Ovarian stimulation, also known as ovulation induction, is a medical procedure that increases the production of eggs in a woman’s ovaries. Ovulation induction is typically done with a medication, sometimes with surgery or other procedures.
So, what is ovulation( Ovulation kya hota hai)?
The goal of ovulation induction is to give clinicians more eggs from which to take healthy ones for IVF treatments.
Ovarian stimulation has been used in association with IVF to increase the number and quality of eggs available for fertilization, especially when the quality of eggs is lower, as indicated by fewer than 5 mm follicles on an ovary.
Follicular-stimulating hormone (FSH) has been used for ovarian stimulation since 1954. When it was first used, FSH was made from human urine, but this practice is no longer used. Since then, many other medications have been developed to help with ovarian stimulation. These medications mimic the effect of FSH in the body.
Types of medications
As of 2011, there are five types of FSH-releasing medications: recombinant FSH (Gonal-f or Follistim), human menopausal gonadotropin (Menogon, Repronex, Bravelle), follitropin alfa (Gonal-f) and two long-acting analogs of FSH, namely a trivalent (containing all three isoforms of human follicle stimulating hormone) GnRH agonist and a long acting monoclonal antibody to the FSH receptor.
A long-acting version of rFSH was introduced in 2010. It is called Lutrepulse and is manufactured by Serono Endocrinology.
According to the most recent guidelines from the American Society for Reproductive Medicine (ASRM), an injectable medication called leuprolide acetate, recombinant FSH (Gonal-f or Follistim), and a combination of human menopausal gonadotropin luteinizing hormone releasing hormone, and follitropin alfa (Menogon) are among the most frequently used induction medications.
The guidelines also recommend using GnRH agonists as injectable preparations of pituitary hormones which promote growth of ovarian follicles and bring them to maturity. Gonadotropins are classed as long-acting drugs when they cause no withdrawal bleeding. As of 2010, GnRH agonists were used in 35% of all cycles, with relatively little variation between the different companies.
In the past, many different substances have been used for ovarian stimulation. These substances were used to improve the chances of achieving a high pregnancy rate by increasing the number of eggs available for fertilization. Some off these substances included:
In order to ensure that ovulation is induced, doctors often use anti-inflammatory medications such as ibuprofen or naproxen.
Side effects of these drugs include: nausea, abdominal pain, diarrhea and headache. Side effects are also common with gonadotropin injections and include: fatigue, headaches and depression.
Some patients may experience Ovarian hyperstimulation syndrome( OHSS) if they are undergoing fertility treatment. OHSS can cause severe abdominal pain and distention, nausea, vomiting and diarrhea. Most women will experience mild to severe pain during their cycle and hormone injections. These symptoms are usually uncomfortable but not severe enough to warrant any medical intervention. Occasionally, some women may have prolonged symptoms of pain, as well as swelling and tenderness of the pelvic tissues. Sometimes this can last for weeks after the cycle ends.
The most common causes of ovarian hyperstimulation syndrome (OHSS) include: obesity, premature menopause, administration of certain medications such as anticoagulants, certain anti-depressants, anti-anxiety medications, steroids and cancer chemotherapy.
Ovarian Stimulation is a safe procedure when done properly. However, it is known to cause side effects, such as abdominal cramps, bloating, painful breasts, and weight gain. In rare cases, women may experience Ovarian hyperstimulation syndrome (OHSS). This syndrome can sometimes be treated with medication and fluids given through an IV. The treatments have been shown to improve the chances of becoming pregnant. If treatment isn’t possible, OHSS can be life-threatening for women who undergo ovulation induction.