IVF

Stimulation of the Ovaries

The aim of IVF treatment is to obtain multiple eggs after stimulating the ovaries with appropriate drug protocols. For this purpose, drugs in the form of injections are generally used. Although it is sometimes necessary to start with premenstrual preparations according to the treatment protocol chosen according to the individual characteristics of the person, ovarian stimulation mainly starts with menstruation. 

The protocols we use in IVF treatment; 

1) Long Protocol (GnRH agonist protocol, luteal estrogen priming protocol)

2) Short Protocol (GnRH Antagonist protocol, progesterone primed protocol)

3) Microdose Protocol (OC-Mikrodose flare up protocol) 

4) Ovarian Sensitizing Protocol ( Letrozole (Femara) protocol) 

5) Minimal Stimulation Protocol

6) Dual Stimulation Protocol (Double ovarian stimulation in the same cycle)

While determining the dose of egg enlargement drug to be used in the treatment, dose adjustment should be made by taking into account the patient’s age, the response to previous IVF trials, body mass index, the number of antral follicles in both ovaries, that is, the ovarian reserve. By paying attention to all these issues, stimulation with the lowest possible dose will help to achieve both patient safety and high success rates. 

After the treatment is started, the daily dose of medication is started. It is important that the drugs to be used are used as described on a regular basis every day. 

How many days does ovarian stimulation last?

The use of ovarian stimulating drugs takes 8-10 days on average. During this period, it is necessary to measure the size of the egg sacs, namely the follicles, by measuring estradiol in the blood and ultrasonography from time to time. During ovarian stimulation, determining the individualized drug use protocol and dose according to the individual characteristics of the woman and the ovarian stimulation response, if any, is of vital importance in terms of the response to be received and thus the success of IVF. Inadequate use of the drug dose may decrease the response, while overuse of the dose may increase the risk of developing overstimulation syndrome (OHSS). 

In the presence of polycystic ovary syndrome (PCOS) or in cases with a high ovarian response and more than 18 egg sacs with a size larger than 11 mm on the day of the cracking injection, it is preferable to freeze all embryos obtained that month and not to make fresh transfers in order to avoid the risk of OHSS. we are doing. 

After the follow-up, when the egg sacs reach the desired size, we plan the egg collection process 34-36 hours after the cracking needle. In general, we prefer to make cracking needles when the size of at least 3 egg sacs exceeds 17 mm in our applications. The purpose of applying the cracking needle is not to crack the eggs, but to ensure their final maturation. 

Treatment can be canceled during ovarian stimulation in 10-15% of patients. 

During ovarian stimulation, no special diet is required in terms of nutrition. We recommend that you consume vegetables and fruits as normal of the season, and not to use alcohol and cigarettes. If you need to use a medicine due to another ailment, you should consult us and make sure that it is appropriate. During this period, there will be no harm in working, doing light exercises and having sexual intercourse until the last days of stimulation. 

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