In recent years, an unprecedented breakthrough has occurred in the field of infertility treatment, and hormonal effects on the female body have become one of the most important areas of reproductology. To normalize menstrual cycles in which ovulation does not occur, as well as during assisted reproductive technologies, a woman is injected with special drugs. In fact, these are hormones produced by the body, but in a slightly larger amount. They contribute to accelerated growth and maturation in the ovaries of not one, but several follicles containing eggs at once. When it comes to in vitro fertilization, such a procedure is necessary to obtain a supply of eggs for fertilization and transfer to the uterus.
During the stimulation period, a woman experiences a special condition. Under the influence of drugs, the ovaries increase, each growing follicle becomes dominant, large, and in some cases, when there are a lot of growing follicles, this process can turn into ovarian hyperstimulation syndrome. To avoid side effects, the scheme of administration of drugs in ISIDA is chosen with special care. Fortunately, reproductive professionals accumulate knowledge about the use of hormonal drugs, and, according to the global trend, the amount of hormones is minimized. The specialists of the clinic are getting closer and closer to finding the golden balance: to achieve the desired result, and at the same time give preference to gentle methods of influencing the body.
Who needs it?
Standard protocols make it possible to obtain a large number – about 20, or even more – of eggs, but such schemes are not suitable for everyone. For example, a small amount of stimulant drugs is recommended for polycystic ovaries. In this case, it is better to get a small amount of follicles, but of good quality. A similar approach is needed if the supply of eggs in a woman is already small. Standard doses of hormones will still not give the desired effect. Age, hormonal status, a number of diseases – all these factors require special treatment. Sparing protocols are necessary when the patient has to fight against undesirable tumor processes. Previously, oncologists feared that hormonal drugs would lead to the growth of neoplasms. Today they know exactly what diseases stimulation is still possible. And then the preliminary sampling of germ cells allows you to avoid the negative effects of radiation or chemotherapy. The resulting oocytes or embryos are cryopreserved, and in the future, when the body recovers after a difficult therapy, it is quite possible for a woman! – there will be a chance to become a mom. Recently, the number of such visits to the clinic has increased, and this suggests that more and more women are learning that cancer is not a sentence not only for life, but also for future motherhood.
In special cases
Today there are many different schemes of preparation for the collection of eggs, they can be based both on the use of the natural capabilities of the body and on various combinations of drugs. Here are some examples:
- The “natural” protocol, or IVF in a natural cycle, implies the absence of hormonal stimulation. Such a scheme involves obtaining one unnaturally mature egg and is used in cases where stimulation is categorically contraindicated, or when few eggs were obtained in previous IVF attempts or they were not of very good quality, or if the patient refuses stimulation. The effectiveness of this method is quite low, but it is guaranteed to allow, firstly, to avoid side effects associated with the introduction of additional doses of hormones, and, secondly, to try to get a single egg, but chosen by the body itself, hoping for its high quality.
- Combined protocols are built on a “lightweight” scheme. At the first stage, tablet preparations are used and only then, if necessary, injectable ones. Most often, this approach allows you to stimulate the growth of a small (1-5) number of follicles with high-quality eggs. If the purpose of stimulation is not IVF, it reduces the risk of multiple pregnancies. In addition, the procedure is distinguished by a lower cost of drugs. In order to avoid hyperstimulation, a drug can be administered in the final, reducing the risk of its development to zero. Unfortunately, after it, the chances of pregnancy during embryo transfer in this cycle decrease somewhat. The solution is cryopreservation of embryos and their transfer to the uterine cavity in the next (unstimulated) cycle. This allows a woman to recover, lead a normal lifestyle without suffering from symptoms that provoke an increase in the ovaries – and make an attempt to become a mother at a convenient moment.
- The Shanghai Protocol is another new technology involving two–stage stimulation. After the matured follicles are ready for extraction, there is still a certain number of “babies” that have yet to develop. Therefore, after the first puncture, the careful hormonal effect continues, and within one cycle you can get almost the same number of egg cells as after two courses. Initially, such a scheme was developed for cancer patients, and also modified for women with a small supply of eggs. The ISIDA clinic drew attention to another advantage of the protocol – it is good for those patients who are limited in time.