Ovarian stimulation has been considered to be a boon for women who have been facing problems with their ovulation. Since ovulation naturally suggests a normal menstrual cycle and also indicates normal female fertility, situations in which an ovary fails to produce a mature egg directly point towards the condition called amenorrhea, and from there, infertility.
As long as this issue prevails, it will keep on pushing a woman to the point of becoming highly infertile, making her lose all hopes of conceiving and bearing a child. Concerns related to ovulation and fertility have thus prompted the need to analyze the prospects of ovarian stimulation in this article. The feasibility of this method will be determined by understanding how it works to promote female fertility, especially in those who are having persistent issues with ovulation.
Ovarian Stimulation – What It Is and Why Is It Required?
Explaining Ovarian Stimulation
Ovarian stimulation refers to the process of artificially stimulating the ovaries to produce and release the desired quantity of eggs. Since stimulation requires follicle maturation through artificial techniques, basically through fertility medications or supplements, this procedure is recommended in cases where women find it hard to conceive through natural means.
Poor ovulatory reserve being one of the predominant factors besides advanced age, makes the ovaries incapable of producing and releasing the required quantity of eggs and in needed quality. Thus, technically speaking, ovarian stimulation not only assists in the process of stimulating the follicles to release eggs, but also raises the possibility of successful fertilization through this procedure.
Albeit the fact that fertilization also requires assistive modalities, such as IVF and/or IUI, this method has been considered highly effective in treating and managing fertility-related issues by improving/increasing the chances for the inseminated sperm to reach the fallopian tube/s and fertilizing the formed eggs through ovarian stimulation. In the case of IVF, this involves maximizing the quantity of eggs to be retrieved during the egg retrieval process. Doing so allows more than one egg to be mixed with the semen, thus increasing the chances of fertilization and resultant conception.
When Is It Necessary To Consider Ovarian Stimulation?
Ovarian stimulation is required in cases that necessitate females to undergo fertility treatment. This is prior to opting for IUI or IVF when natural fertilization does not take place even after stimulating the ovaries.
This process will also require extensive lab tests, which upon being reviewed by the physician, will prompt the latter to prescribe medications to help stimulate the ovaries. It would be appropriate to mention here that fertility medications/supplements are one of the most preferable options to stimulate the ovaries.
It is because they act like natural hormones, i.e., in the likes of the follicle-stimulating and luteinizing hormones to help induce ovulation. Because both IVF and IUI require eggs of high quality and quantity, medications like Clomiphene citrate, gonadotropins, Letrozole, and Bromocriptine are known to effectively help in this regard.
How Does Ovarian Stimulation Work?
Since it has been discovered that fertility medications function like normal hormones to assist in the stimulation and maturation of the ovarian follicles, it is obvious that these will help produce and release eggs in the desired quantity and quality than normally required for fertilization via IVF or IUI.
Ovarian stimulation, therefore, involves a phase-by-phase manner in which an individual is first administered these hormonal medications, and this is done for 8 to 10 days after completing one menstrual cycle.
Ovarian stimulation, as could be stated, is most often considered a preliminary step in IVF or IUI. The goal of this procedure is to harvest as many eggs as possible to maximize the chances of fertilization of at least one egg. Following successful fertilization, the formed zygote is then implanted back into the uterus.
Noting that it is the FSH that mostly triggers follicles to mature, egg growth happens simultaneously. It is certain that with the release of eggs, there is the resultant and increased production of estrogen. It should be known here that though both FSH and LH assist with ovulation, there is a subtle difference between these two hormones – while FSH causes the follicles to mature and aid in egg growth, leading to estrogen production, it is the LH that helps with the release of the more mature eggs. Surprisingly,
fertility medications work on this concept, which is why they seem more like natural hormones, thus improving the chances for those having fertility issues secondary to ovulatory disorders. Fertility medications are usually self-administered through injections and this process should continue for 9 to 11 days.
Ovarian Stimulation and Eggs Retrieval
From all that has been discussed so far, it has been established that ovarian stimulation plays a pivotal part in IVF/IUI. It is equally important to note here that the processes involved there do not simply end with stimulating the ovaries to release the required quantity and quality of eggs through the self-administration of fertility medications.
Monitoring of the follicles is also highly critical to ensure that the hormone levels are optimal to assist in ovulation. Doing so helps prevent the risks and the ensuing complications associated with Ovarian Hyperstimulation Syndrome (OHSS).
Since monitoring occurs post-ovarian stimulation, what remains is egg retrieval. This usually leads from the hormonal level tests/monitoring upon which a physician can be able to predict the exact date for retrieving the eggs.
Once it has been found that the follicles are maturing as expected, the physician will schedule a date for injecting the Human Chorionic Gonadotropin (hCG) to trigger egg maturation and ultimate retrieval for utilization in the IVF/IUI procedure.
Egg maturation happens within 35-36 hours, which is exactly 1½ days post hCG administration, during which time, a fertility specialist will perform a transvaginal oocyte retrieval procedure. This process involves aspirating/extracting the eggs. Usually, a transvaginal ultrasound probe is utilized during this time to help guide the needle for retrieving the matured eggs.
Along with the matured eggs, the fluid contents are also aspirated from the follicles, which are then collected in a test tube. The number of eggs retrieved through this procedure, therefore, determines how well the ovaries have responded to the ovarian stimulation technique.
The discussions carried out so far have helped in proving that ovarian stimulation does indeed play a vital role in IVF/IUI. Though all these processes come within the assisted reproductive technology, one should not leave out to consider that the chances of fertilization depend on the quality and quantity of the eggs retrieved.
Couples undergoing such techniques of conception should also be wary of other risks associated with the procedure, which include the OHSS that was mentioned above. Nevertheless, monitoring the follicles post-ovarian stimulation will effectively help prevent the same.