Santiago Brugo Olmedo M.D.
Medical Director
Seremas Medicine for men and women
Seremas Home Seremas Procedures Seremas High Complexity Assisted Reproduction Techniques Seremas Ovulation Stimulation

Ovulation Stimulation

During this stage medication is used in order to prepare the ovaries, in other words, to set them under medical control to get the best possible answer to stimulation.

Stimulation consists of administering different medication so that ovaries produce several mature oocytes instead of only one, situation that happens every month spontaneously. There is broad consensus on the fact that possibilities of achieving pregnancy are more if more than one oocyte is fertilized and more than one embryo is transferred per cycle of treatment.

The objective of ovulation stimulation is to retrieve a higher number of oocytes from both ovaries and to avoid the reabsorption of follicle cohort which accompanies the dominant one. This allows us to count on more oocytes which, once retrieved from the ovary, can be inseminated to make fertilization easier.

Why is more than one oocyte required? Depending on the woman’s age, some oocytes she produces spontaneously, have chromosomic alterations which do not prevent them from being fertilized but do avoid implantation and embryo normal development.

When more than one oocyte is fertilized, chances of getting more than one embryo increase. When more than one embryo is transferred, there are more possibilities of finding that one of them is normally constituted and can implant. That is the reason why when we transfer more embryos, chances of achieving pregnancy increase. On the other hand, chances of multiple pregnancy also increase.

Hormonal stimulation methods: Hormonal stimulation has two stages. The first one consists of blocking the release of LH from the woman’s hypophysis. In order to get this, we use daily subcutaneous injections of agonists and/or antagonists of hypothalamic factors (GnRH). Depot injections or inhalers can also be used. Once the woman’s hypophysis is blocked, the second stage starts. It consists of stimulating hormonally the woman’s ovaries. The most used drugs for ovulation induction are a combination of both the hormones with which hypophysis normally stimulates the ovary. They are: Follicle Stimulating Hormone (FSH) and Luteining Hormone (LH), generically called HMG. We also count on pure FSH obtained through technology of recombinant DNA. Depending on the specific case, sometimes a combination of antiestrogens (Clomiphene Citrate) in association with HMG is used.

Sometimes used medication may cause some mild side effect such as headache, changes in mood, abdominal inflammation, and gradual increase in weight. However, in case symptoms such as blurred vision, intense headache or accelerated increase in weight might occur, it becomes indispensable to inform your doctor about it.

Ovulation induction takes about 10-12 days. During this period and in order to evaluate growth and development of follicles, ultrasound follow-up is performed. This process consists of 3-4 transvaginal ultrasounds and some blood tests (fast is not required) to measure levels of estradiol (hormone produced by the follicles) which increases as long as follicles grow.

When most of these follicles have reached an average size of 18-20 mm, a hormone called HCG is injected. This is the hormone which concludes follicular maturity. About 36 hours after HCG, the follicles retrieval is programmed.

PROCEDIMIENTOS | Técnicas de Reproducción Asistida de Alta Complejidad
Stimulatied ovary under ultrasound.

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