Hormonal stimulation / Ovarian stimulation
Stimulation treatment of the ovaries for the purposes of follicular maturation should stimulate the growth of multiple follicles in the ovaries of women who have been unsuccessful in trying for a baby, causing the eggs inside to mature. During this phase of hormonal stimulation, the ovaries' response to the drugs is monitored by an ultrasound and, if necessary, hormonal testing.
This stimulation procedure can in principle be used to support the following treatments:
- Optimisation of follicular maturation In some cases, hormonal stimulation is used to optimise follicular maturation and induce ovulation. The ideal timing for a sexual intercourse between the couple trying to get pregnant can then be calculated.
- Insemination Hormonal stimulation also makes sense before proceeding with the sperm transfer (insemination using the partner's sperm). This is often used when disturbances to follicular maturation are determined or suspected, or if the male suffers from a mild fertility disorder.
- Transfer of donor sperm Stimulation treatment is also necessary in the context of transfer of donor sperm. This is performed whenever pregnancy has previously failed to materialise when hormonal stimulation was not used, or when a follicular maturation disorder is known or suspected.
- IVF, ICSI Fertilisation procedures outside the body – IVF (in-vitro fertilisation) and ICSI (intracytoplasmic sperm injection) – also start with a hormonal stimulation phase. The goal here is to stimulate the ovary in a controlled way to encourage multiple follicles to mature, so that in the next step, several eggs can be removed and combined with the partner's sperm.
The process of hormonal stimulation
The stimulation phase usually last for 10 to 14 days. During this time, a certain amount of hormone is injected under the skin every day (hCG or triptorelin). You yourself or your partner can take care of injecting the hormones, which saves you from having to go to the doctor every day. In order to ideally monitor the maturation of the ovarian follicles and thus of the eggs, several blood samples are taken from patients during the stimulation phase and ultrasound examinations of the ovaries are performed. The optimal state of maturity of the eggs can be identified based on the findings obtained.
Determining hormones through blood tests
An ultrasound examination and a blood test are carried out between the 10th and 12th day of the cycle to determine the levels of the hormones involved in follicular maturation. This allows our doctors to determine exactly when the most favourable time is to obtain fertile eggs.
Ovulation is triggered by means of a so-called trigger injection containing the hormone human chorionic gonadotropin (hCG). The eggs are harvested approximately 34–36 hours after administration of this trigger injection. In order to do this, the mature eggs are removed from the ovary via the vagina under ultrasound monitoring by means of a special, thin needle – the so-called follicular puncture – and they are then transferred into a nutrient solution. Here at the VivaNeo Fertility Clinic, you will receive a light anaesthestic for the follicular puncture.
If insemination, IVF or ICSI was selected as the method, we will need the partner's sperm on the day of egg retrieval. Every couple undergoing fertility treatment has the option of collecting this sperm sample at home and then bringing it into the clinic or alternatively delivering it to our clinic rooms. The semen is processed in the laboratory, so that the mobile sperm are ready for combining with the eggs that are capable of fertilisation.
Side effects and risks
Hormonal stimulation can cause side effects, of which the doctor will inform their patients well in advance. It is therefore important that the doctor regularly monitors maturation of the egg and hormone levels during treatment to avoid hyperstimulation and minimise risks.
Possible side effects of the treatment are primarily the following:
- Hot flushes
- Depressed moods
In rare cases, the so-called ovarian hyperstimulation syndrome (OHSS) occurs. The ovaries become enlarged, or too many follicles develop, which are also too great in size. Hyperstimulation syndrome causes a bloated abdomen, pain, nausea and shortness of breath. The physician must be informed immediately. Because, if there are too many eggs, the risk of a multiple pregnancy (twins, triplets, etc.) increases, which is associated with health risks. The dose of the hormone preparation can then be reduced for the next treatment cycle.
If you want a baby but have been unable to have one, the doctors in our fertility clinic will be happy to advise you individually about your options. So please contact us.