There are two ways t he fertility doctor can determine the ovarian reserve. The first is through hormone testing at the beginning of your menstrual cycle. The second is t hrough antral follicle counts. There are small follicles in the ovary that look like cysts and each of these follicle s ha ve an egg in side.
By inserting an ultrasound into the vagina, the doctor can count the numbe r of follicles you have that month. During an IVF cycle , you take hormone injections to stimulate the ovaries to grow the eggs.
These hormones are called gonadotropins and they mimic how the brain naturally s timulates the ovaries. By giving wom e n these hormones, we can often get more eggs to grow.
Woman who have a lot of eggs left in their ovaries need lower amounts of hormones while women with less eggs need higher doses. Furthermore, some women have ovaries that are more sensitive to the medications than other women. So the amount of medication every patient needs is different and how each patient responds to the medications can be different too.
That being said, there is an optimal number of eggs. This is most likely due to an adverse effect of intense ovarian stimulation on the receptivity of the endometrium as has been convincingly demonstrated 4, 5. This study also provides evidence that aiming for a higher egg yield during ovarian stimulation does not seem to compromise the quality of the eggs obtained. This has been debated for years but recently accumulated evidence suggests that a detrimental effect of intense ovarian stimulation on egg quality is unlikely.
On the contrary, obtaining a higher number of eggs will probably lead to a higher number of competent eggs and, as the present study has shown, to more chromosomally normal euploid embryos.
While this study does provide strong evidence in the ongoing debate over the importance of egg numbers as determinants of IVF success, any attempt to propose an optimum number of egg collected needs to take into account many other parameters such as:. It should not be overlooked that aiming for a high number of eggs usually more than 15 can increase the risk of ovarian hyperstimulation syndrome OHSS , a potentially serious complication of ovarian stimulation.
However, newer IVF protocols can substantially reduce this risk, allowing fertility specialists to maximize the results from a single IVF cycle and thereby reduce the financial, physical and emotional cost of fertility treatment. Increasing the oocyte yield should always be performed safely which means an individualised approach should be discussed with your fertility specialist. Patients wishing to know more about this study, including how to increase their chance of pregnancy from IVF treatment, should speak with their local fertility specialist:.
The optimum number of oocytes in IVF treatment: an analysis of cycles in China. Hum Reprod. How many oocytes do we need to maximize cumulative live birth rates after utilization of all fresh and frozen embryos? Association between the number of eggs and live birth in IVF treatment: an analysis of treatment cycles.
Progesterone elevation and probability of pregnancy after IVF: a systematic review and meta-analysis of over 60 cycles. This can make the medicines used in the next stage of treatment more effective.
The medicine is given either as a daily injection that you'll be taught to give yourself, or as a nasal spray. You continue this for about 2 weeks.
Once your natural cycle is suppressed, you take a fertility hormone called follicle stimulating hormone FSH. FSH increases the number of eggs your ovaries produce. This means more eggs can be collected and fertilised. With more fertilised eggs, the clinic has a greater choice of embryos to use in your treatment. The clinic will keep an eye on you throughout the treatment. You'll have vaginal ultrasound scans to monitor your ovaries and, in some cases, blood tests. Before your eggs are collected, you'll have an injection of a hormone called human chorionic gonadotrophin hCG that helps your eggs to mature.
You'll be sedated and your eggs will be collected using a needle that's passed through your vagina and into each ovary under ultrasound guidance. Some women experience cramps or a small amount of vaginal bleeding after this procedure.
The collected eggs are mixed with your partner's or the donor's sperm in a laboratory to fertilise them. In some cases, each egg may need to be injected individually with a single sperm. This is called intra-cytoplasmic sperm injection or ICSI. Donor sperm also can be used. Sperm are separated from the semen fluid in the lab.
Typically, transvaginal ultrasound aspiration is used to retrieve eggs. During this procedure, an ultrasound probe is inserted into your vagina to identify follicles, and a needle is guided through the vagina and into the follicles.
The eggs are removed from the follicles through the needle, which is connected to a suction device. In intracytoplasmic sperm injection ICSI , a single healthy sperm is injected directly into each mature egg. ICSI is often used when semen quality or number is a problem or if fertilization attempts during prior in vitro fertilization cycles failed.
Three days after fertilization, a normally developing embryo will contain about six to 10 cells. By the fifth or sixth day, the fertilized egg is known as a blastocyst — a rapidly dividing ball of cells. The inner group of cells will become the embryo. The outer group will become the cells that nourish and protect it. Embryo transfer is done at your doctor's office or a clinic and usually takes place two to five days after egg retrieval. If successful, an embryo will implant in the lining of your uterus about six to 10 days after egg retrieval.
After the embryo transfer, you can resume your usual daily activities. However, your ovaries may still be enlarged. Consider avoiding vigorous activity, which could cause discomfort.
If you develop moderate or severe pain after the embryo transfer, contact your doctor. He or she will evaluate you for complications such as infection, twisting of an ovary ovarian torsion and severe ovarian hyperstimulation syndrome.
About 12 days to two weeks after egg retrieval, your doctor will test a sample of your blood to detect whether you're pregnant. The chances of giving birth to a healthy baby after using IVF depend on various factors, including:. Talk with your doctor about any factors that apply to you and how they may affect your chances of a successful pregnancy. Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. Mayo Clinic does not endorse companies or products.
Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview In vitro fertilization Open pop-up dialog box Close. In vitro fertilization During in vitro fertilization, eggs are removed from mature follicles within an ovary A.
Request an Appointment at Mayo Clinic. Egg-retrieval technique Open pop-up dialog box Close. Egg-retrieval technique Typically, transvaginal ultrasound aspiration is used to retrieve eggs.
Blastocyst Open pop-up dialog box Close. Blastocyst Three days after fertilization, a normally developing embryo will contain about six to 10 cells. Share on: Facebook Twitter.
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