How Many Follicles for IVF?
How many follicles for the IVF treatment and what egg quality a patient develops depends primarily on her fertility potential.
Without ovarian stimulation, a woman with regular monthly menstrual periods releases only one egg during each ovulatory cycle. Using such unstimulated cycles would make the IVF process very inefficient. It is possible to gently stimulate the ovaries to make them grow more than one egg by using ovarian hormonal stimulation. Hormones used to stimulate the ovaries are identical to our bodies hormones. No "strange" drugs are used for this purpose.
How many follicles and eggs for the IVF treatment will develop depends on the following three factors:
- The current fertility potential of the patient. What egg quality she was born with, and what has happened to her eggs since her birth.
- How "good" the menstrual cycle in which IVF starts is. Even among very fertile women, there can sometimes be significant variation in the quality of eggs produced from one menstrual cycle to another.
- The ovarian stimulation itself. The type of ovarian stimulation, the selection of medications, and the dosing of medication are always individualized, but of the three factors, this is the least important for the number and quality of eggs produced.
Ideally, IVF ovarian stimulation should result in the development of 8 to 15 follicles and eggs. Too few or too many follicles may result in a suboptimal quality of the retrieved eggs.
At Bay IVF, we use gentle, individualized ovarian stimulation protocols and strive for the highest egg quality rather than quantity. This approach minimizes the number of clinic visits and decreases the likelihood of ovarian hyperstimulation without reducing the probability of a successful outcome.
Several forms of ovarian stimulation protocols exist, each with many modifications. Your treatment is always individualized to maximize the probability of a successful outcome. The selection of an optimal protocol for your IVF treatment is based on your reproductive history and your pre-treatment evaluation. Below is an example of IVF ovarian stimulation protocols used at Bay IVF. Your individualized protocol may take less or more time to complete.
Ovarian Stimulation Example
Follicle stimulating hormone (FSH) or a combination of FSH/luteinizing hormone (LH) hormones will stimulate the production of multiple eggs in the ovaries. They are given subcutaneously once a day or every other day with tiny needles for approximately ten days.
During this time, your progress is monitored by estradiol (estrogen, E2) and progesterone blood levels and ultrasound examinations.
Ovarian stimulation should result in the development of several eggs in each ovary. The ultrasound image below shows a stimulated ovary. Each of the several follicles (dark circles) contains a microscopic egg.
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With Dr. Polansky
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