Ovarian Stimulation and IVF Monitoring

Georgia Regents Reproductive Medicine and Infertility Associates in Augusta, Georgia performs ovarian stimulation techniques in in vitro fertilization (IVF) to stimulate the ovaries to produce several eggs (oocytes), rather than the usual single egg as in a natural cycle.

Multiple eggs increase the chance of obtaining multiple embryos (fertilized eggs) for transfer and the probability of conception.

Ovarian Stimulation Medications

There are multiple medications required to boost egg production. Each is administered by injection only. Lupron, Follistim, Bravelle, Repronex and Gonal-F are given subcutaneously (beneath the skin), and the others are intramuscular injections (into the muscle).

These ovulation induction medications coax the ovaries to produce more than one egg to the point of maturity. Hormone levels of estrogen and progesterone reach levels much higher than normal values. When the estrogen level becomes elevated, side effects may be experienced.

Because of these possible side effects, it is important that we carefully monitor your response to these medications.

Monitoring During Ovarian Stimulation

This monitoring also allows your physician to determine when the eggs are ready for the next stage, oocyte (egg) retrieval.

Monitoring includes frequent blood drawing for estradiol (estrogen) and possibly progesterone, LH and FSH levels. These blood tests will take place over approximately a twelve-day period.

Another part of ovarian stimulation monitoring involves the use of intravaginal ultrasound to track follicular growth. The eggs develop inside fluid-filled cysts of the ovaries called follicles, which enlarge as the eggs mature. Ultrasound studies usually begin after an estrogen response has been measured and continue on a frequent basis until oocyte (egg) retrieval.

Ovarian stimulation with the fertility medications causes multiple follicles to develop. This is desirable in IVF because as the number of eggs increases, the chance for success increases. 

Risks of Ovarian Stimulation

One risk of ovarian stimulation involves multiple embryos, which can also increase the risk of multiple pregnancy.

Approximately 25–28 percent of pregnancies with IVF will be multiple. Most of these will be twins, but triplets, quadruplets or even greater multiple pregnancies can occur.

A procedure called "selective reduction of pregnancy" has been performed in several medical centers across the country in selected cases of triplets or more. Selective reduction is not offered onsite. More information on this procedure and recommended centers is available on request.

Please contact us with questions about ovarian stimulation, or if you want to schedule an appointment for ovarian stimulation or IVF.