Category: Health

Does ovulation happen before menstruation – this question torments a lot of women. Fertilization of the egg is possible only if ovulation occurs before the cycle. The best time for pregnancy is in the middle of the menstrual cycle. Ovulation before menstruation occurs, but very rarely, in such cases, two eggs mature, and a woman can give birth to twins. In this case, this may occur either due to the onset of repeated ovulation, or due to a failure of the cycle.

How long before the appearance of bloody discharge should ovulation occur

After a follicle has formed in the ovary, the inner lining of the uterus begins to increase. After that, the egg enters the fallopian tube, this moment comes about two weeks after menstruation, until the 16th day before it. These processes are extremely important for the intended fertilization of the egg.

After the egg enters the body of the uterus, spermatozoa also penetrate here, also through the fallopian tube, only on the other side. Only after the meeting of the egg with the sperm is fertilization performed. If this does not happen, the egg is excreted by the body outside, that is, menstruation occurs. It turns out that you can get pregnant a week before your period, although the chances are not so great. 5 days before their onset – even less.

Gynecologists believe that the optimal cycle of menstruation is 28 days, the time for conception is the middle of the cycle. At this point, everything is in place for a successful fusion of the egg with the sperm.

How long does the ovulation period last

Those women who plan to conceive, keep a calendar of ovulation dates. And this is correct: in order for conception to occur for sure, you need to know the period and duration. Based on the total duration of menstruation, the ovulatory period occurs:

• with a cycle of 21 days for 5-9 days;
• with 25 after 9-13 days;
• with 30 for 16-20 days;
• with 35 for 19-23 days.

Provided that the monthly regularity does not differ, then it is extremely difficult to correctly calculate the day of the onset of the ovulatory period. In this case, it is better to use other, more accurate methods of deduction. It lasts for each woman in different ways.

Answering the question whether there can be ovulation before the most monthly, we come to an unambiguous – in most cases it can not. It happened that women got pregnant before their periods – such cases are very rare.

Gynecology knows cases when women get pregnant on the day of the cycle, which is considered completely zero. This is explained by changes in the hormonal background, this happens against the background of emotional state, stress and other factors.

Due to severe stress, the menstrual cycle can shift, affecting the period of ovulation. As a result, two ovaries are able to secrete an egg. Not necessarily on the same day, it can happen on different days, and pregnancy will occur during menstruation.

Can it come sooner

In cases where a woman’s cycle is 35 days, even if she is absolutely healthy and her monthly periods come regularly, the release of a mature egg may occur earlier. And the fertile period-later for a week or a little longer.

This can provoke:

• Hormonal disorders in the body.
• Emotional overstrain and stress.
• Weakened immune system.
• Exacerbation of chronic diseases.
• Violation of metabolic processes Overeating or, conversely, starvation.
• Sudden climate change.
• Heavy physical activity

The fertile period may also shift due to the withdrawal of contraceptive drugs, after an abortion or due to a miscarriage.

Does the absence of ovulation before pregnancy mean conception

You can conceive a child only when a woman has matured an egg. The absence of ovulation indicates that this process does not occur in the body of the expectant mother. This means that there can be no question of any pregnancy. In such cases, you need to go to the gynecologist and find out the cause of what is happening. The root cause of this may be a hormonal imbalance.

You can correct it with a specially selected therapy. If the cause cannot be established, doctors resort to radical methods, for example, during the period of alleged ovulation, the patient is injected with a drug that causes the formation and maturation of the follicle with the further release of the egg.

Is it possible to fertilize an egg after ovulation

No, a miracle, in this case, will not happen. A day after ovulation, women have a period that gynecologists call absolute infertility. For those who do not know the answer to the question of whether there can be ovulation before menstruation, we explain the essence of what is happening during the ovulatory period.

Ovulation divides the monthly cycle into two parts. The first is the phase of follicle maturation (duration, on average, 6-9 days). The second is the yellow body phase, the duration of this period lasts, depending on the cycle, and is, on average, 14 days. The second refers to the period of absolute infertility.

Pregnancy does not occur because a mature and ready-to-fertilize egg lives only 24 hours. Sometimes it can live even less. After it begins to collapse.

Can the ovulatory period occur before menstruation

The moment when the egg enters the uterus depends on the hormonal level and the duration of the follicular phase. In some young girls, these processes are very slow. Ovulation and pregnancy before menstruation are possible, due to the fact that the first phase becomes a little longer than usual. The primary cause of this may be a deficiency of the hormone estradiol. The moment of ovulation in such cases falls on the day of the beginning of menstruation, and the cycle itself should move.

Menstruation can not begin at the time of rupture of the follicle, because here comes the luteal phase, which lasts 14 days plus / minus 2 days.

If the ovulation period occurred at the beginning of the cycle and at this point the couple had unprotected contact, then the probability of fertilization remains high. In women in such cases, it is believed that ovulation occurred just before menstruation. In fact, the cycle, or rather its duration, has increased due to the follicular phase.

Probability of fertilization a week before the cycle

If pregnancy is not included in the family plans, then you need to be protected before the cycle constantly, even for a week. Although ovulation can not occur a week before menstruation, there is a chance of fertilization. This applies to young girls and women on the verge of menopause. In medical practice, such cases have happened. The reason for this may be too long periods, irregular cycles or severe stress loads.

The calendar schedule of pregnancy protection in such cases does not work, the probability of unwanted fertilization increases. In cases where the release of a mature egg fell on the period a week before the cycle, the woman must necessarily feel the characteristic symptoms of the fertile phase.

Is there a chance of pregnancy a day or two before the cycle

Many women believe that this is impossible. This statement is false, in fact, there is such a probability, although it is scanty. If a woman is absolutely healthy, then the greatest chances of pregnancy, namely 95%, fall in the middle of the cycle, the chance of fertilization of the egg a day before menstruation is reduced to 1 %, but it still exists. Gynecologists believe that unwanted pregnancies in women occur due to the fact that they simply incorrectly calculate the ovulatory period or because of a violation of the cycle itself.

Can ovulation be more than once

In almost all healthy women, ovulation occurs repeatedly during their lifetime. The regularity of the cycle does not play any role here. The approximate time of the second one is 24 hours or 2/3 days after the first one. The maximum difference is 1/1. 5 weeks in the same cycle. This fact is explained by the fact that both ovaries simultaneously matured eggs. At the time of release, the second hormone level decreases, but the probability of fertilization remains.

In conclusion: ovulation before menstruation

Summing up all the above, it can be noted that even the healthiest representative of the fair sex can have shifts in the ovulatory phase – this is the answer to the main question, which was mentioned above, whether there can be ovulation a week before menstruation, a day or just before them.

Such deviations are temporary, most often the regularity of the cycle is restored by itself. If this is a consequence of pathological changes in the body, then you can not do without the help of doctors.

Coronavirus in pregnant women: Infection with COVID-19 during pregnancy can affect not only the health of the mother, but also the development of the child, according to obstetricians and gynecologists. So, the coronavirus can affect the slowing of fetal growth, provoke incorrect laying of its vital organs, and also lead to prematurity of the child.

Is coronavirus dangerous for pregnant women?

If a woman has contracted a coronavirus infection in the second trimester of pregnancy, this can lead to a slowdown in the development of the fetus.

At the same time, there is a possibility that the effect of CAVID-19 on the child will continue after the recovery of the expectant mother, the expert believes. “So, in the first trimester, a virus carried by a pregnant woman can affect the growth of the fetus, and in the second — cause a slowdown in the development of the child,” the doctor said.

According to her, such consequences are associated with respiratory failure – in a woman in the late stages of pregnancy, the stomach presses on the lungs, thus reducing their volume.

In addition, the coronavirus also affects red blood cells (red blood cells that supply the body with oxygen).

“Red blood cells lose the ability to carry oxygen, respectively, the fetus begins to experience oxygen starvation, so automatically slows down and its growth and development»

Coronavirus in pregnant women: facts

Experts believe that only patients who have COVID-19 in moderate to severe forms, and it is during the second or third trimester, should be afraid.

According to the doctor, with this course of the disease, the fetus may be so short of oxygen that doctors — in order to alleviate the condition of the child — often resort to terminating the pregnancy by caesarean section.

In this case, the woman herself often suffers from the inability to breathe, so this operation is also carried out in order to save the life of the woman in labor, Marian Knight, a professor at Oxford University in the UK, previously told the BBC.

Ed Mullins, a British gynecologist at the Queen Charlotte and Chelsea Hospital, also stated that when the fetus develops distress syndrome, childbirth is accelerated artificially. “This is done in order to provide more effective treatment for low oxygen levels in a woman,” the medic explained.

Transmission of the virus

As for the transmission of coronavirus from mother to child in utero, such cases have not yet been recorded. “The fetus is not a direct target for COVID-19. The virus has no proven teratogenic effect (disruption of embryonic development due to external factors) on the fetus. The placental barrier is really good for him. As a rule, children are born healthy».

She added that in order to avoid serious disorders in the body of a pregnant woman and fetus, expectant mothers with coronavirus should be isolated in time and placed under medical supervision. “Remember that stress is the main danger of a successful pregnancy. Do not read unverified news, follow all hygiene measures and be positive, ” the medic said.

Ovulation is the threshold of conception and pregnancy. This is the period of maturation of the female sexual egg. There is no ovulation process — there is no pregnancy. Can ovulation occur during pregnancy? Does clomid help ovulation?

When an egg Matures in the follicle of the female ovary, it leaves it and goes through the fallopian tubes to the uterine cavity. This process is called ovulation and means the readiness of the woman’s body to conceive. Against this background, hormonal changes occur, which are accompanied by painful and aching sensations in the lower abdomen, thick vaginal discharge. It is during ovulation that a female egg can be fertilized by a male sperm during sexual intercourse. If this did not happen, conception did not take place, then it is removed from the body after a while. This is the period of menstruation — the beginning of the menstrual cycle.

When an egg is fertilized by a sperm during ovulation, it moves up the fallopian tube again and attaches to the wall of the uterus. Pregnancy occurs, the embryo develops. It is logical that the female body directs all its forces to the healthy bearing of the baby. At the same time, for 9 months, the eggs no longer Mature. It is so arranged by nature that after the onset of an “interesting” position, ovulation can harm the woman and the embryo.

Once fertilization has already occurred, the production of new eggs is no longer needed by the woman’s reproductive system. Her body is rebuilt: the ovaries do not produce eggs, the cervix is blocked by a specific mucous membrane, and sperm can no longer show activity in it.

Ovulation occur during pregnancy – Exception to the rule

If we still assume that ovulation during pregnancy is possible and a new conception can occur, then the fetal egg simply cannot attach to the uterus, because the embryo is already developing there.

There are no rules without exceptions. Therefore, sometimes the process of ovulation occurs when carrying a baby. But only in the first month of pregnancy. At its early stage, there is a possibility of a second egg coming out of the ovary and fertilizing it. To date, several cases of re-fertilization after pregnancy are known. But these are the rarest exceptions to the rule. That is, a woman can not bear two embryos at the same time with different terms of conception. A multiple pregnancy is the carrying of two or three babies conceived at the same time. They are born in the process of one birth, one after another.

About ovulation tests

Today, they help couples who want to have a child and try to determine whether the female body is maturing eggs, use the optimal day for conception.

All ovulation tests are based on the same principle. Their effect is to change the color of the indicator strip as a result of getting luteinizing hormone. Its level during ovulation is the highest, which is what the test responds to. So can it happen that a pregnant woman’s ovulation test will show a positive result? Practice shows that this is excluded. Such a test cannot be positive for the expectant mother. However, the same practice confirms that due to their inattention, many representatives of the weaker sex use a different test — for pregnancy. That’s why the result is positive. And this is quite natural. After all, the task of such a diagnostic method is to confirm the “interesting” position. It is confirmed by the presence in the blood of the pregnancy hormone-chorionic gonadotropin. The indicator strip of the pregnancy test responds to its presence.

The ovulation test can be false positive, that is, unreliable, in some cases. We are talking about kidney failure, hormonal dysfunction of the body, postmenopause. Then it is possible to increase the level of luteinizing hormone in the blood.

So, the onset of ovulation in pregnant women is impossible, so it is already laid down by nature. Therefore, during this period, during intimate relationships, contraceptives are no longer used— there is no need for them.

Clomiphene (clomiphene citrate), commonly known under the brand names Clostilbegit and Clomid – is a drug that is prescribed for ovulation and fertility disorders. This pharmacological agent can be used by women who do not ovulate, as well as those who have a lack of luteal phase. LH (luteinizing) and FSH (follicle-stimulating) are hormones that control the ovulation process. Various clinical and scientific studies have provided statistics that consumption of clomiphene stimulates the pituitary gland to produce more of these all-important hormones to normalize ovulation.

In modern times, clomiphene, discovered back in 1956, and ovulation continue to be closely related, as the drug has proven effective for ovarian stimulation and is therefore widely used for this purpose. Other drugs that also stimulate the process of egg release from the follicle are bromocriptine and metformin.

How does clomiphene work?

the body’s cells exchange information through substances such as hormones and neurotransmitters (neurotransmitters). they come into contact with the receptors of various tissues to cause a chemical reaction.

The mode of action and mechanism of the drug are quite similar to the female sex hormone-estrogen. Similarly, clomiphene comes into contact with a receptor present in the hypothalamus (an endocrine gland located in the brain). the drug blocks estrogen from showing its biological properties, while the body believes that this hormone is not enough. this automatically causes the body to produce more gnrh (gonadoliberin), which in turn causes the release of lh and fsh. In fact, FSH helps in the maturation process of follicles (or potential eggs) and therefore produces more estrogen. If clostilbegyt operates so that ovulation occurs more frequently.

How effective is it?

According to statistics, 70% of women report positive results within 6 months after the start of using the product, as evidenced by the solution of issues with ovulation. In addition, about 40% of women are reported to be able to conceive a child after starting treatment. There are several other factors that can affect the chances of getting pregnant, such as a woman’s age and weight. In addition, the period of the menstrual cycle, the frequency of sexual intercourse and male factors such as mobility, speed, shape and number of sperm can also influence the ability to get pregnant. The doctor may increase the dose over time to increase the chances of conceiving a child, as a low dose may not be sufficient for some patients.

Clomiphene and ovulation: what are the side effects?

In addition to the positive effect of clomiphene, as with many other drugs, there may be some side effects:

• Breast sensitivity;
• Significant weight gain;
• Blurred and blurred vision;
• Changes in normal sleep quality and rhythm;
• Abdominal pain;
• Mood swings;
• Severe bleeding during menstruation;
• Spotting;
• Sensations of a rush of heat;
• Nausea;

Another side effect of clomiphene is dryness of the cervical mucosa, which can affect the quality of sexual intercourse; however, this defect can be compensated by the use of vaginal lubrication.

As a side effect, OHSS (ovarian hyperstimulation syndrome) may occur. This condition is characterized by a reversible increase (edema) of the ovaries due to an active reaction of the body to hormones and is quite common (> 10% of women). OHSS should be suspected if excessive flatulence or bloating occurs. This can be a serious problem, but usually ovarian hyperstimulation syndrome that occurs due to the use of clostylbegit is a mild condition that goes away on its own. The severity of OHSS may increase if you take HCG (another fertility medication).

Clomiphene can lead to multiple ovulation, hence increasing the likelihood of twins (10% of births instead of – 1% without it) and triplets.

Some studies have shown that clomiphene, when used for more than a year, can increase the risk of ovarian cancer. Subsequent studies have not confirmed these findings, so we can not speak confidently about this.

According to statistics, the incidence of fetal diseases with the use of clomiphene does not exceed the level that is observed in conception without it. There are no data indicating a higher number of congenital abnormalities or spontaneous abortions after using this drug. although there are also studies that show that the number of congenital heart abnormalities is significantly higher with its use than with its counterpart for ovarian stimulation – letrozole.

Sexual acts when taking clomiphene

The period and frequency of sexual acts when using the drug is not much different from trying to get pregnant without any medication. The ideal time is considered to be two days before and after ovulation, so that the chances of pregnancy increase. The cycles of egg release from the ovary can vary, as in some women they are longer, while in others they are shorter. The ovulation period may even differ from cycle to cycle in the same woman. You can be disappointed if you get too hung up on conception, so it’s better to just relax and try to implement interesting ideas in the bedroom.

Many doctors believe that pregnant after 45 years is not the best time to conceive a child, even dangerous. Others support women who become pregnant after 43, and believe that this is the most appropriate time to conceive a child. With late pregnancy, a reliable Foundation is laid that allows you to give birth to a healthy child.

Before you figure out whether you can still get pregnant in 40 years from the first time, a woman should understand what the psychological, biological and calendar age is. Each organism is different, so later fertilization is only on the calendar, and for health reasons just right. If a woman at 44 feels the strength and desire to become a mother, you need to use the moment.

Features of ovulation after 40 years

Age is one of the main factors affecting a woman’s ability to conceive. The supply of oocytes in the body is limited. It lays at the stage of embryonic development. Some of the eggs die in adolescence. The remaining oocytes are consumed with each menstrual cycle. Therefore, by the age of 40, there are very few eggs left. The work of the reproductive organs during this period changes dramatically. This affects the overall well-being of a woman.

Ovulation after 40 years is much less common than at a younger age. This is due to a physiological decrease in the level of estrogens in the body. The hormone is responsible for the maturation of eggs and increasing the thickness of the endometrium. In addition, it is responsible for preserving youth. When the production of estrogens is disrupted, there is a change in the duration of the menstrual cycle. In some women, it completely disappears. Lack of estrogen in the body is accompanied by the following signs:

• Deterioration of skin elasticity;
• Frequent mood swings;
• Depression libido;
• Changes in the nature of selections.

Life expectancy of an egg after ovulation in a woman’s body after 40 years

Doctors say that ovulation after 40 years rarely leads to a successful pregnancy.

This is due to a reduction in the life span of the egg after it leaves the follicular walls. Until the age of 40, it lives an average of 24-48 hours. This figure decreases markedly with age. Pregnancy in this case becomes possible if the man’s spermatozoa are active enough. In other cases, you may need the help of specialists.

Pregnant after 45 years: Symptoms of ovulation

In General, ovulation after 40 years has no special distinctive features. It runs the same way as before. Some women do not notice any characteristic symptoms of the fertile period. It may be accompanied by the following symptoms:

• Increased sexual desire;
• Heaviness in one of the ovaries;
• Flatulence;
• Increasing the volume of vaginal secretions and changing their consistency;
• The increased sensitivity of the mammary glands;
• Increased sense of smell and taste.

When fertility increases, the position of the uterus changes. It rises high in the vagina and becomes softer. The throat opens slightly. This is necessary for unhindered penetration of seminal fluid into the genital tract. At the same time, the basal temperature index decreases.

An ovulation test helps you get more information. It responds to an increase in the hormone LH in the body. But the result should be interpreted in conjunction with other signs of ovulation. LH can increase not only during the fertile period, but also in the presence of gynecological diseases.

After the expected ovulation, the woman should visit the ultrasound again. The fact that the follicle has successfully ruptured is indicated by its disappearance and the presence of fluid behind the uterine cavity. In place of the follicle, a yellow body appears, which is characterized by uneven outlines. The absence of characteristic signs of the ovulatory period indicates luteinization of the follicle. This problem requires adjustment of the hormonal background with medication.

Choosing the right sex position

• Missionary. The classic position, the man during sexual intercourse is on top, the woman lies on her back. The ejaculate is actually immediately delivered to the uterine cavity and fertilization will occur faster. The pose is considered universal, suitable for couples of any complexion.
• Knee-elbow. The woman must kneel with her elbows on the bed, while the husband is behind her. Provides such deep penetration that the sperm immediately passes into the cervix.
• The General’s posture. The partner lies down on her back, puts her feet on her husband’s shoulders, like shoulder straps.Posture to achieve the optimal penetration depth and thrills.

Clomid and pregnant after 45 years

Also, do not forget that after consulting with your doctor and his approval for the use of clomid, you can increase your chances of getting pregnant.

Clomid is a drug that is used in gynecological practice for the treatment of female infertility. It belongs to the group of antiestrogens. This means that it blocks receptors (nerve endings) in the ovaries and hypothalamus, which leads to a decrease in estrogen production. Also, this drug stimulates the maturation of follicles, ovulation itself and the level of estradiol in the blood.

Female infertility: what are estrogens?

Estrogens are a group of steroidal female sex hormones that are produced primarily in the ovaries. Men also have a small amount of estrogen in their blood, which is produced by the testicles and adrenal glands (in both sexes). Estrogens are divided into three types: estrone, estriol, and estradiol. Clomid has a particular effect on estradiol levels in the blood.

Functions of estrogens:

Feminization. This means that it is thanks to estrogens that a woman has a feminine appearance. During adolescence, these hormones are actively produced and form secondary sexual characteristics (Breasts, buttocks, abdomen, female hair, growth of internal and external genitalia).

Reproduction. A group of hormones called estrogens activates the production of mucus in the vagina, as well as its epithelization, which creates the necessary conditions for maintaining the viability of sperm. Estrogens stimulate the maturation of the egg (follicle) and the onset of ovulation, in which the Mature egg is released from the ovary and it can be fertilized by the sperm. Further, after ovulation, if fertilization has occurred, estrogens are responsible for the preservation of the fetal egg, blood supply to the placenta and preparation of the breast of the expectant mother for lactation. If the egg is not fertilized by the sperm, these hormones activate the detachment of the inner layer of the uterus (endometrium) and, as a result, menstruation begins.

Other effects of estrogens include regulation of calcium levels, blood cholesterol, blood pressure, liver function, and mental activity.

How Clomid works

Clomid contains the main active substance – clomiphene, which blocks the receptors that perceive estrogens in the hypothalamus (the part of the brain that controls the hormonal background of the body). As a result, the production of gonadotropic hormones (follicle-stimulating and luteinizing) increases, which activate maturation and intra-secretory (endocrine) function of the follicle in the ovaries. As a result of all the above processes, the use of the drug Clomid leads to the fact that the level of estradiol in the blood increases significantly.

Causes and symptoms of reduced estrogen

• The main reason that the level of estrogens in a woman’s blood decreases is the lack of activity of the ovaries that produce them. As the body ages, there is also a shortage of them. An important reason may be various pathological changes on the part of the pituitary gland.
• Sometimes there is a decrease in the level of estrogens in women who are engaged in professional sports, when the physical load on the body is excessive. This phenomenon occurs due to the fact that testosterone (male hormone) is intensively produced.
• Another important point is the presence or absence of adipose tissue. It is proved that estrogens are also produced by fat cells. This means that exhaustion or sudden weight loss is extremely dangerous for the female body, namely for its reproductive ability.

Symptoms that occur with estrogen deficiency

• In adolescence, a lack of estrogen leads to insufficient development of secondary sexual characteristics, a decrease in the size of the uterus, late onset and failures in the menstrual cycle.
• In reproductive age, a decrease in the level of estrogens provokes a decrease in sexual desire, sharp mood swings, various violations of the duration and other indicators of the menstrual cycle. In parallel, memory and performance are reduced, insomnia appears and the skin condition (its elasticity, color, turgor) worsens. Stretch marks, pigmentation, and inflammatory rashes appear on the skin. Female infertility and dysfunctional uterine bleeding may occur.

Special instructions for female infertility that apply to the drug Clomid

Taking this medication increases the likelihood of multiple pregnancies.

The development of effective action of the drug is possible only if the patient has a sufficient amount of her own estrogens. The lower their level, the less effective Clomid is.

Treatment with anti-estrogenic drugs, as well as any other, should take place under the careful supervision of a gynecologist. Periodically, the ovarian function is determined and other special examinations, including vaginal ones, are performed.

During the course of therapeutic treatment with Clomid, it is recommended to take special care when working with mechanisms that carry a potential danger, and when driving a car.

Today we will talk about ovarian stimulation, ovulation and IVF. One of the main causes of infertility is a woman’s lack of ovulation – anovulation or very irregular ovulatory cycles-oligoovulation. In the natural cycle, in the area of the follicle that has accumulated, a woman of reproductive age is determined by the yellow body, which prepares the endometrium for embryo implantation. Yellow body in IVF, how can you restore the normal ovulatory menstrual cycle?

The causes of ovulatory disorders can be different, they include various endocrine disorders, as well as problems with the Central nervous system. One of the most common causes of anovulation is polycystic ovary syndrome, overweight or underweight, and chronic stress in women.

There are several ways to determine that a woman does not ovulate. The most affordable method is to measure basal (rectal) temperature over several menstrual cycles. To diagnose anovulation, ultrasound is also used in the dynamics of the menstrual cycle, which tracks the absence of a maturing follicle or yellow body on normal days.

They also take a blood test for sex hormones in the dynamics of the menstrual cycle.

When establishing the fact of anovulation, you need to undergo a comprehensive examination to find out the reason for the absence or irregularity of ovulation, as well as to exclude other possible causes of infertility and identify concomitant diseases.

Preparing for ovarian stimulation in IVF

Normalization of weight

Polycystic ovary syndrome in women often leads to anovulation. These women are often overweight. Before starting drug or surgical ovulation stimulation, weight correction is mandatory. Weight loss of only 5-10% of the original in some cases leads to the appearance of independent ovulation, or improves the body’s response to the effects of medications. Weight deficit also needs to be corrected, since it is known that ovulation is possible in women who weigh at least 45 kg (with an average height of 160 – 170 cm).

Treatment of diseases that caused anovulation

It is necessary to treat all identified causes of anovulation – pelvic inflammatory diseases, hormonal disorders such as hyperandrogenism, hyperprolactinemia, etc. Often at this stage, women restore the ovulatory cycle and begin to grow follicles.

Preparation of the endometrium

Preparation of the uterine mucosa (endometrium) for possible implantation of the fetal egg is carried out. Drugs of female sex hormones – estrogens and gestagens-are prescribed in different combinations, under the control of ultrasound. Hormones promote the growth of the endometrium in the first phase of the menstrual cycle and its secretory transformation in the second phase of the cycle.

Ovarian stimulation. Stimulation of ovulation

Ovulation stimulation is an effective means of restoring fertility in many women with anovulation. In women with an absent or irregular ovulatory cycle, ovulation stimulation may be aimed at obtaining multiple eggs during treatment with assisted reproductive technologies. Careful selection of the treatment program for ovulation stimulation, as well as accompanying monitoring, lead to excellent results. It should be understood that not only natural conception, but also IVF in the absence of ovulation is not possible. Therefore, ovulation stimulation is mandatory for the IVF procedure. It is possible that the sensations during stimulation before IVF will not be pleasant, but the joy of motherhood brings more pleasant sensations. Side effects after IVF are minimal.

Medical stimulation of ovulation

Under the condition of normal spermogram parameters and with passable fallopian tubes, treatment usually begins with drug-induced ovulation stimulation. It can be carried out with the drug clomiphene citrate (klostilbegit). The patient takes medication for 5 days from day 3 to day 7 of the menstrual cycle. From day 8 of the cycle, ultrasound is performed to determine the ovarian response to stimulation and control the growth of the dominant follicle. Based on the results of ultrasound monitoring, the patient is assigned a time for injection of chorionic gonadotropin (pregnil), which stimulates the process of egg maturation and ovulation, and then sexual intercourse.

If the ovaries do not respond well to ovulation stimulation with clostylbegit or pregnancy has not occurred after 6 cycles of ovulation stimulation, then gonadotropin stimulation is recommended. These drugs are more effective than clomiphene citrate, but they require more careful monitoring, because the risk of multiple pregnancies increases.

Surgical stimulation of ovulation

In the absence of the effect of medical stimulation of ovulation, laparoscopy and wedge-shaped resection or drilling of the ovaries (piercing the ovary with an electrocoagulator or laser beam) are performed. These methods partially destroy the dense ovarian capsule, which contributes to ovulation. In the first cycle after the operation, ovulation is monitored. If ovulation does not occur, then in addition is appointed clostilbegyt in the usual way.

When ovulation is stimulated, the following complications are possible: ovarian hyperstimulation syndrome during IVF, multiple pregnancy, and drug-induced liver damage. Signs of hyperstimulation can be different: the state of health worsens when stimulated before IVF, neoplasms (cysts) appear in the ovaries.

All medications are prescribed by the attending physician strictly individually, ovulation stimulation is constantly monitored to avoid possible side effects.

Ovarian stimulation in IVF: discharge, sensations, well-being

Why is ovulation stimulation mandatory for IVF?

Pre-IVF stimulation is performed to simulate the normal cycle that results in the maturation of an egg. As a rule, ovarian stimulation for IVF is performed on the 3rd-5th day of the cycle for several days. Much depends on the type of procedure and treatment method. Gonadotropins are administered to the patient intramuscularly or subcutaneously. Menopur stimulation is often performed during IVF. In some cases, antiestrogens are used.

To increase the probability of fixing the zygote after settling, a progesterone drug is prescribed. It helps to preserve the viability of the egg. If IVF IS positive, progesterone should be taken before the 12th week of pregnancy.

With poor ovarian reviews, ovulation may not occur. In this case, repeated stimulation is required.

It should be taken into account that IVF ovulation stimulation has a certain number of acceptable options and after each procedure, the number of eggs in the body decreases. In addition, the stimulation procedure is quite painful. Patients often have abdominal pain when stimulated before IVF, and discharge during stimulation before IVF is also not uncommon.

When performing ovulation stimulation before IVF, it is necessary to exclude the use of other drugs, to warn against viral diseases, to reduce physical activity, and to avoid changes in body temperature. Doctors also advise you to lead a certain lifestyle when stimulated. IVF is possible if you refuse alcohol, caffeinated beverages and sexual contact.

Double stimulation in IVF

If repeated ovarian stimulation during IVF is performed within the same menstrual cycle, then such stimulation is called double. Double stimulation in IVF is directed at the antral follicles of the follicular and luteal phases. Double ovarian stimulation is performed for women with an insufficient number of eggs or women with a lack of time (for example, it is important to preserve fertility before treating cancer). Double stimulation for IVF allows you to get twice as many embryos as with the traditional approach.

IVF with minimal stimulation

In a standard IVF program, ovarian stimulation is performed very actively to get more cells. At the same time, the choice of embryos of the best quality and their development to the desired stage is more likely. However, there are a number of indications that ovarian stimulation before IVF is better to start with minimal stimulation. Minimal IVF stimulation involves going through the same stages of stimulation as the standard IVF Protocol, with the only difference that:

• lower doses of hormonal drugs are used,
• few follicles Mature during the cycle,
• and there is no risk of ovarian hyperstimulation.

Usually, a woman is prescribed a hCG test after IVF to confirm pregnancy. And if the analysis showed that conception did not occur, then the monthly period after IVF will come necessarily.Usually, monthly periods after a negative IVF result occur on the 3rd — 12th day.Monthly periods during IVF pregnancy (successful conception), it is possible to continue poor menstruation during the first 2-3 months. However, there should be no blood clots or lower abdominal pain.