With IVF, “controlled ovulation” treatment is often used to obtain more follicles than with natural cycles. This is why many women with infertility may have a misconception that IVF can lead to premature ovarian failure. They believe that the use of ovulation-promoting drugs during IVF treatment causes multiple eggs to develop in the ovaries at the same time, resulting in the premature ovulation of a large number of eggs in the ovaries, which affects the ovarian function and causes premature ovarian failure. In fact, this is not the case. First of all, let’s understand the process of follicle development and maturation. The number of eggs in a woman’s body is basically fixed from birth, about 2 million at birth, after which most follicles gradually degenerate and atrophy during childhood, leaving only about 300,000 at puberty, but not all of these follicles can mature and ovulate. Therefore, only about 400-500 follicles develop and ovulate during a woman’s lifetime, which is only about 0.1% of the total. When a woman is in her reproductive years, a number of follicles develop each month, usually about 3-11. These follicles are recruited and selected, of which only 1 dominant follicle usually reaches full maturity and expels an egg. The recruitment process is a very important stage in the maturation of the follicle, just like the well-known large number of sperm, but only one in a million is finally fertilized. The recruitment of sinus follicles occurs during the late luteal phase of the previous menstrual cycle and during the early follicular phase of the current menstrual cycle. After the serum FSH level reaches a certain threshold, a group of sinus follicles is recruited in the ovary and enters the growth and developmental track. In this cluster, some follicles are sensitive to low FSH while others are not, so the sensitive follicles enter the next stage of growth. Therefore, on day 7 of menstruation, among the cluster of recruited developing follicles, the one with the lowest FSH threshold develops into the dominant follicle first. The rest of the follicles develop to a certain point and degenerate on their own through apoptotic mechanisms, i.e. follicular atresia occurs, which we call selection. With the action of FSH, the dominant follicle continues to enlarge, forming a preovulatory follicle and secreting estrogen to reach the peak of the positive feedback regulation on the hypothalamus, prompting the massive release of GnRH from the hypothalamus, which in turn causes the release of gonadotropins from the pituitary gland and the appearance of the LH/FSH peak, which is a reliable indicator of imminent ovulation and appears 36 h before follicle rupture. after ovulation, if no fertilization occurs, the next menstrual flow occurs around 14 days After ovulation, if fertilization does not occur, the next menstrual period will occur around 14 days later. Ovulation promotion is the process of increasing the dose of FSH to bring some of the non-sensitive follicles into the sensitive ranks, which means that the follicles that should have been in atresia are pulled back into the growth queue with the drugs to grow further and reach the standard of mature follicles, instead of bringing forward all the later follicles. Will the use of ovulation medication affect subsequent follicles? When the follicles are in the resting phase, they are non-dependent on gonadotropins, and in layman’s terms, the resting follicles are in a sleepy phase and do not respond to hormones. Therefore, ovulation treatment does not affect the number of eggs or the functional reserve of the ovaries and will not lead to premature ovarian failure.