1. Why does she have more eggs than me?
The ovarian reserve function of each woman is different. Young women with polycystic ovaries have good ovarian reserve, more small follicles and more dominant follicles, while older women have low ovarian function, less small follicles and fewer large follicles. To use an analogy, we will cook as much rice as you provide us. As you can see, the number of eggs obtained is determined by your own conditions.
2. Will ovulation promotion lead to premature ovarian failure?
Ovulation promotion does not lead to premature ovarian failure. Every menstrual cycle, a group of follicles (from several to dozens) develop at the same time. Due to hormonal regulation in the body, only one follicle eventually grows and becomes the dominant follicle, while the others are atretic and die. Therefore, even though there are hundreds of thousands of follicles in the ovary at birth, only a few hundred of them eventually grow to become the dominant follicle, while the rest of the follicles are atretic and die. In contrast, ovulation promotion fertilizes those follicles that are not growing enough and are going to be atretic, so that they do not die and grow into large follicles, but has no effect on the growth of the next menstrual cycle or the next batch of follicles. Therefore, ovulation promotion will not deplete the follicles prematurely and will not cause premature ovarian failure.
3. Why is my ovulation protocol different from hers?
We follow the principle of individualized treatment, which means that the treatment plan is tailored to each woman’s specific situation. Everyone has different ovarian reserve, different age, height and weight, different infertility factors, different years of infertility, and different reactivity to drugs. Therefore, our ovulation promotion program is developed by considering all the above factors.
4.Why did my doctor give me a domestic ovulation promotion drug?
Each drug has its own characteristics, but the effect of each drug can be used to the best of its ability, not the imported drugs can promote the best and most follicles. We will adjust the type of medication and dosage according to the patient’s responsiveness to the medication, the growth rate of follicles, the growth rate of hormones, etc.
5.Why did my doctor suggest me to give up this ovulation promotion?
Abandoning ovulation promotion midway is called cancelling the cycle. In the following cases, we may recommend you to cancel the cycle: First, the dose of medication is quite high, but the ovaries do not respond, no follicle growth, which is called poor ovarian response; Second, the follicle response is too good, a small amount of medication to grow too many follicles, continue ovulation promotion will certainly occur OHSS, which may be life-threatening, at this time we may recommend you to directly puncture to retrieve eggs. Third, the LH rises during ovulation promotion, which cannot be suppressed by drugs, and the follicles luteinize early before they grow. Fourthly, the woman’s body condition is not good, she has high fever or sudden acute illness.
6. Why should I give up fresh cycle transfer?
Fresh cycle transfer needs to have all the conditions of timing, location, and human resources to achieve great success. When the endometrium is unevenly echogenic, too thick or too thin, it is not conducive to embryo implantation; when there is fluid in the fallopian tube, it may flush and poison the embryo; when the ovulation promotion estrogen is too high and too many eggs are retrieved, the possibility of ovarian hyperstimulation syndrome is extremely high, which will aggravate the condition and endanger the life after embryo transfer; when there is no quality embryo or transferable embryo, there is no plantable seed. When progesterone is too high, it may affect the synchronization of the endometrium and embryo development, and the two are not synchronized and compatible, and the embryo will not be easily implanted. When a woman has conditions that are not suitable for transfer, such as fever, infection, and poorly controlled chronic disease may affect the further development of the embryo.
7. Why do I need a hysteroscopy?
Hysteroscopy is recommended for clear diagnosis when the ultrasound repeatedly indicates uneven or hyperechoic endometrium, or when the imaging film indicates that the uterine cavity line is not smooth, or when uterine malformation is suspected; if the pathology report of the endometrium indicates abnormalities, treatment is required before transfer. The endometrium serves as the land for embryo planting, if it is moth-eaten and not fertile, it is definitely not conducive to seeds taking root, so it is necessary to make a good land before sowing. The condition of doing hysteroscopy is usually done 2-7 days after menstrual cleansing and no intercourse from the beginning of menstruation.
8.What should I do if sperm retrieval fails?
For patients with very severe oligospermia, sometimes a few sperm may be obtained through epididymal or testicular sperm retrieval, but sometimes no sperm may be retrieved, and multiple failed sperm retrievals can be considered for sperm donor.
For patients with sexual dysfunction, sperm retrieval may fail due to stress. In this case, you can freeze the sperm in advance, in case the sperm retrieval fails on the day of egg retrieval, you can use the previously frozen sperm for fertilization.
9. What is the doctor saying that I have a bad endometrium?
Generally, we evaluate the endometrium by ultrasound, which includes two aspects, one is the thickness of the endometrium, 8-13mm is appropriate, too thin or too thick is not conducive to embryo implantation. The second is the morphology and echogenicity of the endometrium. Before ovulation or egg retrieval, the endometrium should be type A, with uniform and clear echogenicity, no strong echogenicity, and three lines can be seen. During ovulation monitoring, we sometimes find some problems with the endometrium in some women. Some of them have dotted or lamellar strong echogenicity, some of them are too thin or too thick, some of them have strong echogenicity with no three lines visible, some of them are separated, and there is a small amount of fluid between the endometrium. These are all signs of a bad endometrium.
10.Why are my follicles not growing?
We have a classification of ovarian reactivity, there is a category called ovarian hyporeactivity and a category called ovarian slow reactivity. Low ovarian response means that the ovaries are unresponsive and insensitive to medication, requiring high doses of ovulatory drugs to promote ovulation, or not responding to high doses of ovulatory drugs, so the follicles do not grow. Slow response patients, as the name suggests, are slow to grow follicles, which can be improved by adjusting the medication.
11. Why can’t I start this cycle when I was told to enter the IVF cycle this time?
It mainly happens in patients with low ovarian function, after down regulation or without down regulation, the hormones are not qualified, usually the FSH is too high, at this time the ovaries will not respond well to the application of ovulation drugs, it is not suitable to enter the cycle, we need to continue to wait and use the drugs, and then enter the ovulation cycle when the hormones are suitable.
12.Why should I take oral contraceptive pills? I don’t want contraception, I want children
For patients with polycystic ovary syndrome, they often have hyperandrogenemia or hyperandrogenic performance, or LH is much higher than FSH, when the application of oral contraceptives can adjust the abnormal endocrine level to normal. If you try to conceive without treatment, you may not have a dominant follicle to grow and become pregnant easily, or the abnormal hormones may affect the quality of the eggs and make it easy for embryonic abortion or spontaneous miscarriage to occur.
Oral contraceptives inhibit ovulation and also inhibit the growth of the endometrium. For patients with uneven echogenicity of the endometrium, or with inflammation of the endometrium, the addition of progestin can improve the endometrium and prepare the embryo for implantation. As you can see, taking oral contraceptives is to provide better physical conditions for pregnancy, and not for contraception.
13.I came late so I didn’t get my blood drawn, what should I do?
We set 8:00 a.m. to draw blood in room 649 of the Fertility Center in order to send blood samples to the laboratory at 8:30 a.m. to give our patients priority and expedite the results so that we can guide the medication in the afternoon. If you come late and don’t get your blood drawn, you will have to go to the third or fourth floor of the clinic to get your own blood drawn, and you may not be able to get your hormone results that day for reference, so your doctor will have to use medication based on experience. Therefore, patients should not be late and must come on time to have their blood drawn.
14.How can I get my eggs if my ovaries are in a bad position?
The normal position of the ovaries should be on both sides of the uterus, while in a small number of patients there may be pelvic inflammation and adhesions, and the position of the ovaries has changed, some are close to the large blood vessels in the pelvis and some are located on the top of the uterus, which is not a good position to find during the usual ultrasound monitoring of the follicles, which may make it more difficult for the doctor to retrieve the eggs. If the ovaries are close to the large blood vessels, we first consider safety first and try to take all that can be taken, and those that cannot be taken will not be risked. If the ovaries are on the top of the uterus, the puncture needle may have to go through the uterus or the bladder, and it may be uncomfortable to urinate after going through the bladder, but recovery is usually quick.
15.What should I eat during ovulation promotion? Do I need to take a lot of supplements?
People are very concerned about this issue, what is the best thing to eat during ovulation promotion? In fact, during ovulation promotion, a balanced and healthy diet is fine. You don’t need to drink a lot of soy milk or eat a lot of meat and fish every day, and you don’t need to take all kinds of supplements, which may not be good for the normal work of the digestive tract. What you eat normally, you can also eat during ovulation promotion, but you can’t drink alcohol or eat spicy food, etc.
16.Is there any difference between IVF baby and natural pregnancy baby?
There is almost no difference in physical development, IQ, and emotional perception between babies born from IVF and those from natural pregnancies. However, because there are more twins in IVF, twin pregnancies may have relatively more complications during pregnancy and delivery, such as hypertensive disorders during pregnancy, gestational diabetes, preterm labor, placental abruption, and low birth weight babies. The first IVF case, Louis, was just in his thirties, and this issue is worth continuing to explore.
17.Why should I keep using progesterone after transplantation?
Ovulation promotion is different from normal menstrual cycle, we make the follicles finally mature by night injection – HCG injection. The luteal cells left in the ovary after egg retrieval lack hormone stimulation and have a reduced ability to secrete estrogen and progesterone, so exogenous supplementation of sufficient progesterone is needed for luteal support to maintain pregnancy. Until the placental function is gradually formed around 10 weeks of pregnancy, we then slowly subtract exogenous progesterone to allow the placenta to function.
18. Can IVF induce tumors?
Many women are afraid that the use of large amount of hormones in IVF will induce tumors. This view is not correct. Ovulation will not induce tumor for no reason, unless the patient herself is a tumor susceptible person, i.e. she has susceptibility genes to tumor in her body or has a family history of tumor. Simply put, someone who is likely to get a tumor in the future, having IVF at a young age may accelerate the arrival of the tumor. For a patient without these factors, who would not have gotten a tumor, doing IVF will not give her a tumor out of thin air.