By prescribing a carefully controlled dose of Follicle stimulating hormone (FSH) and other hormones and monitoring their effects, we will bring to maturity as many of your immediately available follicles as possible, while also preventing them from ovulating prematurely.
It’s important to understand that no amount of FSH will stimulate more follicles than are available to be recruited. The dose needs to be enough to stop the usual competition that takes place among them, but once that threshold is reached there isn’t a lot of control possible over the number of recruits that will grow.
Secondly, using FSH injections does not use up follicles and their eggs any faster than they’re already being used anyway. They actually began their development months earlier. And the non-recruits – those that don’t produce mature eggs – are simply reabsorbed.
More is not better when it comes to FSH dosing. If the dose is too high it can be damaging to the eggs and may also put a woman at risk of ovarian hyperstimulation syndrome. The duration of FSH administration is also important – the normal length of the follicular phase generally needs to be made available to the growing follicles, which takes 11 days or more.
At Zen A.R.T. Fertility, we usually check a woman’s estrogen level after three or four days of stimulation. If there does not seem to be much response, the dose of FSH can be increased. If the response has been too brisk, the dose of FSH can be reduced gradually.
You will have your first ultrasound after seven or eight days of stimulation. Ultrasonographers who are very familiar with follicle tracking perform the ultrasound examinations.
The need for further monitoring will be determined by your individual response to the treatment at this point. You may need to have blood tests and ultrasounds every other day until the follicles reach 18-20mm in diameter – large enough to contain a mature egg.