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What drugs to take ovarian stimulation. Rules for the use of hormonal stimulation drugs. Choosing a hyperovulation scheme

Unfortunately, problems with self-conception are quite common. Thanks to the rapidly developing world of gynecology, reproductive medicine, most of them can be successfully eliminated. So one of the options for treating infertility is ovarian stimulation to plan pregnancy. The method is widely used and brings quite real results. According to statistics, about 30-40% of women become pregnant successfully after ovarian stimulation.

The essence of the procedure

Before proceeding with the description of the concept of what stimulation of the ovaries in gynecology is and how the ovaries are stimulated, it is necessary to understand when it is necessary. For various reasons, the female reproductive system can malfunction. This is manifested by various symptoms - the ovaries do not respond to different phases of the menstrual cycle or do not respond intensively enough, the woman ultimately does not ovulate.

As you know, the lack of full ovulation is a serious obstacle to the conception of a child. In such situations, hormonal stimulation of the ovaries is required. Stimulation of ovulation, in addition to the goal of conceiving a child through sexual contact, is also prescribed without fail during artificial insemination and during intrauterine insemination.

Ovarian stimulation is the use of special drugs that help restore the correct ratio of hormones that affect the process of maturation, follicle rupture and egg release. Stimulation to get pregnant is prescribed if, as a result of the year, the couple was unable to conceive a child on their own.

Pregnancy on stimulation actually occurs after intercourse, but before it, the woman “turns on” her ovaries with the help of special drugs.

In the case when an older woman is over 35 years old, then 6 months of unsuccessful attempts are enough to prescribe such therapy. Stimulating pregnancy begins with a detailed examination of both spouses to identify possible contraindications and determine the correct treatment tactics.

In order to understand how to wake up the ovaries to get pregnant, you should adhere to the following recommendations:

1. hormonal drugs are taken exclusively as prescribed by a doctor;
2. you can independently adjust your diet and lifestyle, which also affect hormonal levels;
3. the use of traditional medicine in a complex can increase and accelerate the effect of general therapy, it can be different herbs to stimulate the ovaries.

How many eggs mature when stimulated? When stimulated, many more eggs mature. On average, this is 5-10, when 1, maximum 2 eggs mature in the natural cycle. Although a stimulated pregnancy is inherently no different from a natural pregnancy, the chance of having twins is several times higher.

Means and preparations

Basal temperature, monitoring it throughout the cycle can be the first to signal a woman about existing problems with ovulation. A readily available ovulation test should also be used when trying to get pregnant for the first time. Women over 40 should accept the fact that their ovulatory reserve is significantly depleted and anovulatory cycles at this age are not uncommon.

Depending on the results of the examination, before starting treatment, the doctor selects the necessary stimulants for pregnancy. The drugs used by specialists to stimulate the work of the ovaries can be conditionally divided into the following groups:

• funds based on human menopausal gonadotropin (HMG) - menogon, pergonal, menopur, contain the hormones LH and FSH, which are necessary for the proper maturation of the egg and the onset of ovulation;
• containing the recombinant hormone FSH - puregon, gonal-F, highly purified drugs, most similar to natural follitropin;
• ovulation triggers - human chorionic gonadotropin (hCG) - rot, prophase, choragon, ovitrel;
• antiestrogenic drugs, with the main ingredient clomiphene citrate - clostilbegit, serophene, clomid. By reducing estrogen in the body, they help increase synthesis.

In many respects, such a tactic of treatment is correct, taking into account all the individual needs of a woman, determines success. Most often, the first stimulation begins with the drug Klostilbegit. But, recently, femara stimulation is common. It is a preparation with the active ingredient Letrozole.

Initially, its use is associated with the treatment of breast cancer, but its moderate antiestrogenic effect allows it to be used as an alternative to Klostilbegit.

Such hormonal treatment in no case can you prescribe yourself, this is a serious shake-up for the body. And with the current therapy, any arbitrary change in the dose can lead to unpredictable consequences. The only independent acceptable options are ovarian stimulation for planning pregnancy with folk remedies. For this purpose, decoctions and infusions of various herbs are mainly used, which have a beneficial effect on the work of the female genital organs.

To stimulate the ovaries with folk remedies to get pregnant, you can take a decoction of rose petals, juice from quince and aloe leaves. The substances they contain are capable of causing ovulation. Stimulation of the pituitary gland with folk remedies to improve its production of FSH and LH is carried out with the help of sage. In addition, it perfectly helps to thicken the endometrium of the uterus for the future fetus.

Features of stimulation

To have children is the sacred right of every woman at any age. Therefore, if you suspect or already known problems with the maturation of the egg, you can try to feed your ovaries to plan pregnancy. In addition to traditional medicine, before starting an expensive medication prescribed by a doctor, it is worth trying special exercises to stimulate the ovaries. We are talking about yoga, acupuncture, special gymnastics for the genitals.

How much does ovarian stimulation cost? The pricing policy of such a procedure will consist of the cost of drugs, tests and visits to the doctor. Therefore, on what types of stimulation will be chosen, what kind of ovarian response will be, the clinic will be paid or not, how wide the list of tests will be, and the cost of the procedure depends.

On average, the range of costs ranges from 20 to 70 thousand rubles. Speaking of types of stimulation, it comes on the choice of drug regimen. What combination of sequence and duration will be prescribed to the woman.

One of the varieties of obtaining superovulation is the so-called double stimulation. The procedure means that you will receive double egg production in one menstrual cycle. It is carried out for IVF protocols with freezing of material, for women with a low ovarian reserve or for maintaining fertility before starting the proposed treatment, for example, oncology.

As with any medical intervention, the process of artificial activation of the ovaries can have side effects.

The main situations that indicate how dangerous stimulation is:

• possible risk of OHSS;
• the risk of cysts;
• allergic reactions, stool problems;
• ectopic pregnancy;
• earlier ovarian depletion - with abuse of the number of procedures.

The main sensations when stimulating ovulation in the case of its normal course, without side effects- This is a slight swelling of the ovaries, moderate pain in the lower abdomen, which goes away on its own. If, after stimulation, the ovaries hurt for a long time, the woman observes other symptoms - swelling, malaise, swelling of the abdomen, then seek help from a doctor immediately.

There are ways in medicine to help a woman conceive a child, where there is no need to take hormonal drugs - this is eco without hormonal stimulation. True, the indication for such a procedure is healthy ovulation that occurs on its own. Here is the paradox. It is impossible to solve problems with ovulation without correcting hormonal levels.

Consistent and strict adherence to doctor's prescriptions in most cases will give positive result... The cherished two stripes will surely delight a woman. But, do not forget about cases when it was possible to conceive after several unsuccessful attempts - the effect of the so-called "pregnancy on cancellation". If the stimulation of the ovaries does not work, it is always possible to resort to ART.

At reproductive age, a woman is in constant readiness for the birth and bearing of a child. This happens because two types of hormones are cyclically produced in a woman's body:

• preparation of the body for conception is carried out by estrogens - growth and acquisition hormones (1st phase);
• preservation of pregnancy is provided by gestagens - hormones of maturation and preservation (2nd phase).

The change from the first phase to the second starts only after ovulation. The release of the egg replaces the process of cell growth with a maturation program. In the absence of ovulation, the cycle is considered defective. From the point of view of gynecologists, monthly bleeding with a disturbed cycle is considered anovulatory, dysfunctional. In this position, it is impossible to plan a pregnancy. Lack of conception within two years without the use of contraception is defined as infertility. Let's consider what methods of treatment of female infertility exist.

Traditional techniques

Traditional methods of therapy for female infertility include therapeutic or surgical treatment aimed at restoring the normal (ovulatory) menstrual cycle. To begin with, doctors exclude the absence of pregnancy due to the insolvency of the man. A sufficient erection does not guarantee fertility. Semen analysis is the first step towards treatment.

Fertility therapy for women begins with anti-inflammatory treatment. No pharmacological agents will help to stimulate ovulation of a diseased ovary. Anti-inflammatory drugs are used, according to indications - antibacterial agents. Injections of B vitamins, which have an anti-inflammatory effect on both vascular and nervous tissue, are of great importance.

Surgical methods include resection, or ovarian drilling of the ovaries.

Therapeutic stimulation of ovulation is produced by hormonal drugs that cause the synthesis of gonadotropins - hormones that regulate the growth and maturation of follicles.

Assisted reproductive technologies

Assisted reproductive technologies provide for in vitro fertilization of your own or donor eggs. Conception is done outside the body. IVF is performed only on strict indications, after a thorough examination of both sexual partners.

More information on the topic

A woman's inability to get pregnant becomes a big tragedy for every married couple. A woman is literally pursued by the dream of a baby, gnawing at the thought of her physical inadequacy. Unfortunately, today infertility is becoming one of the most common problems in married couples.

If a woman does not ovulate or is extremely rare, ovulation is stimulated. Thanks to the stimulation of ovulation, thousands of women become mothers every year.

Medical indications for stimulating ovulation arise when a couple cannot naturally conceive a fetus for a period exceeding one year, with regular unprotected sex. For couples over 35 years old, this period is reduced to 6 months.

It is very important to carry out an ultrasound control of follicle development to obtain a result during the period of stimulation, otherwise such a procedure is useless. It makes no sense to stimulate ovulation when male infertility.

Carrying out the procedure in the presence of obstruction of the fallopian tubes can lead to an ectopic pregnancy. Therefore, stimulation of ovulation should be prescribed only after laparoscopy.

Every woman wonders how to properly stimulate ovulation and what methods exist for this.

Medication stimulation

Before the appointment of stimulation, both spouses are sent for a medical examination. Successful stimulation of ovulation with Clostilbegit is possible when the doctor draws up the most competent protocol for the procedure.

That is, taking medications, taking tests, conducting examinations according to a peculiar schedule, taking into account age and individual characteristics married couple. Also, the doctor takes into account how the egg will subsequently be used: for IVF, ICSI or for fertilization in a natural way.

With the classical scheme, the intake of clostilbegit begins from 5 to 9 days of the menstrual cycle. With additional stimulation of ovulation using Puregon, Clostilbegit is prescribed from 3 to 7 days.

The admission period is accompanied by ultrasound monitoring of the follicle maturation process. When it reaches 17-18 mm, the woman takes Pregnil and ovulation occurs in 24-36 hours. According to statistics, about 15% of couples manage to become pregnant after stimulating ovulation on the first attempt. The duration and cause of infertility and the woman's age also play a role.

Stimulation by folk methods

Many women consider the "natural" variant of stimulation to be more preferable - taking medicinal herbs. They take boar uterus, red brush leaves and sage to stimulate ovulation, which are freely sold in every pharmacy. For the maturation of eggs, take 3-4 times a day, 1 table. spoon for one glass of boiling water of sage infusion in the first half of the new cycle.

Drinking an infusion of borax uterus, rich in progesterone, begins from the second half of the cycle. Lack of progesterone prevents the fertilized egg from penetrating into the cavity of the uterine wall and it dies. To stimulate ovulation to be most effective, you need to be able to calculate it correctly and the probability of conception will be much higher.

Taking a decoction of rose petals is not only pleasant and tasty, but also healthy. Following folk methods, a man and a woman, when using such a romantic broth before going to bed, 1 teaspoon each, will certainly be able to conceive a child.

This phenomenon is explained by the content of vitamin E in rose petals, which has a beneficial effect on the ability to conceive. Moreover, women prepare a decoction from the petals of white and pink roses, and men - red and dark pink. To prepare the broth, 1 table is enough. tablespoons of petals per 200 ml of boiling water, followed by exposure for 15 minutes in a water bath.

The reception of mummy in combination with juices is positively characterized: sea buckthorn, quince, carrot. It is taken on an empty stomach in the morning and in the evening. Mixing ratio 1:20.

Vitamin therapy and ovulation stimulation

The expectant mother must provide the need for trace elements and vitamins with proper and rational nutrition. First of all, a woman must provide the body with folic acid, since its lack in the body can cause intrauterine developmental pathologies. To replenish the body with another essential element - potassium iodide, iodized salt should be used in food.

How to properly conduct stimulation to avoid "unpleasant consequences"? Hormonal drugs contribute to the maturation of a full-fledged egg in a woman's ovaries. The dosage and selection of drugs to stimulate ovulation are calculated individually and are aimed at the formation of eggs capable of fertilization.

The choice of a method for restoring ovulation is determined based on the reason for its absence. And it should be admitted that if at the beginning of the treatment the reason for the absence of ovulation was not precisely established, then stimulation is unlikely to give a positive result.

When establishing a diagnosis of the absence of ovulation, the chart of basal temperature of a single cycle cannot be taken as a basis. Several cycles of observation must be followed. Otherwise, the prescribed treatment can cause enormous harm in the future completely healthy body... It is better if the tests for hormones are carried out several times to make sure that there is a problem or not in this area of ​​the body.

In case of deviation from the norm of thyroid hormones, male hormones and prolactin, it is not worth starting to stimulate ovulation. You should first bring them back to normal so that they do not interfere with ovulation. Perhaps, with the restoration of the norm of hormones, ovulation will also be restored.

Ultrasound monitoring

Based on repeated ultrasound observation. If there is an "ideal" 28-day cycle, the first ultrasound is performed 8-10 days after the end of the last menstrual period. Next, an ultrasound scan is performed at least every two to three days. This frequency is determined by the state of the uterus and ovaries. Stop ultrasound when establishing the fact that ovulation has occurred or with the onset of menstruation.

Before the start of stimulation, no matter what drugs, the results of the husband's spermogram should be on the hands, indicating the suitability for natural conception. Stimulation must be strictly controlled by a doctor. Constant ultrasound monitoring will allow you to analyze the body's response to the stimulation process and the development of follicles! This is the only way to judge with confidence whether the follicles are growing and whether the ovulation process is taking place.

How ovulation is stimulated, the main stages

If Clostilbegyt is chosen for stimulation, then on the 5th day it begins to be taken and ends on the 9th. When choosing to stimulate menogon or puregon, the reception begins already from the 2nd day of the cycle and ends somewhere after 10, the doctor determines the exact date based on observations of the stimulation process.

The start date and duration of the stimulation procedure depends on the state of the patient's ovaries and uterus and is determined directly by the attending physician in each case individually. The first ultrasound scan, performed a few days after the start of the stimulation procedure, is followed after two to three days.

The observation is carried out until the follicles reach the size of 20-25 mm. To prevent follicle regression and exclude the possibility of follicular cysts formation at this stage, an injection of hCG is prescribed. The dose chosen by the doctor helps to "start" the ovulation process.

With a favorable course of the process, ovulation begins 24–36 hours after the prescribed injection of hCG. After confirmation of this by an ultrasound examination, injections of progesterone or uterine are prescribed for additional "support" of the corpus luteum of the ovaries. According to the patients' reviews, the stimulation of ovulation with Clostilbegit most often leads to conception.

Taking into account the male factor, the doctor prescribes specific timing and frequency of intercourse and inseminations during stimulation. If the spermogram is good, then after the injection of hCG, intercourse should be daily or every other day until the end of ovulation and the formation of the corpus luteum.

If the use of clostilbegyt does not cause ovulation or follicular growth, then it is recommended that after the third unsuccessful course, revise treatment methods and conduct additional examination.

Important: Clostilbegit is not recommended to be applied more than 6 times. Abuse of the drug can cause ovarian depletion and cause "early menopause". And this will jeopardize further attempts to treat infertility using their own eggs.

With this outcome, you will have to be content with IVF with a donor egg. As a drug with a pronounced antiestrogenic effect, it is better not to prescribe clostilbegit for the problem of endometrial growth.

Before carrying out medical procedures and diagnostics, one should make sure that there are no acute inflammatory processes, which are a contraindication, since they carry the risk of a deterioration in the general condition of the patient.

In the middle of the menstrual cycle, the ovary of a healthy woman exits the ovum from the follicle of the egg into the abdominal cavity. If this natural process is disturbed, ovulation is stimulated using special drugs - ovulation inducers. Of the most commonly used drugs to stimulate ovulation, Klostilbegit is known.

Stimulation of ovulation by gonal and menopur replenish the endocrine gland of the pituitary gland with hormones and control the process of follicle maturation and the onset of ovulation in the woman's body. Produced in the form of injections, injections are prescribed to stimulate ovulation intramuscularly or injected subcutaneously. The ovulation stimulation scheme is drawn up based on the established type of ovulation disorder and the period during which the violation is noted.

Ultrasound monitoring during this period avoids the growth of several follicles at the same time. Each examination is accompanied by counting the number of growing follicles, measuring their diameter and determining the thickness of the uterine lining.

When the diameter of the leading follicle reaches at least 17 millimeters, Pregnyl enters into action, causing the release of the egg from the follicle. Depending on the specific type of marital infertility, intrauterine insemination is performed with the sperm of the donor or husband, or sexual intercourse is performed.

A positive effect is the stimulation of ovulation with gonal, confirmation of this is the feedback from women who have successfully become pregnant and will soon celebrate the main event in their lives.

Ovulation stimulation should be preceded by the following medical examinations:

• Syphilis;
• Hepatitis B and C;
• Ultrasound of the mammary glands;
• Smear (woman);
• Oncocytology smear (woman); Crops for the detection of chlamydia, candida, trichomonas, ureaplasma, gardnerella, mycoplasma;
• The patency of the fallopian tubes;

A prerequisite is the conclusion of a general practitioner about a woman's ability to carry a pregnancy.

The blood is examined for the presence of antibodies, and therefore immunity to rubella. The patency of the fallopian tubes is one of the important conditions for the onset of pregnancy, fertilization takes place here.

Several methods are used to assess patency:

• Laparoscopy;
• Metrosalpingography;
• Transvaginal hydrolaparoscopy.

The assessment method is selected by the attending physician based on the available indications. If inflammation or trauma of the uterine mucosa, intrauterine device is detected, hysteroscopy of the uterine cavity is performed.

Lack of ovulation can cause:

1. Hormonal imbalance, which may be caused by the termination of the use of contraceptives. The body will take some time to fully recover its functions. This can take several months.
2. Intense sports, illness, stress and others, physical and serious psychological stress.
3. Excessive thinness and lack of adipose tissue.
4. Clinical causes such as polycystic ovary disease and pituitary dysfunction.

Stimulating ovulation is one of the most common treatments for infertility. Before starting the procedure, a preliminary examination of the ovaries is carried out in order to identify possible contraindications to stimulation.

As a result of the study, preliminary estrogen therapy may be prescribed or the desired ovulation stimulation scheme and dosage necessary to create optimal conditions and obtain a successful attempt are built.

With multifollicular ovaries, stimulation of ovulation can lead to multiple pregnancies. This is due to the fact that several enlarged follicles are formed in the ovaries at the same time. Ovaries with many follicles can be observed on ultrasound and at other times of the cycle.

Follicular development can be delayed when taking hormonal contraceptives, when breastfeeding, in adolescence, with sudden weight loss, obesity, thyroid dysfunction and other endocrine diseases. Pregnancy with such ovaries is quite compatible and will pass normally in the absence of other disorders.

Some patients identify multifollicular ovaries with the concept of polycystic ovary disease. However, the main difference between multifollicular and polycystic ovaries is the normal volume of the ovary.

The number of follicles does not exceed 7-8, the diameter is 4-10 mm, and the content of LH and FSH, insulin, testosterone in the blood is within normal limits. Thus, the diagnosis of multifollicular ovaries cannot be considered a disease. Rather, it is a certain condition that is not the cause of infertility, irregularities in the monthly menstrual cycle, etc.

With polycystic ovary, testosterone and insulin levels are increased. The volume of the ovaries is almost twice as large, the ovarian capsule is thickened. Stimulating ovulation in polycystic disease involves hormone therapy, which lowers the level of male hormones. Already within the first months after the appointment of the drug, the result is noticeable. Ovulation-stimulating drugs include clomiphene citrate and metformin.

The problem of infertility is a common problem for a married couple. In half of the cases, the reason lies in male infertility. That is why the examination is prescribed for both spouses. For examination, men carry out a spermogram, which is carried out after 3-5 days of abstinence.

Stimulation of ovulation with IVF

IVF (In Vitro Fertilization) took place for the first time in 1978 in England. The method is used for infertility caused by problems of the fallopian tubes, ovulation, and sperm quality. IVF is used for conceiving a child by women over 45 years old.

The method provides for the fertilization of the egg not in the woman's body, followed by the placement of the embryo in the uterus. Of course, the price of the IVF method for stimulating ovulation is the highest compared to other methods.

The main indications for IVF are defects or absence of fallopian tubes. In Vitro Fertilization is recommended when there are insufficient or no sperm in the male sperm.

In the period between the 19th and 23rd days of the menstrual cycle, a drug is administered to prepare the woman's body for hormonal stimulation. Further, the follicles are stimulated under constant ultrasound control. When the follicles reach the desired size, a puncture is done and the egg is sent for fertilization. The embryo is transferred to the uterus after a few days, and a pregnancy test is performed two weeks later.

To minimize possible risks, a comprehensive examination is carried out before IVF treatment.

The main risks of the IVF procedure:

• allergic reactions;
• ovarian hyperstimulation syndrome;
• ectopic pregnancy.

The drug Klostilbegit is prescribed to stimulate ovulation in women and men for the treatment of oligospermia. Who stimulated ovulation with Clostilbegit confirms that the drug promotes increased production of hormones in the pituitary gland and hypothalamus, after which the work of the ovaries in women stabilizes and causes the maturation of follicles.

Stimulating ovulation at home

At home, you can experiment with aromatherapy using herbal oils of anise, cypress, basil, sage to stimulate ovulation. When bathing, adding 3-5 drops of pink geranium and lavender oils to the bathroom will help to normalize hormonal levels. Such stimulation of ovulation will be less costly than treatment with ovulation stimulating pills.

Stimulation of ovulation must certainly be carried out under the qualified supervision of a physician and be based solely on medical indications. The consequences of illiterate ovulation stimulation can be extremely complex. The wrong dose of drugs, neglect of the examination can cause irreparable harm to the female body.

Improper performance of stimulation can result in ovarian rupture or lead to early exhaustion. At home, products that stimulate ovulation should be included in the diet: cereals, quail eggs, dairy products, vegetables and fruits, seeds (flaxseed, sesame, pumpkin). Reviews of women who have undergone ovulation stimulation can be read on numerous forums.

Replies

Many women, desperate to get pregnant and have a baby, decide on stimulation. It is carried out exclusively under the supervision of a doctor. Self-use of certain medications can lead to unpleasant consequences and complications. This article will tell you about how ovarian stimulation works for planning pregnancy in different situations... You will learn about some medications that can help increase egg growth. You can also find out what kind of ovarian stimulation for planning pregnancy has reviews.

What is this procedure?

Many women faced with the problem of conception are aware of the ovaries for planning pregnancy. However, there are also such representatives of the weaker sex who first hear about this manipulation. What is it?

Stimulation is the effect on the female genital organs, in particular on the ovaries, medicines... During the procedure, there is an increase in the release of certain hormones by the pituitary gland. Thus, the doctor can correct the woman's condition in the direction he needs. There are a great variety of drugs for stimulation. Not all of them are used for every woman. Choosing a list of medications is the prerogative of the doctor. However, this should be done only after diagnosis.

When is it necessary to carry out the procedure?

Stimulation of the ovaries for planning pregnancy is always done when this condition is mandatory even if a woman has a stable cycle and regular follicle maturation.

Another indication for manipulation is in a woman for six cycles in a row. It is worth recalling that this situation completely deprives a woman of fertility.

The indication for ovarian stimulation is the desire of a couple to conceive two or more children at once. If the fairer sex is in such a situation that she needs to remove the ovaries, then the procedure is carried out with the aim of freezing the cells for their further fertilization.

Contraindications

Ovarian stimulation for pregnancy planning is not performed with polycystic disease. In other words, if your reproductive organs produce several monthly that do not rupture, then the procedure can only aggravate the situation. In this case, an individual approach to each patient is selected. Surgical intervention is sometimes required.

Ovarian stimulation is not performed to plan pregnancy with menopause. Theoretically, while in menopause, a woman can conceive a child with the help of certain hormonal drugs. However, most experts consider such an act frivolous. Indeed, with the age of a woman, the risk of having a child with deviations increases. Also, in about half of all cases of stimulation before menopause, the doctor and the patient are defeated, since the pituitary gland and ovaries no longer respond properly to the drugs used.

Carrying out procedures is contraindicated if the fairer sex has an increased sensitivity to the selected medications. Also, a woman's ovaries are not stimulated if her partner has fertility problems. In such a situation, it is necessary to find a good specialist and first restore the fertility of a man.

Stimulation is not performed if there are problems with the endometrium. After all, even if fertilization occurs, the embryo will simply not be able to attach to the wall of the genital organ.

Procedure method

How to stimulate the ovaries to plan pregnancy? first, a woman needs to be tested. The main of all diagnostic procedures is ultrasound. During the procedure, a specialist examines the ovaries, determines their size and the presence of dominant follicles. The state of the endometrium is also established.

Ovarian stimulation involves the use of hormonal agents. Depending on the condition of the woman and her preferences, the preparations can be in the form of capsules for oral use and solutions. The latter are administered intramuscularly, intravenously or subcutaneously. Stimulation is usually carried out from the second or fifth day of the cycle. In this month, a woman is assigned from three ultrasound diagnostics, which will help determine, with an accuracy of several hours, the moment the egg is released.

Drugs

Stimulation of the ovaries for planning pregnancy with IVF is performed by several means at once. First, the patient is given drugs that promote follicle growth. Then the eggs are removed, and the woman begins to take hormones of the second phase. This is necessary to support the development of embryos, which will enter the uterine cavity within a few days. In a natural cycle with stimulation, things are a little different. First, the doctor grows the follicles and then ruptures them. Only after that, the expectant pregnant woman begins to use hormonal drugs of the second phase.

Among all the drugs used, the following can be noted. "Menopur" and "Menogon" - they regulate the balance of hormonal substances in the body. "Puregon" and "Gonal" - these formulations contribute to the production of follicle-stimulating hormone. "Pregnil", "Ovitrel" - these funds contain chorionic gonadotropin. It acts on mature cells, promoting their correct opening. Also, these drugs prepare the genital organ for the upcoming pregnancy. "Serofen" and "Clomid", as well as the well-known "Clostelegit". These medicines have anti-estrogenic effects.

Algorithm of actions

How is ovarian stimulation performed in stages? It all depends on the chosen technique. In most cases, a woman is prescribed drugs like "Klostilbegita", which she takes on an individual basis. They help lower estrogen levels and stimulate follicular growth.

The final stage of stimulation is the use of drugs such as "Duphaston" or "Utrozhestan". At the same time expectant mother appointed vitamin complexes containing folic acid. After receiving the test results, the correction scheme can be changed.

An alternative way of stimulation and feedback about it

Most gynecologists and fertility specialists report that using folk remedies for stimulation can be dangerous. Few people manage to get the desired result from such an intervention. However, complications can be expected by almost every representative of the fairer sex.

Most women throughout stimulation folk recipes use one drug. Whereas the usual manipulation involves a multiphase change of drugs. Reviews of women about this technique are twofold. Some say that they managed to get pregnant, while others criticize this principle of intervention.

Ovarian stimulation for planning pregnancy with folk remedies

What methods can be used for stimulation without resorting to the help of doctors? Here are some recipes.

• Sage. This herb should be brewed and drunk instead of regular tea from day 5 to day 15 of the cycle. Sage is known to inhibit prolactin, which often prevents pregnancy.
• Roses and plantain. The dried fruits of these plants are poured with boiling water in the same proportion. Next, you need to let the broth brew and strain it. Take the composition immediately after the end of menstruation until the middle of the cycle.

It is worth saying that despite many positive reviews, such therapy is not carried out during the preparation for in vitro fertilization.

Instead of a conclusion

Now you know how ovarian stimulation is done if you need to get pregnant. HCG analysis is submitted 8-14 days after ovulation, which must be confirmed by ultrasound. The results of this study will answer main question- did you manage to get pregnant.

Remember, if you have problems conceiving, you should see your doctor. It is forbidden to use the above-described means on your own, as they can cause unpleasant reactions. In some situations (with hyperstimulation), apoplexy occurs - this is a rupture of the ovary. This pathology requires urgent surgical care. I wish you health and good results!

The method of hormonal stimulation of the ovaries is advisable to use in cases where a woman has an ovulation disorder, but her partner did not have any violations reproductive function... In addition, the application of this technique is practiced in the presence of infertility of unknown etiology.

Two secretory glands that belong to the endocrine system - the pituitary gland and the hypothalamus - are responsible for the female's menstrual cycle and the maturation of the egg in her body. Violations of the functional activity of these organs leads to the fact that ovulation occurs in rare cases or is absent altogether. In such situations, a fertility specialist may recommend ovarian stimulation.

The principle of the procedure is to normalize the hormonal background of the female body and achieve regular maturation of a viable and high-quality egg. The implementation of the method is possible by taking hormonal drugs (gonadotropins). They come in the form of suppositories, tablets, or injections.

Manipulation must be started 3-5 days monthly cycle, taking into account that the first day of the cycle is the first day of menstruation. Hormonal medications are recommended to be taken every day. In medical practice, the most popular are subcutaneous and intramuscular injections.

During the procedure, a specialist through ultrasound monitors the development of follicles and the thickness of the endometrium. This manipulation is resorted to once every 2-3 days. Each organism has different terms for the maturation of the future egg, usually it takes 10-15 days.

In addition to ultrasound examination, it is sometimes necessary to donate blood for tests with the same frequency. This is necessary to determine the concentration of the female sex hormone estradiol. When estradiol reaches the desired level and the follicle size is 16-18 mm, the patient is injected with hCG, a hormone that stimulates the release of the egg. One day after the injection and for the next 2-3 days, it is necessary to have sexual intercourse. During this period, a woman may have to take progestational drugs, which create favorable conditions for conception.

It is possible that during the stimulation period and after it, pain may occur in the lower abdomen, which is the result of the influence of hormonal stimulation on the ovaries, which are forced to function more intensively. If the pain sensations intensify, continue for quite a long time and are cramping in nature, then you should immediately consult a doctor.

We are pleased to invite you for an individual consultation at

Reproductive Medicine Clinic of the IVF Institute of Professor Stsalai.

Our goal is to help you fulfill your dream of becoming happy parents!

Parkweg 1 9201 Krumpendorf am Worther See

Tel .: + 43 720 512 483

eko-center-austria.ru

What is ovulation stimulation and how does it work?

When a woman cannot get pregnant for a long time, it is a tragedy for the whole family. Parents of a young couple want to become grandparents, sisters and brothers to have nephews, and young spouses are desperate because conception does not occur and the long-awaited pregnancy does not come.

A woman is literally haunted by thoughts of the desired baby, she dreams of becoming a mother, waiting for the cherished two strips on a pregnancy test. But her dreams are crumbling with the monthly arrival of critical days, she feels inferior. After long attempts to conceive a child, misunderstandings arise between the spouses in the family. Infertility is becoming the main problem for the family, which is difficult to deal with.

If a woman's ovulation period occurs very rarely, or does not occur at all, ovulation stimulation is used. Thanks to this stimulation, many previously sterile married couples, after numerous unsuccessful attempts, were able to become happy parents.

Infertile are those couples in which conception does not occur during the year with unprotected sex, or the pregnancy is terminated at the most early dates... If one of the spouses is over 35 years old, then the diagnosis of infertility is made within six months.

Stimulating ovulation is the most common fertility treatment for women. If sterile in married couple is the husband, then this method is not suitable for this family. In order for the doctor to prescribe treatment for you by stimulating ovulation, you must be diagnosed with anovulation - a violation of the menstrual cycle, as a result of which the period of ovulation does not occur and the maturation of the egg does not occur.

Preparation for stimulating ovulation is as follows. There are certain tests that need to be done before stimulation is prescribed. Thanks to these mandatory examinations, possible reasons why the stimulation method may be unacceptable is investigated. If there are no contraindications for stimulating ovulation, then conclusions are made on the results of the examinations:

• what kind of treatment regimen to choose;
• in what dosage to prescribe medication;
• is it necessary to carry out preliminary therapy;
• what drugs are most suitable for your body.

Consider what examinations the doctor prescribes before prescribing stimulation:

• Check the permeability of the pipes. Research can be done in three ways:
  1. Metrosalpingography is a non-operative method in which an X-ray is taken. The disadvantage of this method is the large radiation dose on the reproductive organs of a woman.
  2. Ultrasound metrosalpingography is a modern method of checking the patency of the fallopian tubes, it is performed painlessly and quickly. It is performed on an outpatient basis, within a short period of time. The results of the procedure can already be received on the day of the procedure. Ultrasound metrosalpingography is performed after the end of menstruation. The method consists in filling the uterus and tubes with a special contrast agent through the cervical canal. If there are no problems with the patency of the tubes, then the contrast agent enters the abdominal cavity. With this procedure, you can clearly see the contour of the fallopian tubes and their location, the contour of the uterine cavity, endometrium, the presence of polyps and nodes. This method has a great advantage over conventional metrosalpingography - the ovaries are not irradiated.
  3. If problems with the patency of the tubes are detected, laparoscopy is prescribed. Laparoscopy is a type of surgery. The operation is performed under general or local anesthesia. In laparoscopy, several small holes are made in the abdomen. A small camera is inserted into one hole, with the help of which the image is transmitted to the monitor. The rest of the holes are intended for the tool, with the help of which the necessary manipulations are performed. If the permeability of the pipes is hampered by the spikes in the pipes, then they are removed. If the patency of the tubes is difficult, then the stimulation of ovulation is not prescribed, since the risk of ectopic pregnancy is high. Beforehand, it is imperative to restore the patency of the pipes.
• The husband's spermogram is done. This analysis is needed by the doctor to understand whether the sperm of the patient's spouse is suitable for natural conception. In case of insufficient sperm quality, a woman undergoes artificial insemination or extracorporeal fertilization.
• Ultrasound examination (ultrasound). This study is carried out twice a month: the first time during menstruation, the second time on the 20th day of the menstrual cycle. With ultrasound, various pathologies can be identified and treated prior to stimulation.
• Assessment of ovarian reserve. The ovarian reserve is assessed using ultrasound: if an insufficient size of the ovaries and a reduced intensity of blood flow are found, it means that the state of the ovarian reserve is unfavorable for conception. Ultrasound in this case is done on the second day of the cycle.
• Compatibility test. If this test is negative, your doctor will recommend that you perform artificial insemination.
• A hormone test is performed at the beginning of the menstrual cycle:
  1. Follicle-stimulating hormone (FSH). The analysis is carried out on the fourth day of the menstrual cycle. Depending on the amount of the hormone in the woman's body, drugs are selected for stimulation.
  2. Luteinizing hormone (LH). Also, like the FSH analysis, it is carried out on the fourth day of the cycle. If the amount of these hormones is too small, then drugs with the presence of both hormones - FSH and LH - are prescribed for stimulation.
  3. Prolactin. It is one of the pituitary hormones produced in the brain. The test can be taken on any day, regardless of the menstrual cycle.
  4. Estradiol. It is the most active female sex hormone produced in the ovary. It is also called the beauty hormone. For rent on the 4th-7th day of the menstrual cycle.
  5. Androgens. These are male sex hormones of a steroid nature. With a large amount of these hormones in a woman, pregnancy may not occur.
  6. Thyroid hormones. Tests for these hormones help the doctor understand if the thyroid gland is functioning properly. The analysis is submitted on any day of the menstrual cycle.

Stimulation of ovulation with medications

Preparations for stimulating ovulation are different, but very often at the first attempt, doctors prescribe clostilbegit - a direct stimulation drug that leads to an increased production of hormones that stimulate the activity of the ovaries.

Why are these pills prescribed? They are time-tested, affordable, and have a 35% pregnancy outcome.

Interesting to know: initially, clostilbegit was developed as a contraceptive, but as a result, after repeated use in practice, this drug gave an absolutely opposite result. The effect of the tablets has not yet been fully understood, but multiple pregnancies often occur due to the simultaneous maturation of several follicles.

Very often, patients trust their doctors, hoping for their conscientiousness and knowledge. If a doctor has prescribed Clostilbegit for you without a preliminary examination, do not trust such a specialist, and find a more competent attending physician. Sometimes doctors of the old school, after many years of work, relying on their experience, do not see the point in conducting analyzes and examinations. In fact, all the individual indicators of the female body are very important in treatment.

For the successful outcome of the treatment of infertility by the method of stimulation, a competently drawn up protocol of this procedure is important. Each couple needs an individual approach and their own special treatment. The protocol should take into account all the nuances of treatment based on examinations:

• correct intake of medications;
• test results;
• the age of a man and a woman is taken into account;
• the duration of the impossibility of conception.

Also, the doctor is considering which option is suitable for using the egg:

• in vitro fertilization;
• ICSI;
• the natural way.

The start and duration of the stimulation procedure depends on the condition of the ovaries and uterus. The doctor makes a conclusion about the suitability of the ovaries and other important organs on which ovulation depends.

Stimulation with clostilbegit begins after the fifth day of the menstrual cycle. You need to drink tablets 2 times a day (sometimes once a day) for five days. On the 7th and 14th day of the cycle, an ultrasound scan is performed to monitor the maturation of the follicle.

In the middle of the cycle, when the dominant follicle has grown to a diameter of 20 mm, Chorionic Gonadotropin is prescribed. Chorionic gonadotropin (hCG) is a hormone secreted by the placenta during pregnancy. The level of hCG in the blood begins to rise immediately upon the onset of pregnancy, increases several thousand times by the 12th week, and decreases by the third trimester. If the hCG in the blood of a woman drops at the beginning of pregnancy, this may indicate an ectopic pregnancy or a threat of miscarriage.

After the administration of hCG drugs, ovulation occurs two days later. Then, after the injections of hCG, the doctor sets the frequency of intercourse and certain dates. Sexual intercourse should be daily until the end of the ovulation period. The level of hCG during this period is growing rapidly.

After ultrasound, progesterone drugs are prescribed for hormonal balancing of the two phases of the menstrual cycle and to support the corpus luteum of the ovaries. Continuous monitoring of the processes caused by stimulation is carried out using ultrasound monitoring. Based on these observations, you can adjust the treatment and avoid many problems.

It is important to know: clostilbegit can be taken no more than six times. After long-term use of this medication, ovarian depletion occurs, which can lead to menopause. Using your own eggs will become impossible and you will have to use an egg donor (IVF).

Traditional methods

Many women follow natural processes. Stimulation of ovulation can be carried out using folk methods... If you cannot get pregnant, the following remedies can be used as an alternative to medications:

• It is recommended to drink sage infusion three times a day, brewing one tablespoon per glass of boiling water. Sage infusion improves ovarian function and stimulates egg maturation and endometrial growth. This infusion is recommended for use in the first phase of the cycle.
• The boron uterus contains progesterone, an adrenal hormone that affects the normal functioning of a woman's reproductive system. A decoction of the borax uterus is prepared and consumed according to the same principle as the infusion of sage.
• The grass red brush possesses medicinal properties and helps to heal mastopathy, uterine cystosis, cervical erosion and other female diseases. To prepare the broth, you need one tablespoon of the crushed root of a red brush, pour 300 ml of water and boil for five minutes. It is recommended to use this herb in combination with the infusion of the borax uterus.

You can also drink a decoction of rose petals, try aromatherapy using aromatic oils from basil, anise, sage. All of these plants are excellent ovulation stimulants. While taking a bath, you can add a few drops of concentrated lavender and geranium oils. All these methods normalize hormones and stimulate ovulation.

Reviews of traditional medicine are controversial, perhaps it all depends on faith in what you are doing. If you think that all these methods are useless, then you should not use them. Self-hypnosis plays a significant role in this topic.

Medical stimulation must be carried out under the supervision of an experienced physician. Indeed, due to improper stimulation, there can be very deplorable complications. You also need to be careful with folk remedies. Good is that in moderation. Tune in to a positive result, and the long-awaited pregnancy will definitely come, you just need to put a little effort into it. And stimulating ovulation is perhaps your solution to the problem.

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All about planning children. Birth of a child

Every year the problem of female infertility is becoming more and more urgent. Unfavorable environmental conditions, stress, various chronic pathologies and many other critical factors reduce the likelihood of natural conception or make it almost impossible. In the last decade, infertility resulting from insufficient maturation of the ovaries of normal anatomical structure has been successfully eliminated by stimulating ovulation. This technique, based on a corrective effect on the germ cells with synthetic analogs of female sex hormones, leads to pregnancy in 65–70 cases out of 100.

Preparations for stimulating ovulation

The drugs used in gynecological practice for the artificial maturation of oocytes are divided into the following groups:

• the first group - stimulants of growth and formation of follicles;
• the second group - triggers of ovulation, causing the ovulatory peak of luteotropic hormone;
• the third group - drugs that support the full functioning of the corpus luteum.

Each hormonal agent used to stimulate ovulation is selected purely individually and is administered according to a special scheme called a protocol.

Drugs that stimulate the growth and formation of follicles

Klostilbegit

This is a tablet formulation of the first group, used to stimulate the production of gonadotropic hormones. According to reviews, the stimulation of ovulation with Clostilbegit is an inexpensive, relatively simple and quite effective technique. This agent, which has the ability to specifically bind to receptors of the pituitary gland and hypothalamus, triggers the synthesis of sex hormones.

Ovulation stimulation pills are used from the fifth to the ninth day of the menstrual cycle. The dosage of the drug is set on an individual basis, after a diagnostic examination. Clostilbegit is prescribed for women with a normal anatomical structure of the gonads, and is also used to stimulate ovulation in polycystic ovaries.

Indications are rare irregular menstruation, complete absence of menstruation, moderate endometriosis, infertility of unknown etiology.

Menopur is a follicle-stimulating drug, a synthetic analogue of menopausal gonadotropin. He is appointed in the following situations:

• with ineffectiveness of stimulation of ovulation with Clostilbegit;
• with polycystic ovary syndrome;
• when carrying out assisted reproductive technologies to induce the growth of multiple follicles.

Gonal-F is a potent recombinant gonadotropin in the first group of drugs to stimulate ovulation. The indication for the use of Gonal is the lack of effect from other follicle-stimulating synthetic hormones, hormonal insufficiency, lack of ovulation, planning pregnancy by IVF.

HCG injections

After the abolition of the stimulant for the production of gonadotropic hormones, the woman is injected with human chorionic gonadotropin to induce ovulation. The synthetic analogs of the pregnancy hormone include Ovitrel, Prophase, Horagon, Pregnil, etc. The dosage of the drug is selected individually.

Stimulation of ovulation with Clostilbegit and an injection of hCG promote the start of the ovulatory process, prevent follicle atresia (reverse development) and prevent the formation of follicular cysts. As a rule, the release of the egg from the ovary occurs 24-36 hours after the injection of hCG. This process is confirmed by ultrasound.

Corpus luteum progesterone support drugs

To support the full functioning of the corpus luteum, which is necessary for the preservation and proper development of pregnancy, in the second half of the menstrual cycle, a woman is prescribed progesterone preparations (Urozhestan, Progestozhel).

To replenish the lack of estrogen, which contributes to the growth and strengthening of the epithelial tissue of the endometrium and ensures the successful implantation of the embryo into the uterus, from the 5th to the 21st day of the menstrual cycle, the administration of estrogen-containing drugs is indicated (Proginova, Estrogel, Divigel). It should be noted that the funds of this group do not affect the hormonal background and do not change the schedule of the menstrual cycle when stimulating ovulation (reviews of those who become pregnant).

Ovulation stimulation protocol

1. The use of stimulants for the production of luteinizing hormones (until the follicle reaches a size of 18-25 mm).
2. Injection of hCG, suggesting the onset of ovulation within 24-36 hours.
3. Taking progesterone drugs (second phase of the menstrual cycle).
4. Taking estrogen medications (from 5th to 21st day).

The choice of basic drugs is carried out taking into account the hormonal background, age and ovarian reserve of the patient. During the period of ovulation stimulation, a woman is recommended to be under constant medical supervision. This will allow timely ultrasound monitoring of the ovarian follicular apparatus and not miss possible asymptomatic disorders.

Stimulating ovulation with folk remedies

If there are contraindications to the induction of ovulation with hormonal drugs, as well as if this technique is ineffective, you can try to resort to alternative medicine. Stimulating ovulation with folk remedies includes herbal medicine (treatment with herbs and natural preparations), acupuncture (acupuncture) and pelootherapy (mud therapy). When embarking on non-drug correction methods, it should be understood that it may take a long time to achieve the desired effect.

Herbal medicine

• sage (decoction and infusion);
• umbrella plants (fennel, anise);
• jasmine;
• avocado;
• geranium, evening primrose (essential oil);
• jojoba;
• linden (infusion and decoction);
• adam's root (decoction);
• plantain seeds (infusion);
• chamomile (infusion);
• boron uterus (herbal decoction);
• fresh quince juice;
• infusion of tea rose petals;
• willow bark (broth);
• leaves and flowers of calendula (decoction);
• aloe juice;
• sorrel (infusion);
• leaves and flowers of carnation (decoction);
• liquorice root;
• decoction of St. John's wort;
• alcoholic tincture of lemongrass, ginseng, eleutherococcus, golden root.

All of the above plants, containing a large amount of essential oils, vitamins, acids, alkaloids and phytohormones, have been used for the treatment of infertility for a long time. Phytohormones, which are natural analogs of estrogen, have a milder effect on the female body and practically do not cause side effects. In the course of numerous studies, it was found that herbal preparations stimulate the work of the ovaries and, in most cases, favor the onset of pregnancy.

When starting to stimulate ovulation with herbal remedies, it is necessary to strictly follow the rules for their preparation and storage, as well as the dosage and duration of administration. To achieve the effect, herbal preparations should be taken regularly, at a certain concentration, for a long time. Of course, you first need to consult with a specialist, since each plant has not only beneficial features, but also contraindications and uncontrolled use can lead to unpredictable consequences.

Baths of plantain roots and leaves have proven to be effective for stimulating ovulation at home. To prepare the infusion, 50 grams of raw materials should be poured with 1 liter of boiling water. When the solution is infused, it must be filtered and added to the bathing water. The procedure is recommended to be carried out daily for two weeks.

Acupuncture

From the point of view of Chinese medicine, the impossibility of conception occurs due to an imbalance between the various systems and organs of the female body. The meridians associated with the fertility of germ cells include the kidneys, liver and spleen. There are 365 acupuncture points distributed along them, regulating the flow of vital energy. Under the influence of acupuncture on problem areas located below the navel, in the uterus and ovaries, the blood supply to the pelvic organs increases, metabolism improves, the activity of the female sex glands is stimulated and hormonal levels normalize.

Mud therapy

The method of stimulating ovulation with therapeutic mud is used in resorts specializing in the treatment of diseases of the female reproductive system. For this purpose, specially purified peloids are used. They can be used as a stand alone component or in combination with kelp. The healing mud is applied to the abdomen and thighs for 20 minutes, after which it is thoroughly washed off with water. According to those who become pregnant after stimulating ovulation with pelootherapy, to achieve maximum effect, it may be necessary to insert mud tampons into the vagina - also for 20 minutes. The duration of the course of treatment is 10-15 procedures.

Currently, to stimulate the ovulatory process with sulfide mud, rich in minerals, trace elements, gases and salts, it is not necessary to go to a resort. These funds can be purchased at the pharmacy and applied at home. However, you should first consult with your doctor, since this technique has a number of contraindications, and after using peloids, complications may develop.

Consequences of stimulating ovulation

Stimulation of ovulation is a rather responsible procedure that must be carried out strictly according to medical indications and under the constant supervision of a doctor. Previously, a woman needs to go through a complete diagnostic examination to determine the initial level of follicles in the ovaries. Only after that, the specialist will be sure of the correct selection of hormonal drugs and the accurate calculation of their doses.

The consequences of incorrectly performed ovulation stimulation include:

• ovarian hyperstimulation syndrome;
• the formation of follicular cysts;
• the occurrence of a cyst of the corpus luteum;
• hormonal disorders;
• disorders of the central nervous system;
• gastrointestinal problems;
• apoplexy (rupture) of the ovary;
• ectopic pregnancy;
• early ovarian depletion (menopause);
• metabolic disorders leading to excess weight.

Another "consequence" of ovulation stimulation can be multiple pregnancies. Therefore, before deciding on this procedure, you must carefully weigh the pros and cons, take it very responsibly and clearly follow all the doctor's recommendations.

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Why and how to stimulate ovulation in women?

The maturation of an egg in a woman's body and its release from the ovary (ovulation) are cyclical processes that repeat every 25-28 days. They make up the menstrual or reproductive cycle that underlies conception. If one of its stages is violated, the onset of pregnancy can be difficult.

Stimulating ovulation is an important method of modern reproductive technology. She gives nice results with insufficient production of certain hormones in a woman's body, and allows her to become a mother.

How to stimulate ovulation, the gynecologist decides in everyone specific case individually.

How does ovulation happen?

The ovaries, in which the female reproductive cells (eggs or oocytes) mature, are paired organs located in the small pelvis. They open outward directly into the abdominal cavity.

Eggs develop in follicles - spherical formations that line a layer of epithelial cells.

Normally, one egg matures in one cycle - in each ovary in turn. The cell released into the cavity is captured by the funnel of the oviduct or fallopian tube.

The epithelium of this formation bears cilia, which cause the movement of the oocyte from the ovary to the uterus. This is where fertilization occurs most often.

The ovulation process has a complex system of hormonal regulation. It starts in the brain. The hypothalamus secretes gonadotropin-releasing hormones that act on another endocrine gland - the pituitary gland. It in turn produces luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

LH determines the process of egg release from the ovary, and FSH determines its maturation and growth. During pregnancy, thanks to the mechanism feedback, the production of these hormones is stopped.

What is adnexitis or salpingo-oophoritis and how is it dangerous for the female body?

The necessary analyzes and the main stages of preparation before carrying out artificial intrauterine insemination are discussed in this article.

Causes of hormonal imbalance in women

In some cases, malfunctions begin in the hypothalo-pituitary system of the female body. A woman experiences difficulties in conceiving a child, there are irregularities in the cycle or a complete cessation of menstruation. There are several reasons for this:

• genetic. Certain defects associated with sex chromosomes interfere with the creation of a normal hormonal background;
• pathological. As a result of a tumor or inflammation, the pituitary gland or hypothalamus is unable to produce enough essential hormones;
• indirect. The pituitary gland and hypothalamus are closely related to other organs endocrine system- the adrenal cortex and the thyroid gland. With their dysfunction, it is also possible to disrupt the normal course of ovulation.

Indications and contraindications for ovulation stimulation

Hormone therapy is prescribed in following cases:

• infertility of unknown genesis. They talk about this problem when a woman is unable to become pregnant in a natural way in the absence of identified reasons with regular sexual intercourse with one partner for a year;
• hormonal deficiency if it is impossible to eliminate it in another way;
• the use of one of the methods of artificial insemination, associated with the collection of eggs from the ovary. In particular, ovulation stimulation is carried out with IVF and ICSI.

Do not carry out hormonal stimulation for the purpose of natural conception in the following cases:

• the patient is over 35 years old;
• more than 6 unsuccessful attempts to stimulate;
• there are structural disorders in the body that prevent the onset and course of pregnancy (obstruction of the fallopian tubes, cancer, etc.).

Ovulation stimulating drugs

In modern practice, three groups of drugs are used that stimulate ovulation in women:

The use of medicinal herbs is possible only after consulting a doctor and conducting research.

The dose of the drug is determined by the initial hormonal background. The schedule for taking is called the ovulation stimulation protocol. It is highly individual for each patient.

Reception is appointed on the 3-5th day of the cycle. Every day, follicle maturation is monitored using ultrasound and basal temperature measurement.

In addition, once every few days (starting from the 5th day of admission), the level of estradiol is determined (a hormone produced by the ovaries, it acts on the walls of the uterus, stimulating the development of the placenta) and the cervical number (analysis of the mucous secretion of the cervix, before menstruation it becomes more watery and crystallizes in a special way).

In the absence of the effect of therapy, the dose is increased. An adequate response is indicated when the follicle grows at a rate of 2 mm per day. At higher growth rates, drugs are adjusted or stopped.

When the follicle reaches a size of 18-22 mm, all indicators are monitored daily. The hormone intake is stopped. Follicular growth is accompanied by a thickening of the walls of the uterus (formation of the placenta).

When it reaches a thickness of 12 mm, a dose of human choriogonadotropin (hCG) is administered, which is responsible for the functioning of the empty follicle (corpus luteum) as a gland, which is typical during pregnancy.

Stimulation of ovulation with an injection of hCG is prescribed if the goal of therapy is conception.

In procedures aimed at normalizing the cycle, this stage is excluded.

It is recommended to have intercourse within 48 hours. When pregnancy occurs after ovulation has been stimulated, the patient is prescribed gestagens (hormones aimed at bearing, produced by the corpus luteum), in the absence of pregnancy, the decision on further therapy is made after the first menstruation.

Potential consequences and complications

The most common complication of hormone therapy is OHSS (ovarian hyperstimulation syndrome). It is accompanied by the formation of cysts, fluid accumulation, stool disturbance, and poor health.

Depending on the degree of OHSS, it can go away on its own or require intervention, including surgery. Increases the risk of complications, stimulation of ovulation in patients with polycystic disease.

When carrying out hormone therapy, a woman should be sensitive to her well-being and inform her doctor about any signs of discomfort.

Multiple pregnancies can also occur, which is associated with the maturation of several eggs at once, or an ectopic pregnancy. If a woman is intolerant of one of the drugs taken, allergic reactions are possible.

The effectiveness of stimulating ovulation in infertility is 10-38%. The method allows you to adjust the hormonal background and create the necessary conditions for conception.

Strict adherence to medical prescriptions and positive attitude are the key to a positive outcome of ovulation stimulation.

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2018 Blog about women's health.