Stimulating your ovaries

To understand the IVF process, ideally you need to be familiar with the relevant parts of the menstrual cycle, so here's a quick recap on how eggs are normally formed in your body. The pituitary gland in your brain regulates your menstrual cycle by producing two hormones: follicle-stimulating hormone (FSH) and luteinising hormone (LH). Your pituitary gland releases follicle-stimulating hormone which, as the name suggests, stimulates the growth of several follicles in your ovaries. Follicles are fluid-filled sacks and each follicle contains one egg. As the follicles grow, one becomes dominant and the other follicles stop developing. When the dominant follicle reaches a certain size, your pituitary gland releases luteinising hormone, which causes the egg to mature and leads to ovulation, when the follicle bursts and releases the egg. Your fallopian tube captures the egg, which may then be fertilised.

The drugs that are used in IVF 'trick' your body into bringing to maturity multiple follicles and eggs and then stop the eggs from ovulating too soon so that in-vitro fertilisation can take place.

You receive daily injections of follicle-stimulating hormone to promote the growth of multiple follicles. When the follicles reach a certain size you have a single injection of human chorionic gonadotrophin (hCG) to trigger the final maturation of the eggs.

To prevent the follicles from releasing the eggs too soon, most controlled ovarian stimulation protocols include a class of drugs called gonadotrophin-releasing hormone (GnRH) analogues, given as either a nasal spray or an injection. This drug blocks the body's normal production of follicle-stimulating hormone and luteinising hormone from the pituitary gland, and makes sure the eggs aren't released before the egg collection procedure.

You receive your injections of follicle-stimulating hormone subcutaneously, meaning just under the skin, with a short needle. Since you need these injections on a daily basis, the most convenient method is for you to give yourself the injections, and the nurse shows you exactly how to do this.

If you find it too difficult to inject yourself, the nurse can show your partner or a friend how to give you the injections.

After a week or so of injecting yourself with follicle-stimulating hormone, you probably feel a bit like a pincushion, but your injection technique should be down pat. Now's the time to attend your scheduled vaginal ultrasound examination to find out how your ovaries are responding to the drugs. From the ultrasound image, your doctor can:

1 Check your ovaries close up to count and measure the size of the follicles that are growing.

1 Measure the thickness of the lining in your uterus, which is an important indicator of how 'ready' the eggs are.


Looking at the ultrasound image, you may see a few bigger follicles and many small follicles. Bear in mind that the number of follicles you see on ultrasound is not necessarily the same as the number of eggs you end up with, because:

1 Only the big follicles contain mature eggs.

1 The eggs can be hard to find, so counting the number of bigger follicles doesn't necessarily equal the number of eggs you get.

In addition to the ultrasound, you may be asked to have a blood test to measure the level of oestradiol (a hormone produced by growing follicles) in your body.

Putting together the information from the ultrasound examination and the blood test helps your doctor to decide how many more days of follicle-stimulating hormone injections you need and whether the dose should be increased or decreased.

Breaking the menopause myth

Will I reach menopause sooner because I 'use up' so many eggs in IVF?

Many women who use fertility drugs and produce a lot of eggs ask this question. Women become menopausal when they run out of eggs, and since in a normal menstrual cycle only one egg ovulates, the question is a fair one for women on IVF producing many eggs. Fortunately, IVF stimulation does not shorten your ovaries' active life. Here's why:

1 In a normal cycle, several follicles begin to grow but over time one takes the lead to become the dominant follicle and produce a mature egg at ovulation. All the other follicles are spent and lose their chance to ever produce an egg.

1 In a stimulated cycle, the fertility drugs rescue the follicles that would've been spent in a normal cycle and allow many of them to grow and reach the stage where they contain a mature egg.

So you produce the same number of eggs in a stimulated cycle as in a normal cycle: The difference is that in a stimulated cycle more of them reach maturity.

Pregnancy Nutrition

Pregnancy Nutrition

Are You Expecting? Find Out Everything You Need to Know About Pregnancy and Nutrition Without Having to Buy a Dictionary. This book is among the first books to be written with the expertise of a medical expert and from the viewpoint of the average, everyday, ordinary,

Get My Free Ebook

Post a comment