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What is the role of hormones in IVF ?

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3 fertility expert(s) answered this question

Answer from: Raúl Olivares, MD

Gynaecologist, Medical Director & Owner
Barcelona IVF
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There are different types of hormones, and they play a different role in the different phases of the IVF. The first group of hormones that we use is those hormones that are going to stimulate the ovaries, mainly FSH or hMG.  This kind of drugs are going to work on the ovaries, and they are going to grow more than the single follicle that the woman produces in the natural cycle.  These drugs are usually taken as subcutaneous injections.

We are also going to have hormones that are going to block the natural ovulation of the woman.  These kinds of drugs are two different types, the GnRH agonist or the GnRH antagonist. The drugs are taken subcutaneously as well, and they are designed to block the natural ovulation and let us decide when we want to trigger the ovulation.  Usually, these two drugs, the gonadotrophins that are going to stimulate the ovaries and the antagonists or agonists are going to be taken together for a few days.

Whenever the patient is ready for the egg collection, we are going to use a  third type of drug called hCG,  which is going to be used to trigger the ovulation.

Then after the egg collection, we are going to use the fourth type of drug, which is progesterone, and the main role of the progesterone is to open the implantation window and lead to the necessary changes in the endometrium that will allow the embryo implantation.  Progesterone can be taken either in vaginal pessaries, oral pills, subcutaneous injections, or intramuscular injections. Mainly, we work with vaginal pessaries because they are quite easy to take, and the effects are more than enough, but in some cases in which the levels of progesterone are not good, we may recommend taking subcutaneous injections of progesterone or simply add them to the vaginal pressures that the patients are already taking.

Answer from: Guillermo Quea Campos

Gynaecologist, Specialist in Reproductive Medicine
Pronatal Fertility Clinics
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We use hormones during stimulation fundamentally to improve oocyte retrieval in a way to allow us to have a greater possibility of having viable embryos to transfer later in IVF cycles.

Answer from: Tomas Frgala, PhD

Gynaecologist, Head Physician at UNICA Clinic - Brno
Unica Clinics – Prague and Brno
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Well the only way to perform the IVF without any additional hormones would be to perform a natural IVF cycle . We’re talking about it elsewhere in that case we just follow the dominant follicle and try to jump in at the right time triggering the maturation of the egg, harvesting the egg and fertilizing it with the partner’s sperm cell. However having just one egg in this whole process makes this rather unsuccessful project. It’s usually an approach with a very low success rate. Otherwise, we need to specify which hormones we’re talking about. We’re probably mainly thinking about the FSH – the follicle stimulating hormone that’s applied via the subcutaneous injections usually from day two of the cycle which overrides the natural process where just one dominant follicle is recruited and the other follicles actually don’t grow and eventually disappeared throughout the cycle, here with the increased FSH, the follicle stimulating hormone dose, we actually try to get most or perhaps all of the follicles started that are in the ovaries ready for this specific cycle. So, the so-called antral follicles which should be there, usually in account 5 through 10 or 5 through 11 in each ovary (which is considered the normal ovarian reserve), we need to follow their development, we need to eventually trigger the maturation of eggs at the right time. On one hand, we try to avoid too strong a reaction – the so-called hyper stimulation, on the other hand, we’re trying to get as many ripe eggs as possible. There are two other hormones that can play a role and that are sometimes distributed and that’s the estrogen and progesterone however, these are the same hormones that every woman has in every cycle. Usually most of these are actually produced by the dominant follicle and these hormones shouldn’t really present any.

About this question:

Why do we use hormones for IVF, and how they may impact success?

Which hormones are involved in IVF, and what is their role? What hormones do I need to take during IVF?

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