Medications used in controlled ovarian stimulation

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When a woman is going to undergo fertility treatment it is necessary to administer medications to stimulate the ovaries. This is what is known as controlled ovarian stimulation (EOC).

Drugs for ovarian stimulation contain hormones that act naturally in the menstrual cycle and their function is to cause the maturation of more than one ovule.

Depending on the fertility treatment and the number of ovules required, one or two in artificial insemination (AI) and several for in vitro fertilization (IVF), the stimulation should be more or less smooth. This is controlled by adjusting the hormonal dose and monitoring by ultrasound.

Below you have an index with all the points that we will discuss in this article.

Index

Medications used in controlled ovarian stimulation

How does the ovary work?

At the beginning of each menstrual cycle, a growth phase of a few follicles in the ovary naturally occurs. The follicles are small structures filled with fluid where the maturation of an egg takes place in each of them.

Next, a follicular recruitment takes place according to the hormonal levels. This means that only one of the follicles is able to respond to the hormones and develop into a larger pre-ovulatory follicle. The rest of the follicles degenerate and the ovules that were inside are lost.

The hormone FSH is responsible for stimulating follicular development. At 7-8 days of follicle growth, the level of FSH decreases and only one of them is able to survive and continue its maturation.

In the middle of the cycle, on day 14, there is an increase in the hormone LH, known as the LH peak, which causes ovulation: the ovarian follicle is broken and the ovum is expelled to the fallopian tube, where it is susceptible to be fertilized.

Levels of FSH and LH during the menstrual cycle

Treatment for ovarian stimulation

In assisted reproduction, what is intended is to imitate what happens in the natural cycle but on a larger scale, so that several follicles mature at the same time. This is achieved with hormone medication that contains the hormone FSH. In addition, ovarian stimulation is bilateral: the follicles grow in both ovaries at the same time.

The number of follicles required depends on the type of treatment, for which a greater or lesser number of ovules should be obtained:

  • Artificial insemination: 1 or 2 ovules
  • IVF: from 6 to 18 ovules

It is very difficult to predict what the response of the ovary will be to medication, especially in a first cycle of assisted reproduction. In this sense, there are two types of women:

  • Low responders: they obtain few ovules.
  • High responders: they develop many ovules and run the risk of suffering the ovarian hyperstimulation syndrome.

The hyperstimulation can also be due to a too strong dose of the medication.

Therefore, specialists have to adjust the hormonal dose and the days of treatment depending on the response. In addition, this also depends on some characteristics of the woman, such as weight, age and hormone levels.

Response to ovarian stimulation

The drugs used for controlled ovarian stimulation are those that contain gonadotropins (FSH and LH). Among the most prominent are Gonal-f, Puregon, Menopur, Pergoveris, Ovitrelle, etc.







Questions from users





Is there any ovarian stimulation treatment with pills?

No. Injections are the only possible method to administer these hormonal drugs. Although at first it seems complicated, the administration is simple and painless. In the clinic, the specialized staff teaches the patient how to do it the first time and offers some advice.




cryopreservation of oocytes in Guadalajara(Spain)

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