When undergoing in vitro fertilisation (IVF) treatment, there are multiple stages to go through. IVF stimulation is the first stage of this treatment. It occurs after there has been physical exams and tests that the fertility specialist uses to ascertain that this form of assisted reproduction is the best option for a couple hoping to conceive.
What Is Ovarian Stimulation
Ovarian stimulation refers to steps taken to help boost the production of mature eggs by the ovaries. This will make it possible for more eggs to be later retrieved and used to create embryos that will be transferred into the uterus of the woman for implantation to occur. Here is a breakdown of what you can expect to happen when undergoing ovarian stimulation.
Suppression of Natural Menstruation
During the first two weeks of this process, the woman is given medication to help suppress her natural menstrual cycle. She is guided on how to self-administer this medication which may be in the form of daily injections or nasal spray.
After two weeks, the natural cycle should be suppressed. The woman is then switched to another type of medication. These may be follicle-stimulating hormones (FSH) or luteinising hormone (LH). These hormones may be prescribed individually or together. They encourage the follicles on the ovaries to produce more eggs simultaneously. The more mature eggs that can be retrieved, the more successful the procedure is deemed as it means more embryos can be developed.
The state of your ovaries will be monitored over the next 1-2 weeks while on this medication. Ultrasound scans and blood tests will help indicate when it is time to switch to egg maturation.
Also referred to as oocyte maturation, this brings you closer to the egg retrieval stage. The woman is placed on human chorionic gonadotropin (hCG) medications that help to stimulate the eggs to mature. Mature eggs are what is wanted for retrieval. These will be prescribed alongside other medications to prevent premature ovulation. Ovulation is when the eggs are released. The eggs should not be released as they will be surgically retrieved from the follicles in time. Egg retrieval is typically undertaken 34-36 hours after the hCG medication is administered.
How Does It Feel?
We have described the medications and timeframes women go through with IVF stimulation. Let’s now discuss how they feel. For some, there is some level of physical discomfort and even pain with IVF stimulation. Some medications may be in the form of injections that are self-administered daily, meaning there is often pain at the injection site and some anxiety if you are uncomfortable with needles. Those that have a partner or other loved one that can assist may suffer less stress with this.
The stress of the procedures may also result in mood swings that add to the burden of the situation. The hormonal medications of FSH and LH have also been known to trigger side effects of mood swings and depression. They may also lead to physical symptoms of abdominal pain, bloating and breast tenderness. There is also the risk of some women developing the ovarian hyper-stimulation syndrome.
The hCG medication is also injectable. It can also cause some women to develop the ovarian hyper-stimulation syndrome. Symptoms of this condition can include nausea, vomiting, abdominal or pelvic pain, diarrhoea, bloating, shortness of breath, rapid weight gain, and reduced urination. Aside from these painful physical reactions, hCG medications can also cause headaches, feelings of depression and restlessness.
Overall, undergoing IVF stimulation can be physically taxing and sometimes painful. Not to mention the mental and emotional stress that goes with desperately hoping things turn out alright.
Risks Associated with IVF Stimulation
As indicated above, IVF stimulation involves the administering of multiple fertility or hormonal medications. In some cases, this can result in what is known as ovarian hyper-stimulation syndrome (OHSS). This is an excessive response to the many hormonal injectable medications This condition is usually characterised by painful swollen ovaries.
This reaction can last about 7-10 days if the treatment does not result in a pregnancy. Most women are relieved by the time their menstruation resumes. However, if a pregnancy occurs, the symptoms may last longer, as much as several weeks.
It is important to note that this condition is more likely to occur in women who are suffering from polycystic ovarian syndrome (PCOS).
How to Cope
Despite all the stress that comes with IVF treatments, many hopeful parents are still willing to go through it all if it means getting to hold their much-desired baby in their arms one day. Ideally, they would hope to only have to go through this experience once. Here is what you can do to limit the stress and pains of this situation.
Follow your doctor’s advice as strictly as possible. Be keen about when to take medications and how. Get your partner or other loved one to help you if you find it difficult to self-administer injections. If seriously averse, ask if you can get patches or pills instead.
Ask if you are unsure. There are no dumb questions. Just ask if something is unclear. Your doctor will try to ensure you fully understand what is expected of you and what to expect during this process.
Keep close to the clinic. Some of the timelines are tight. Such as the hours to egg retrieval after being administered hCG medications. Try to find a comfortable place to stay near the clinic so you do not inadvertently miss your appointment for retrieval and have to start over.
Take it easy. Rest as much as you need to relieve stress. Experts recommend avoiding any strenuous exercise during the IVF cycle. Your body will be under enough strain during ovarian stimulation so do not seek to push your limits at this time. Stick to low impact exercise if you must and ensure you get enough sleep and good nutrition. Be gentle with yourself.
Consider cryogenic freezing. Freezing your eggs or embryos will allow you to undergo another round of IVF treatment without having to repeat the stimulation and retrieval stages. This means having another try at having a baby without the invasiveness and high costs.