This article is primarily for all the egg donors and patients undergoing a follicle stimulation procedure. This will help them gather as much knowledge as possible about the process and alert them on the precautions they are required to take before the execution.

The second stage of the IVF treatment cycle is the ovarian stimulation. It is executed in order to harvest maximum numbers of mature eggs from the woman’s ovaries to increase the chances of successful fertilization. The fertilized eggs form embryos and are implanted back into the uterus to develop into a healthy pregnancy.

The natural female reproductive cycle is a complicated process. Ovarian stimulation is no less. An IVF cycle can be stressful for patients going through it for the first time.

The entire procedure of ovarian stimulation and preparing for the egg retrieval is an emotional phase for the intended couples. The follicle stimulation involves strict rules and recommendations for its successful implementation. Breaching the rules set for the procedure, may undermine the final outcome. Intended mothers wholeheartedly participate in this procedure to make sure that their IVF cycle is a successful one. Egg donors also involve themselves with all the required professionalism and undergo the procedure with full commitment.

Before the Procedure

The woman goes through extensive fertility screening before the initiation of her ovarian stimulation procedure. The screening include a series of blood tests to track the levels of hormones present in her body. The doctor then recommend a treatment regimen to her based on the test results. She is put on birth control pills in order to control her cycle.

Regular Ovulation Cycle

There are countless ovarian follicles within a woman’s ovaries. Each of these small and fluid-filled cyst ovarian follicles contains an oocyte or an immature egg cell.

A number of follicles grow during each menstrual cycle and release a mature egg during ovulation. A single one of these is known as the dominant follicle. This grows comparatively faster than the others and ovulates in about 18-28mm in diameter.

An egg is ovulated by the dominant follicle during the middle of the menstrual cycle. In case the woman is not pregnant, she is expected to have her period around 2 weeks after the ovulation.

There are certain female fertility issues that have the capacity to affect the normal development of follicles. Polycystic Ovarian Syndrome is one of the most common factors that hinder the natural follicle development. This, however, is a treatable condition.

How Ovarian Stimulation Works

Ovarian stimulation is an important part of an IVF cycle. It maximizes the chances of successful mature egg generation. The phase of stimulation includes injections of medication for 8 to 14 days. This induces the ovaries to generate multiple high-quality eggs. The procedure of stimulation may take longer in case the follicles are slower to mature.

The medications stimulate two key hormones:

1. Follicle Stimulating Hormone (FSH), and

2. Luteinizing Hormone (LH)

The effects of these hormones are as follows:

1. The FSH hormone stimulates the ovarian follicles and helps them grow during the menstrual cycle. As a matter of fact, the non-dominant follicles normally die off as the FSH levels fall before ovulation. FSH injections are given to the patient to maintain higher levels of FSH in the body. This helps and allows the ovaries to produce multiple mature and high-quality eggs.

2. High levels of estrogen usually are expected to trigger a spike in LH just before ovulation that allows the process of ovulation. A large dose of human chorionic gonadotropin (hCG) stimulates the ovulation process.

The egg retrieval phase of the IVF cycle comes before ovulation and after ovarian stimulation.

What to Expect From the Ovarian Stimulation Process

The entire procedure of ovarian stimulation should be executed with a lot of care and is depending on good timing. Any miss in the procedure might call for restarting the procedure over again. This is a frustrating and discouraging experience for the intended parents, as well as the team of IVF consultants working on the particular case. This is a phase when the couple is high on hopes and expectations. Any minor mistake, and they might have to invest even more money and time into the procedure.

Managing Medications

The prolonged series of IVF medications are normally complicated for first-timers. It includes a number of self-administering pills, injections, and patches. Patients need to manage their medications properly. They have to take medicines at different times of the day. There are always the risk of forgetting doses due to the stress they are under. However, this is not something that should be hidden from the doctors. Instead it is important to immediately seek help and advice from the medical team in order to try to prevent any potential damage.

Regular blood tests are done during this time to monitor the stimulation of the ovaries by the effect of the medications that the woman is under. All women respond differently to the medications. The hormones are adjusted to each individual to ensure follicle stimulation. Proper hormone adjustment is very important to reduce the risk of the ovarian hyperstimulation syndrome. Ultrasound tests are also done during this time to monitor the growth of follicles within the ovaries.

Stress and Mood Swings

It is common for the woman to experience stress and mood swings during ovarian stimulation due to the demands of the process. It happens due to the hormonal changes the woman is going through during this time along with the stress of the IVF cycle.

Advice During Ovarian Stimulation Phase

These are the best tips to consider before starting the ovarian stimulation:

1. Go for a reputed IVF consultant team who you can rely on for proper treatment and communication

2. Proper administration of medication

3. Do not delay any query

4. Consult the doctor immediately in case you feel any sort of uneasiness

5. Properly arrange your travels and other requirements under the guidance of the medical team

6. Be patient and gentle with yourself during this stressful period

7. Join yoga or meditation classes to receive physical and mental calmness during this time

8. Regulate your daily routine neatly to live an organized life and avoid miss outs on medication administration

The ovarian stimulation is a challenging part of the IVF cycle. Both the intended mother and the egg donor are prescribed the same medications. Our objective is always to make this period as stress free for them as possible. Apart from proper medicinal arrangements, we induce several therapies that help the woman gain mental and emotional stability during this tough period. We educate them properly on the entire procedure so that they remain alert of the self-administered medications. It also prepares them to identify and understand the mood swings that they might experience during this time. Better knowledge helps them to manage themselves and the process in a better way.

They need to pay a visit to the doctor regularly and take the medications exactly as prescribed. Patients should follow all the instructions and guidelines recommended to them during the stimulation stage. Rules are identical for egg donors as well as intended mothers. They both need to follow them with care and attention to ensure a successful IVF cycle.