In-vitro fertilization (IVF) is a type of assisted reproductive technology involving numerous procedures, including ovarian stimulation. This portion of the treatment program is a common precursor to artificial insemination, as it increases the chances of the sperm fertilizing an egg. 

But what does this process involve? What should you expect? In this article, we review ovarian stimulation and the processes involved. 

Read more: Egg Donation

What is Ovarian Stimulation?

Ovarian stimulation is a treatment designed to induce ovulation and increase the number of eggs your body releases. This procedure is designed to imitate the body’s natural ovulatory cycle by using various hormonal medications, including follicle-stimulating hormones (FSH) and luteinizing hormones (LH).

These hormones initiate the natural process of stimulating the eggs to mature and release, allowing fertility specialists to retrieve them for IVF. This stimulation helps promote the release of more than one mature egg in that one particular month, as would have otherwise taken place without the stimulation, although the release of one egg per month is standard in normal ovarian function. 

However, the release of more than one egg helps increase the probability of pregnancy and limits the need to repeat the process soon after if the initial procedure is unsuccessful. Additional eggs can be used immediately or stored for use at a later date.  The more eggs made available, the more embryos can be produced, and the greater number of embryos allows for the selection of the best embryo to implant. This process of “producing more eggs in one cycle” is found to be the most efficient for the purpose of doing IVF and achieving a successful pregnancy. 

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Ovarian Stimulation Process

The ovarian stimulation process varies based on circumstances specific to the situation, as two approaches are used: the long protocol and the antagonist protocol. 

The long protocol is widely regarded as the conventional process. Women begin this process approximately one week prior to their next menstrual period start date. At this point, the fertility specialist administers a gonadotropin-releasing hormone called GnRH-analogue. 

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This hormone stops natural ovarian function from occurring, preventing the release of eggs before the medical team is ready to retrieve them. Once the menstrual cycle begins, the patient starts injecting hormones daily. While this takes place, the fertility team monitors the progress of the patient and after about two weeks, those eggs are ready to be retrieved. 

In other situations, the IVF team may opt for the antagonist protocol. They often use this method after an unsuccessful long protocol or when the patient has a reduced ovarian reserve or polycystic ovaries

In this process, the injections begin after the menstrual cycle begins. This helps boost egg maturity and promote the release of more mature eggs to raise the number of eggs the medical team collects during retrieval. 

The process the patient undergoes in this ovarian stimulation treatment hinges on factors specific to each individual. The fertility doctor will examine numerous aspects of the circumstances surrounding each situation to select the process that needs to be applied as well as make adjustments on the go.  It’s similar to a pilot landing a plane, the pilot needs to look at many variables concurrently, make adjustments based on the conditions present and bring the plane to that perfect soft landing.  

In some cases, the patient may complete both processes. This is more common when the initial long protocol is unsuccessful, resulting in following up with an antagonistic protocol. 

Ovarian Stimulation Medications

The ovarian stimulation IVF process involves injecting various medications that aid in stimulating egg maturation and release. These injectable medications, called gonadotropins, contain various hormones that mirror the body’s natural hormone release. 

In some cases, your doctor may prescribe oral medications that deliver indirect ovarian stimulation. 

Ovarian Stimulation Injections

Generally, ovarian stimulation injections contain two essential hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones contribute to follicle growth stimulation in the ovaries. 

The follicle-stimulating hormone helps regulate a woman’s menstrual cycle and stimulates egg growth in her ovaries. Conversely, the luteinizing hormone, secreted by the pituitary gland, is responsible for initiating ovulation and hormone production necessary to support a growing baby.  

Combining these hormones in IVF injectables helps recreate the body’s natural processes. Generally, women receive FSH injections for around 8-14 days before oocyte retrieval. 

Managing the Ovarian Stimulation Process

Starting the ovarian stimulation process may present a confusing mix of hope and stress, as past complications or skepticism can weigh heavy on the mind. As you begin the process, feel free to ask your doctor about any questions or concerns that arise, as this may help alleviate stress stemming from the newness. 

Managing your injections is a crucial part of this process. Many women self-administer the injections or enlist the help of their significant other. Taking prescribed pills and patches may also be necessary based on your specific plan.

As you progress through your treatment, it’s important to remember to follow your doctor’s instructions to a tee, as each step requires careful, precise timing. Hiccups along the way can interrupt the process and require a restart, so utmost care is essential. 

Generally, regular testing and appointments are necessary to monitor your body throughout the treatment and ensure you’re responding well. However, if something comes up between appointments, always contact your medical team with any questions surrounding your treatment. 

Ovarian Stimulation Side Effects

The injections and processes associated with ovarian stimulation can present various side effects. While serious complications are rare, it’s essential to understand the potential side effects of this treatment. 

Common side effects of this treatment plan include mood changes, bloating, and cramping. While most women tolerate these injections well and don’t experience severe side effects, serious complications can occur in rare cases. 

Ovarian hyperstimulation syndrome is one of the more serious side effects associated with ovarian stimulation. It stems from an exaggerated response to excess hormones, such as those administered in medications or injections of your IVF treatment plan. 

This syndrome causes the ovaries to swell, creating pain and discomfort and leading to various symptoms, including nausea, vomiting, diarrhea, and abdominal bloating. While it can improve without medical attention, severe cases can require hospitalization. 

Any responsible and professional IVF clinic will monitor a patient undergoing ovarian stimulation very carefully, and in this day and age hyperstimulation is therefore easily avoided, simply due to the protocol of monitoring the patient by the fertility specialists who are directing her treatment.  The chance of getting hyperstimulation increases if a patient misses appointments with her IVF clinic but even if such a condition occurs, it is easily corrected and manageable by the physicians involved. 

Learn More About Ovarian Stimulation for Your IVF Journey

Ovarian stimulation is often a crucial part of the IVF process. If you have questions or concerns about the process or side effects of ovarian stimulation before starting the process, our team at ELITE IVF is dedicated to providing compassionate, expert assistance through the ups and downs of your fertility journey. Contact us today for more information.