Update on ovarian stimulation

What is ovarian stimulation?

In a typical menstrual cycle, the ovary produces a follicle. At the time of ovulation, this one expels an oocyte, which will be, or not, fertilized by a sperm.

Ovarian stimulation: for whom?

Ovarian stimulation is for all women who fail to become pregnant due to irregular or absent ovulation. This technique is the first step before heavier treatments, such as in vitro fertilization (IVF) and inseminations.

How ovarian stimulation works

First of all, you must undergo a fairly long and restrictive battery of tests, but essential if you want increase your chances of pregnancy. After a thorough interview and physical examination, the doctor will ask you to take your temperature every morning for two or three months to find your due date.ovulation. Then he will prescribe blood tests to measure different hormones (FSH, LH and estradiol), as well as a pelvic ultrasound in a specialized office. If you are not ovulating, you will need to take duphaston to trigger your period. It is only after this step that you can start the treatment.

Ovarian stimulation: what are the treatments?

Three types of treatments are possible for a ovarian stimulation :

• benefits pharmaceuticals (Clomiphene citrate, known as Clomid), orally. They have anti-estrogenic action. The advantage: they are tablets to be taken daily for 7 days per cycle. They will induce a FSH secretion, the hormone responsible for the growth of follicles, thus causing stimulation of the ovary.
• benefits hormone injections. Some medical teams prefer administer FSH hormone directly. Gonadotropins (FSH), in injectable preparations, act directly on the production of follicles in the ovary. They are administered by bites (intramuscular, intradermal or subcutaneous).
• Less known, LRH pump delivers the hormone that some women lack (gonadorelin) to allow ovulation. They should wear this pump until they are pregnant. Either way, you may need to try several treatments before you find the one that’s right for you. Hold fast !

Ovarian stimulation via Clomid, gonadotropins… What side effects?

With LRH pump, there is no adverse effect. As for treatment with Clomid, it causes few side effects, with the occasional exception of visual disturbances, headaches, digestive disturbances and nausea. In some cases, this medicine may also have an adverse effect on the cervical mucus, which requires to associate a treatment with estrogen.

Hormone injections, on the other hand, are often accompanied by sensations of heaviness in the legs, heaviness in the lower abdomen, a slight gain in weight or even digestive disorders.

More serious and fortunately rarer, the syndromeovarian hyperstimulation translates to a swelling of the ovaries, the presence of fluid in the abdominal cavity and a risk of phlebitis. This phenomenon occurs whentoo many follicles have matured. But the heaviest effect is certainly psychological. Stress, fatigue… it is important that you feel calm during this treatment.

Monitoring ovarian stimulation

A dual monitoring, biological and ultrasound, is essential during ovarian stimulation. The ultrasounds allow follicles to be measured and therefore their growth to be followed, and the hormonal assays (blood tests) are used to monitor estradiol levels. They also give the measurement of hormonal secretions and follicles.

The objective of this ovulation monitoring is also to adapt the treatment, to prevent the risks of multiple pregnancy (by increasing or decreasing the intake of hormones), to indicate the ideal date for intercourse, or possibly from trigger ovulation, most often by an injection of HCG which mimics the peak of LH ovulation inducer.

Ovarian stimulation: what are the chances of success?

The response to treatment varies from woman to woman. It all depends on the cause of your infertility, your age, your history… When the right treatment has been found, it is as if we had re-established the first link in the chain. It is observed that a pregnancy usually occurs in the first four months.