Medical overview of superovulation

Perhaps a preface to this guide should be a reminder that fertility and achieving a pregnancy is not an exact science. There are so many unknown factors influencing fertility, that even with all the advances in reproductive technology, conception remains as much an art as a science.
Each doctor has his own protocol, and the couple or donor’s reaction to the drugs may result in a change in protocol. Following, is a sample schedule for an egg donor and an egg recipient couple.

The start of a menstrual cycle is referred to as DAY ONE (1) of the cycle.
In an average 28 day cycle, a woman will most likely ovulate around day 14.
According to the treating physician’s instruction, the patient will undergo ovulation induction. It is a procedure that involves the administration of fertility drugs to produce multiple egg (follicle) development. Fertility drugs are administered by injection or sometimes taken orally.

There are two drug protocols that physicians use:

[FLARE UP] This protocol begins on the third day of the donor’s menstrual cycle, and continues for seven to ten days. During this time hormone levels will be monitored by means of blood tests and follicle development will be followed by means of transvaginal ultrasounds.

[DOWN REGULATION] This protocol begins on the twenty-third day of the previous cycle. The physician will temporarily “turn off” the ovaries using GnRh-agonist to promote better egg development.
When the follicles containing the eggs reach the requisite size, an injection of HCG is administered to prepare them for aspiration. The egg retrieval/aspiration is performed in a hospital like facility under sedation. A vaginal ultrasound probe is utilized for aspiration of all ovarian follicles. This is a non-surgical procedure that takes about twenty to thirty minutes, depending on how many eggs are retrieved. However, the patient should plan to spend at least three hours at the clinic. After a brief period in the recovery room, the patient will go home that same day.
The eggs are used by embryologist in IVF or ICSI program to fertilize with the husband’s (or donor’s) sperm.
It is important that you do not blame yourselves or each other, if a pregnancy is not achieved in any given cycle. Fertility is not an “all or nothing” proposition – it’s a matter of degree. Unfortunately, there are factors that are unknown and therefore, no one has any control over that which can affect conception.