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Understanding the First Stage of IVF, Ovarian Stimulation

Have you ever heard about IVF treatment, or have you ever been recommended the same by your fertility expert?

Well, if yes, then you might have come across some difficult-to-understand complex medical terms. Nonetheless, it is important to have an understanding of what happens at each stage of the treatment. So, let us consider the first stage of IVF, i.e., ovarian stimulation.

To better understand the stage of ovarian stimulation, the first factor to know is how ovulation takes place in women.

When Is Ovarian Stimulation Used?
Ovarian stimulation is generally used:
• To induce ovulation in patients with ovulatory dysfunction to help them conceive.
• For egg retrieval in IVF treatments.
• To store eggs for future use.

How Does Ovarian Stimulation Operate? In a natural ovulatory cycle, natural hormonal changes determine the maturation and release of the egg. However, it does not occur naturally in some women and therefore drugs are given to the patient to stimulate ovarian function. This allows you to program any hormonal changes, thus optimizing the quality of the released eggs.

Stages of IVF Treatment
• Ovarian stimulation
• Egg retrieval
• Insemination/ ICSI
• Embryo transfer

There are two types of ovarian stimulation:
• The long protocol and
• The antagonist protocol.

In the long protocol, the ovarian stimulation process is usually started a week before the due date of the next menstrual period. However, in the antagonist protocol, stimulation begins on the second day of the menstrual cycle. Different hormones are administered so that multiple mature eggs can be retrieved with a single egg retrieval procedure.

Ovarian stimulation is achieved through injections of gonadotropin which contains follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These stimulate the growth of several follicles in the ovaries. FSH injections are given for about ten days before the patient is ready for egg retrieval.

The patient is closely monitored using ultrasound during the ovarian stimulation phase, where the number of follicles present is counted, along with their size measurement. If enough follicles with a diameter greater than 17-18 mm are found, the program for the process of egg recovery is scheduled. A final injection of HCG is given to promote the final maturation of the eggs.

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