The first step in starting the IVF cycle is to promote ovulation, and it is also the first technical difficulty that many friends who are exposed to IVF technology for the first time need to overcome. Many people have not even entered the week, they have been overwhelmed by various unfamiliar terms, scaring themselves at every turn, scaring their husbands at the same time, but also suffering from choice phobia.
So, in order to let all of you who are about to start this process reduce your doubts and increase your peace of mind, we will talk about it today, what is the matter of ovulation induction?
Ovulation induction, literally understood simply, is to promote the development of multiple follicles through drugs and increase the probability of conception. It is a method often used in the treatment of ovulation disorders and IVF.
Before ovulation induction treatment, first of all, after the preliminary physical examination, after passing the examination, the doctor will determine the treatment plan according to the patient's age, ovarian function, etc., and carry out drugs to induce ovulation. Then, after the follicle matures, it can be collected for egg retrieval and semen, followed by in vitro fertilization, embryo culture, embryo transfer, and finally the successful birth of the baby.
Theoretically, the principle of ovulation induction is not complicated, but in order to meet the different physical needs of different people, in practical work, doctors should comprehensively consider the age of the patient, the number of basic follicles, sex hormone indicators, AMH indicators, etc. when formulating the ovulation promotion program.
Although we must listen to the doctor's words on what kind of promotion plan to choose, we must also have a certain understanding of these programs in order to better cooperate with the doctor's treatment and reduce unnecessary doubt and psychological burden.
In general, common ovulation induction regimens in medicine include agonist regimens, antagonist regimens, microstimulation cycles, and natural cycles. According to the time of use of pituitary agonists, the agonist regimen is divided into ultra-long scheme, long scheme, short scheme, ultra-short scheme, and so on.
1． Short-acting agonist long regimen
How to do it: It can start on day 1 or 2 of a woman's menstrual cycle, or from the middle of the luteal phase. The most commonly used at present is the mid-term long luteum scheme. After GnRH-a14 to 21 days later, when the pituitary gland reaches deregulation, ovulation induction with exogenous gonadotropins is started again, and the use of gonadotropin-releasing hormone analogs (GnRH-a) is maintained until the day of human chorionic gonadotropin (hcG).
Adaptation: As the most common protocol used in controlled ovarian stimulation at present, it is mainly suitable for pregnant people with ideal ovarian reserve function or polycystic.
2． Long-acting agonist long regimen
Operation method: It is injected in the full or less full amount of long-acting GnRH-a in the 2nd to 5th day of menstruation in women, or the luteal phase of the previous cycle, and after 14 to 35 days, determine whether a second injection is required according to the situation, and the injection can be repeated multiple times according to the condition, and the Gn induction ovulation induction is initiated after the last injection 14 to 35 days according to hormone levels, follicle diameter and number.
Suitable for: Mainly suitable for endometriosis, polycystic ovary syndrome (PCOS) or repeated failures of pregnancy preparation, as well as people with decreased ovarian reserve function.
3． Short-acting agonist short regimen
Operation: It is to use the provocative effect of GnRH-a, usually from the second day of menstruation to the day of injection of hcG, and the use of Gn to promote ovulation on day 3.
Suitable for people: mainly suitable for people with adverse ovarian reactions.
4． Antagonist regimen
How it works: After Gn initiation, gnRH antagonists are added at the appropriate time to combat the premature appearance of pituitary luteinizing hormone (LH) peaks.
Suitable for: Can be used in a variety of groups, especially for PCOS patients, can greatly reduce the risk of ovarian hyperstimulation in PCOS patients. For patients with ovarian hypofunction, the use of antagonist regimens can be closer to the natural growth state of the follicle and reduce the amount of Gn.
5． Microstimulation regimen
How-to: Refers to an ovulation-promoting regimen that uses exogenous gonadotropins in small doses, short courses, with the addition of GnRH antagonists, estrogen receptor antagonists, or aromatase inhibitors. This regimen has the characteristics of short duration, little stimulation, low cost, and high patient tolerance, which can effectively control the incidence of ovarian hyperstimulation syndrome (OHSS) in high-response populations, but the number of eggs obtained is small.
Adapted population: low-response ovarian population, high-response population.
6． Natural cycle scheme
Operation method: Generally do not use any drugs to stimulate the ovaries to induce ovulation, but it is necessary to estimate the ovulation time by repeatedly monitoring the LH peak near the ovulation period in order to obtain mature egg cells, the egg acquisition rate is relatively low, but there is almost no exogenous drug stimulation of the ovaries, the egg state is closer to natural, and the economic cost is less.
Suitable for:
People who are younger and have plenty of time to complete the natural cycle of IVF are trying to conceive;
Old age, decreased ovarian function, the use of ovulation-inducing drugs can not achieve more egg acquisition;
People who are rejected, allergic to ovulation-stimulating drugs, or are unwilling to use ovulation-stimulating drugs to complete the IVF cycle.
With so many ways to promote rowing, how should we choose it? To solve this problem, we must first understand what is the purpose of ovulation induction?
Generally speaking, the purpose of IVF technical process and ovulation induction has the following two points:
First, achieve therapeutic effect on those who do not ovulate or seek help with irregular ovulation;
Second, promote the development of multiple follicles and increase the chance of pregnancy.
Therefore, in the choice of promotion plan, there is no best, only appropriate, must cooperate with the doctor's work, can not take it for granted.
In order to achieve a better stimulation effect, many women are careful, do not dare to sit or stand, and are in a state of high mental tension every day, in fact, they do not have to.
Regular life, normal work and rest, more supplements with nutrients, what problems communicate with doctors in time, excessive tension will be counterproductive, maintain a relaxed mood, save strength, will see a better scenery ahead.