In the process of in vitro fertilization (IVF) in the United States, most patients need to undergo “ovarian stimulation.” What is this about? Will it lead to premature ovarian failure? Let’s explore the relevant knowledge of ovarian stimulation together.

During the reproductive period, in the normal menstrual cycle of women, a batch of eggs is recruited every month, but ultimately only one egg becomes the dominant follicle, matures, and is released, while the rest of the follicles will be locked. The successful implementation of IVF in the United States requires patients to have a certain number and quality of eggs as a prerequisite, so ovarian stimulation treatment is needed. Through ovarian stimulation, the follicles that would have been locked in the same batch can mature, which is actually a reuse of resources, so it will not overdraw ovarian function or cause premature ovarian failure.

For some patients with simple ovulation disorders or inadequate luteal function, after ovarian stimulation, they can be guided to attempt natural conception or undergo intrauterine insemination. The goal of ovarian stimulation for these patients is to obtain 1-2 mature eggs released smoothly, and this stimulation strategy is called ovulation induction (OI).

For patients preparing for IVF, the goal of ovarian stimulation is to obtain multiple mature eggs under the premise of safety. Ideally, the number of retrieved eggs is between 10 to 15, a strategy known as controlled ovarian stimulation (COS).

Steps of Ovarian Stimulation:

Complete Relevant Examinations: Before entering the stimulation cycle, patients need to undergo relevant examinations. The specific examination items may vary among different fertility centers, so it’s essential to follow the doctor’s instructions.
Develop Personalized Stimulation Protocol: Choose a reputable hospital and experienced doctor to develop an individualized stimulation protocol. Doctors usually formulate personalized stimulation protocols based on factors such as the patient’s age, body mass index (BMI), anti-Müllerian hormone (AMH) levels, baseline hormones, previous ovarian stimulation history, and surgical history. Common protocols include long, ultra-long, short, ultra-short, antagonist, natural cycle, and luteal phase stimulation protocols.
Pre-treatment: Before controlled ovarian stimulation (COS), doctors will pre-treat patients with poor ovarian response, polycystic ovary syndrome (PCOS), or male factor infertility (low sperm count, weak sperm, abnormal sperm). Pre-treatment may include:
For poor ovarian responders: Taking supplements like vitamin E, dehydroepiandrosterone (DHEA), growth hormone (GH), estrogen, oral contraceptives, etc., to increase ovarian sensitivity to stimulation drugs and improve egg quantity and quality.
For PCOS: Actively adjusting lifestyle, adopting a low-sugar diet, engaging in appropriate exercise; using oral contraceptives, metformin, etc., before stimulation to reduce the risk of ovarian hyperstimulation syndrome (OHSS).
For mild to moderate idiopathic male factor infertility: Following the doctor’s advice, taking Chinese herbal medicines such as Shengjing Capsules to improve sperm function and antioxidant drugs such as vitamin E, vitamin C, coenzyme Q10, etc., for combined treatment, with a treatment duration of 3 to 6 months.