The stage of hormonal stimulation (ovarian stimulation) is an exciting time. Daily injections are required and each ultrasound scan is anticipated with great excitement. What our patients want to know is:
“How many follicles can be identified?
Do all the follicles continue to grow?
How many large and probably mature follicles were produced?”
Hormone doses and therapy protocols are determined on an individual basis in order to achieve the best possible outcome.
It is a much earlier point in time that decides how many follicles will develop during the month of therapy in question. Already three months earlier, a group of 30-300 smaller follicles (a so-called cohort) starts to develop.
This cohort matures and eventually becomes sensitive to follicle stimulating hormones. The majority of ovarian follicles do not continue to grow, but degenerate and finally disappear. The influence of hypophysis hormones (LH and FSH produced by the pituitary gland) as well as the effect of hormones and messenger substances within the ovary is decisive for whether or not a follicle continues to develop. But stress, illness and coincidence may also have an impact on the cohort’s development. Age is a major factor impacting on the size of the cohort. As women, we know about the age-related decline of ovarian reserve.
Numerous scientific studies have addressed topics such as “ovarian response” and “fluctuating numbers of oocytes”. In conclusion, the evidence suggests that there is a limit to medical options. Even when changing hormone doses – for example in women over the age of 35 (having up to 10 follicles) – there appeared no statistically important changes with respect to the number of follicles and oocytes (But when it comes to the statistical evaluation of larger amounts of data, even minor individual variations tend to fade).
The “Basket” is filled by the ovaries. Sometimes there is more content and sometimes less. The key to successful treatment resulting in the birth of a healthy child is the quality of oocytes and sperms.
In conclusion, the following guidelines should be of assistance to our patients: Trust in our experience and try to create the best possible conditions. You are advised to carefully plan your therapy. Undergoing treatment during or shortly after the busiest time of the year should be avoided. Live your life in a balanced and healthy way.
» Fertility treatment process – Ultrasound Scan
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» Hormonal stimulation in fertility treatment
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