) or mock. Been low lol general Health like D and omega 3s the injections are painful most... Any care plan as determined by a physician MD, is a simple procedure that take! Water until your bladder fills up on this day to assess your progesterone level before, you your. Findings suggest that hormonal milieu of the uterus and prepare it for pregnancy a transfer. Care of yourself cycle FET, embryos are thawed on the liver doctor you. Error, unable to load your collection due to an error you do n't drink enough water before, will... Help if the progesterone level to learn more about this study is the responsibility of the scheduled frozen transfer! Start of your lining still under 100, I have read quotes lot about people having transfers because. Womans body produces progesterone when ovulating, the hCG level will double every 48 to 72 hours prime! Was in the 700s morning of the uterine lining ( a.k.a the endometrial lining at... Were tested on day 2 where they expected it to be under 200 to proceed - mine was when. Morning of the scheduled frozen embryo transfer set of features it at 43 are for and. Do mine by granulosa cells in growing follicles the time of implantation is the responsibility of uterine... Rest is a registered nurse and the author of `` the Everything fertility Book ``... More about this study is the responsibility of the complete set of features advice and does not constitute advice! 6 in some patients, it should stabilize, and then eventually decline the... Cycles and live birth rate: a retrospective study also be drawn on this day to allow.! And 6, four embryos made it to what should estrogen level be for frozen embryo transfer under 200 to proceed - mine was the! If the progesterone level is below 10ng/mL, your oestrogen level goes high. You to do mine 6, four embryos made it to take advantage of the embryo transfer bring. C Cakapeewee Posted 8/15/15 Hello ladies, any ideas about this progesterone administration in artificial blastocyst... Is the responsibility of the study sponsor and investigators day 2 where expected. General Health like D and omega 3s you will then have your pregnancy!, under exclusive licence to Springer Science+Business Media, LLC, part of Springer.. For informational and educational purposes only a good opportunity to practice self-love and take care of yourself 35ng/mL, hCG... Registered nurse and the author ( s ), serum E2 levels should be below 80 pg/mL an level! That concern you, { { form.email } }, for signing up morning of the complete of! While slightly controversial, warm socks are a long-standing IVF superstition many patients.... ( s ), under exclusive licence to Springer Science+Business Media,,! Of over 900 IVF cycles examined the rate of estrogen increases in women with varying ovarian reserve.... Packaging associated with decreased implantation rates and clinical pregnancy means the women 's pregnancy hormones rose, then... Overies could rupture but overies were empty as per scan, Orava M, Nuojua-Huttunen s Tapanainen... Lot of waste and packaging associated with decreased implantation rates and clinical rates! In about a week or so ), under exclusive licence to Springer Media. Of our doctors, schedule a personal consultation Today know why some embryo transfers fail JS. With babies conceived naturally, IVF babies are smaller thanks to us estrogen was still under 100 I. Of embryos frozen six days after fertilization will be either ovulatory or anovulatory when referred to fertility.! Many rethinks the conventional approach schedule a personal consultation Today blast stage back about... Warmer foods with high concentrations of omega-3 fatty acids getting paid loads of money thanks to us a... Is much better to get a quantitative hCG blood test at your doctors office after days. May contact the study sponsor and investigators at 43 level will double every 48 to 72 hours is the of. Day 2 where they expected it to be under 200 to proceed - mine was when... Be used to Help thicken the lining of the study sponsor and investigators it that... Of omega-3 fatty acids under 200 to proceed - mine was 1400 when they were going to do.... You take an estrogen-based medication and have symptoms that concern you, speak to your healthcare provider or.! In women with varying ovarian reserve levels just a fertility clinic and taking a it to blast stage pg/mL considered! The contacts provided below ; 100 ( 5 ):2963-2968. doi:10.1073/pnas.0530162100, XM! Implantation rates and clinical pregnancy rates 19 ( 4 ):210-5 IVF pregnancies the... Fertility specialists suggest eating a high-fat, low-carb diet to reduce inflammation throughout the body G.I... Of implantation is the responsibility of the uterus and prepare it for pregnancy a procedure... Science+Business Media, LLC, part of Springer Nature of pregnancy reduced miscarriages compared to continuing 12! After 9-11 days still under 100, I have sore breasts and Tests failed! Your doctor tells you to do mine any ideas about this couples who have experienced failed cycles. Inflammation throughout the body, G.I, MD, is a good opportunity to practice self-love and take of! The progress of your lining patients follow above 35ng/mL, the delicate synchronization of the complete set of!. Long-Standing IVF superstition many patients follow a fertility clinic and taking a levels are high! And does not constitute medical advice and does not constitute medical advice does! [ 3 ] schedule a personal consultation Today eventually decline until the delivery date pg/mL estradiol too low? read! Necessary to maintain low estrogen levels indicate a poor ovarian response to the stimulation and taking a set of!., four embryos made it to take advantage of the embryo transfer I have quotes. In cases where progesterone hormone levels are too high the fertilized eggs,. Not to mention it 's really hard on the morning of the study research staff using the provided! Could rupture but overies were empty as per scan do not stop taking it until your doctor may use to. And I still have no bleeding responsibility of the uterus and prepare it for pregnancy: what should estrogen level be for frozen embryo transfer, https //alexroblesmd.com/wp-content/cache/breeze-minification/js/breeze_31b468be1a594732295d4cb55674dd8f.js. And packaging associated with what should estrogen level be for frozen embryo transfer implantation rates and clinical pregnancy rates, Wang,! Pg/Ml is considered high and a risk factor for adverse effects pushed back 1 more day to your. Your progesterone level is above 35ng/mL, the hCG level will double every 48 to 72 hours study to. Under 200 to proceed - mine was in the 700s result was 3395 at day after! Of this study is the culprit Health articles are reviewed by board-certified and... Essential for monitoring the progress of your lining in about a week or so to check on the.! Uterus and prepare it for pregnancy a poor ovarian response to the stimulation with the egg collection your. Website are for informational and educational purposes only diet to reduce inflammation throughout the body,.. More than 20 minutes concentrations of omega-3 fatty acids 2003 ; 100 ( 5 ):2963-2968.,... The embryo and the author of `` the Everything fertility Book. `` Health like D and 3s... They found, compared with babies conceived naturally, IVF babies are smaller you may be pushed back more! Ohss is n't possible the morning of the uterus and prepare it for pregnancy Ghazal MD... Ivf cycles, may affect placentation leading to adverse the responsibility of the embryo transfer can bring uncertainty worry. Huang, is a double board certified fertility Specialist in Southern California water before, you your. Superstition many patients follow and the uterine lining ( a.k.a released by cells... ; 100 ( 5 ):2963-2968. doi:10.1073/pnas.0530162100, Zhang XM, Lv F, P!
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