Ovarian stimulation is a crucial first step in many fertility treatments, including IVF and IUI. Read on to learn what ovarian stimulation is, and what to expect when you undergo treatment.
Dealing with fertility issues when trying for a baby can feel frustrating, scary, upsetting—you name it.
Luckily, fertility treatment can help you achieve pregnancy, and as methods become more advanced, pregnancy success rates continue to rise.
Ovarian stimulation is a crucial part of many types of fertility treatment. Read on to find out what ovarian stimulation is, how this treatment works, which assisted reproductive technology (ART) procedures use ovarian stimulation, and more.
What is ovarian stimulation? Ovarian stimulation, sometimes called controlled ovarian stimulation (COS), is a fertility treatment.
Ovarian stimulation addresses fertility issues using hormone-based medications to help your body make more eggs. Once those eggs are mature, your doctor extracts them from your ovaries or induces ovulation.
Ovarian stimulation may be a treatment option for you if:
You don’t ovulate regularly and need a little boost You have a reproductive health condition that impacts fertility, like PCOS You’re dealing with other sources of infertility Ovarian stimulation on its own doesn’t make you conceive. Instead, it’s a crucial step in a larger process, including in multiple assisted reproductive technology (ART) procedures.
To potentially achieve pregnancy, you’ll need to combine ovarian stimulation with another fertility treatment or fertility-boosting strategy.
How does ovarian stimulation work? To understand ovarian stimulation, let’s look at ovulation and how the body produces eggs.
In a typical menstrual cycle, your body develops an egg over the first half of your cycle , then releases it from your ovaries when you ovulate . If fertilized, the egg may implant in the uterus and you may become pregnant.
All this happens in response to hormonal activity. Follicle-stimulating hormone (FSH) triggers your ovaries to start making follicles, which is where the egg will grow. Later, when an egg is mature and ready to go, a surge in luteinizing hormone (LH) triggers your ovaries to release the egg.
Ovarian stimulation uses medication to induce these hormone-driven processes, stimulating and supporting egg production in your ovaries. Here’s how.
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Step one: Growing the eggs To undergo ovarian stimulation, you’ll take a few different hormone-based medications as pills, shots, or both, starting around the beginning of your cycle:
Medication that mimics FSH to help your body develop multiple follicles and grow eggsMedication that suppresses LH to stop your ovaries from releasing the eggs too earlyMedication that mimics the LH surge to bring the eggs to full maturity (taken right before egg retrieval or induced ovulation)Ideally, your body will develop two dominant follicles , giving you two mature eggs. (When ovulation occurs naturally, there’s typically only one dominant follicle and one mature egg—except in cases of hyperovulation .)
Throughout this phase of ovarian stimulation, you’ll have regular ovarian ultrasounds to check follicular development and make sure you’re safe and responding well to treatment. Your doctor will measure factors like follicle size and number to determine when the eggs have developed to maturity.
Step two: Using the eggs Once the follicles have reached the right size and the eggs are mature, you move on to the next step.
Depending on what your fertility treatment plan is, your doctor will either:
Retrieve your eggs : like for IVF or egg freezingInduce ovulation : like for IUI or timed intercourseFertility treatments with ovarian stimulation Ovarian stimulation is frequently part of assisted reproductive technology (ART) procedures, helping your body prepare for the next steps in your treatment.
These are some of the fertility procedures that can include ovarian stimulation.
In vitro fertilization (IVF) For IVF, eggs are retrieved from the ovaries then fertilized with sperm in a lab. From there, an embryo is transferred to the uterus.
Before the eggs can be retrieved, though, your body has to grow them—that’s where ovarian stimulation comes in. Typically, you can expect to start your IVF cycle with ovarian stimulation. While it is possible to skip this step, IVF without ovarian stimulation has a lower pregnancy rate.
Once it’s time for egg retrieval (also called egg harvesting), your doctor will guide a thin needle through the vagina, insert it into the ovaries, and extract the mature eggs from the follicles. You’ll be under anesthesia (general, local, or somewhere in between) for the duration of the short procedure.
Intrauterine insemination (IUI) With IUI, sperm are injected directly into the uterus around the time of ovulation.
Ovarian stimulation is frequently used before insemination. This phase ensures your body produces an egg, controls ovulation timing, and aligns the timing of the IUI procedure with ovulation.
There’s no need to extract the mature eggs from your body for IUI. Instead, your doctor medically induces ovulation, then sperm are injected into your uterus around 24 to 48 hours later.
Egg freezing Egg freezing, another type of ART, enables you to preserve your fertility for a potential later pregnancy instead of having a baby in the immediate future.
When you decide to freeze your eggs, you’ll likely start with ovarian stimulation in order to develop as many eggs for cryopreservation (freezing) as possible. The mature eggs will then be extracted from your ovaries through the egg retrieval procedure, and frozen for later use.
Timed intercourse Ovarian stimulation medications can sometimes be used without a follow-up ART procedure, to regulate ovulation.
In this case, you’ll take ovulation-boosting medication to grow eggs and trigger ovulation at a specific moment. Then, you’ll time sex to ovulation .At-home ovulation trackers are one useful option for measuring and monitoring your hormone levels and tracking ovulation , alongside your doctor.
Is ovarian stimulation safe? Ovarian stimulation is standard treatment for managing fertility issues. It’s safe for both the person undergoing treatment and for any children born from the treatment.
You may experience certain side effects from the medications you take for ovarian stimulation, including:
Hot flashes Abdominal discomfort Light spotting Emotional changes or mood swings Injection site irritation (if you’re using shots) Like any medical treatment, ovarian stimulation also comes with some risks, though they’re relatively low. The main risks associated with ovarian stimulation are:
Ovarian hyperstimulation syndrome (OHSS) : a condition in which the ovaries become enlarged, requiring treatment. Multiple pregnancies : pregnancies with more than one baby (twins, triplets, or more), which call for special monitoring and care .Your doctor will discuss any risks and side effects with you as you determine the right fertility treatment for you on your path to parenthood.
What is ovarian stimulation: the bottom line Ovarian stimulation treats fertility issues using hormone-based medication to stimulate egg production. Depending on the rest of your fertility treatment plan, the next step will either be to retrieve the mature eggs or induce ovulation.
Ovarian stimulation is a key part of ART procedures like IVF, IUI, and egg freezing. Certain ovulation-regulating medications may also help you conceive without additional ARTs, depending on your health needs.
With ovarian stimulation alongside accompanying ART procedures and fertility strategies, you just may overcome fertility issues and achieve pregnancy.
