ARE YOU OVULATING IRREGULARLY OR NOT AT ALL?
HORMONAL STIMULATION THERAPY CAN HELP.
This treatment, known as hyperstimulation, stimulates the ovaries to discharge multiple eggs in a single menstrual cycle. More eggs may result in more embryos, increasing your chances of a successful assisted reproduction treatment.
A comprehensive medical examination will allow our doctors to recommend the most suitable of several available hormone stimulation procedures. Special fertility treatment methods can increase the fertilisation rate and help embryos grow and develop.
Ovarian stimulation is the second stage of IVF fertility treatment. The goal is to collect as many mature eggs as possible from the woman’s ovaries. Collecting many eggs maximizes the chances one of the eggs can be fertilized, implanted back into the uterus, and become a healthy baby.
Because the natural female reproductive cycle is incredibly complex, ovarian stimulation is also a complicated process. An IVF cycle can be stressful, especially when you’re going through it for the first time.
Let us explain what ovarian stimulation is, how it works, and what happens during this phase of your IVF journey.
BEFORE YOU START
Before you start ovarian stimulation, you will have undergone extensive fertility testing. Testing will include blood tests to show the baseline levels of hormones in your body, allowing your physician to recommend a treatment regimen that’s suited to you. It’s likely you’ll also be on birth control pills for several weeks beforehand, so we can be confident about your hormonal clock.
A REGULAR OVULATION CYCLE
Within a woman’s ovaries are hundreds of thousands of ovarian follicles, each of which contains an oocyte (an immature egg cell). A follicle is a small, fluid-filled cyst.
During each menstrual cycle, several follicles begin to develop, each capable of releasing a mature egg during ovulation. Normally, a single one of these—called the dominant follicle—will grow faster than the others. A dominant follicle that is ready to ovulate is about 18-28mm in diameter.
The dominant follicle releases an egg during ovulation, at the mid-point of the menstrual cycle. If a woman isn’t pregnant, she will normally have her period around 14 days after ovulation.
Some female factor fertility issues can affect the development of follicles. The most notable is Polycystic Ovarian Syndrome, a very common and highly treatable condition.
HOW OVARIAN STIMULATION WORKS
In an IVF cycle, you maximize your chances of success by generating as many mature eggs as possible. The stimulation phase involves the injection of medications for 8-14 days, to induce the ovaries to produce many eggs. The stimulation phase takes longer if your follicles are slower to mature.
The medications stimulate (and are derived from) two key hormones, Follicle Stimulating Hormone (FSH) and Lutenizing Hormone (LH). These hormones have the following effects:
As the name suggests, FSH stimulates follicles to develop during the menstrual cycle. Normally, non-dominant follicles die off before ovulation as FSH levels fall. FSH injections maintain higher levels of FSH in the body, allowing the ovaries to produce more mature eggs.
Just before ovulation, higher levels of estrogen trigger a spike in LH, which causes ovulation. A ‘trigger shot’ of a large dose of human chorionic gonadotropin(hCG), which stimulates ovulation, starts the process.
After ovarian stimulation, but before ovulation, comes the egg collection phase of IVF.
WHAT TO EXPECT
The ovarian stimulation process requires good timing and great care. A problem can require the process to be restarted—a frustrating and discouraging experience. At the same time, this phase of treatment can be a time of great hope and expectation.
IVF medications are often complicated. You’ll likely be self-administering a combination of injections, patches, and pills. Under the stress of IVF, it’s very easy to forget what medications you need to take at what times. If this happens to you, don’t be embarrassed or alarmed, but seek help and advice. Our IVF coordinators are ready to assist.
Once you’re taking medications to stimulate your ovaries, you’ll need tests to measure the levels of hormones in the body. Because every woman responds to IVF medications differently, hormones must be adjusted day-to-day to ensure enough follicles are stimulated, and to reduce the risk of ovarian hyperstimulation syndrome.
Your IVF Specialist will require an ultrasound to monitor the growth of follicles within the ovaries.
Because of the need for regular tests and medications, you will be in constant communication with your medical team. That’s one of the reasons it’s important to choose a medical team you trust.
STRESS AND MOOD CHANGES
Perhaps not surprisingly, given of the demands of the process, stress and mood swings are common during ovarian stimulation. Mood swings can be a combination of hormonal changes in your body, and the stress of IVF treatment itself—it’s often hard to separate the two.
WE UNDERSTAND THAT OVARIAN STIMULATION IS ONE OF THE MOST CHALLENGING PARTS OF IVF. WE HAVE EXAMINED THE PROCESS FROM BEGINNING TO END, MAKING IMPROVEMENTS THAT MAKE LIFE EASIER FOR PATIENTS, MAXIMIZING THE CHANCES OF A SUCCESSFUL CYCLE.