Ovarian response is vital to IVF success. Too much or too little response can lead to disappointment or even health risks.
To improve the rate of success during in vitro fertilitzation (IVF) it is necessary to stimulate the ovaries to produce a large number eggs for fertilization through the administration of hormonal medications, follicle stimulation hormone (FSH) and Lutenizing hormone (LH). Ovarian response refers to the ways the ovaries respond to the hormonal medication and the number of quality eggs produced.
Not all women respond the same to ovarian stimulation. Older women typically have a lower ovarian reserve (the number of quality eggs remaining in the ovary) and the ovarian response (number of eggs released when the ovaries are stimulated with medication) is also typically lower.
Younger women can also suffer from diminished ovarian reserve. Premature ovarian aging can lead to a faster than average decline in ovarian reserve. Diminished ovarian reserve can impact IVF success due to the lack of high-quality eggs.
Both older and younger women with lower ovarian reserve are frequently poor ovarian responders. Poor response doesn’t mean a woman can’t get pregnant, but it does mean egg quality and number is less, making it harder to become pregnant. In other words, the more eggs a woman has, and the better quality they are, the better her chances of a successful pregnancy.
Just as some women respond poorly to ovarian stimulation, others can have an overly active, exaggerated response to hormonal medications. They produce an over-abundance of ovarian follicles and eggs with moderate stimulation. This over-response places them at risk of ovarian hyperstimulation syndrome, or OHSS. Symptoms of OHSS range from mild to a life-threatening systemic condition.
Patients with polycystic ovarian syndrome or high antral follicle counts are at greater risk of developing OHSS with ovarian stimulation than most patients who undergo IVF.
Symptoms of mild ovarian hyperstimulation include nausea, abdominal discomfort and mild swelling of the abdomen. Severe cases of OHSS are rare but include symptoms of abdominal distention and pain, low blood pressure, extreme weight gain, poor urine output, dark urine and shortness of breath.
The success of IVF is reliant on the number of quality eggs retrieved. The goal of ovarian stimulation is to collect as many high-quality eggs as possible without over stimulating the ovaries.
Ovarian stimulation protocols should be precisely tailored to each patient and careful monitoring is vital. Ideal timing is also important, along with regular blood tests to monitor hormone levels.
Contact your local URA clinic in Hasbrouck Heights, Hoboken, and Wayne, NJ for more information. Your friendly URA team will be happy to assess ovarian response and provide treatment options.
