Getting treated for infertility is really exhausting both mentally and physically. Before undergoing this treatment, we must be fully aware of the procedure, all the risks associated with it and of course the success rate. This post takes you in detail about super ovulation therapy as a part of infertility treatment.
What is super ovulation?
We all have heard about IVF (in-vitro-fertilization) treatment; Super ovulation is also a part of it. Superovulation is the artificial drug-induced production of multiple eggs that is used in IVF reproductive technology. Normally, a woman ovulates one egg in each month of her period cycle. In the super ovulation process, with the help of fertility drugs , the woman will be able to produce more than one egg, which the doctor will remove from the ovary just before ovulation . More eggs will produce more embryos. This process increases the chances of success rate in IVF.
Which women can opt for super ovulation
Women who are already ovulating but having trouble conceiving may opt for superovulation to improve their chances of getting pregnant by releasing more eggs. Women who have open fallopian tubes and whose partners are unable to produce enough sperm can also opt for superovulation. Another case is that when women are ovulating with the help of oral medication but are unable to conceive, they may choose to superovulate.
process of super ovulation
The process of superovulation is triggered by the release of extra eggs by women with the help of the drug clomiphene . This procedure involves less money, fewer risks and can be considered a milder form of superovulation.
An ultrasound around the time of ovulation will show how many follicles are being released. If only one follicle is released, the dosage of the drugs will be changed accordingly in the next cycle.
Many doctors recommend taking gonadotropins during superovulation. Gonadotropin is a hormonal drug that is injected into the body to initiate ovulation. Women who are taking gonadotropin medications should be carefully monitored to make sure they don’t produce too many eggs.
Women undergoing the superovulation protocol are asked to take three days of medication and then come to the clinic for ultrasound and blood tests. Depending on the response of the ovaries, the doctor will ask you to come back to the clinic during the next one to three days for additional monitoring.
Once the desired number of eggs have matured, the doctor injects human chorionic gonadotropin (hCG) to initiate ovulation. In case of intrauterine insemination (IUI) , you will have to return to the clinic 36 hours after the hCG injection for the insemination procedure.
Fertility Drugs Used in Super ovulation
Superovulation focuses mostly on two processes, stimulating the ovaries to mature more eggs and preventing those eggs from being released prematurely. The doctor needs to be able to save eggs from the ovaries before ovulation. If ovulation occurs before the eggs are retrieved, the IVF cycle will have to be cancelled. The first two drugs described below are used to induce superovulation, and the last two are injected to prevent premature ovulation.
- GnRH agonist
- GnRH antagonist
How many eggs do you ideally need?
The number of eggs you need to mature completely depends on your diagnosis report and treatment. It also depends on the professional experience and opinion of the doctor. Your ultrasound report will show how many follicles are formed in your ovaries. The problem is that not every follicle will give you a good quality egg that can mature into an embryo. Therefore, multiple eggs are produced to improve your pregnancy success rate. Considering the above factors, the number of eggs can range from 8 to 15. In the case of micro-IVF, you only need four or five follicles.
Risks Associated with Superovulation
The following risks are associated with superovulation:
1. More than one child
Superovulation increases the risk of multiple pregnancy ie having twins or more babies. About 20-30% of successful IVF pregnancies result in twins or triplets. Superovulation carries the highest risk of triplets compared to other treatment options.
2. Ovarian Hyperstimulation Syndrome
OHSS is a condition in which gonadotropin drugs cause the ovaries to become enlarged and filled with fluid. The mild form of OHSS is more common and is characterized by bloating and pelvic discomfort; These symptoms also go away soon after the treatment is over. But in some rare cases, OHSS is more severe and women have difficulty urinating, rapid weight gain, dehydration, complications in other organs such as the kidneys and liver, and an increased risk of developing blood clots. To greatly reduce the chance of OHSS, a woman taking gonadotropin medication is closely monitored and treatment is stopped immediately if she appears to be at high risk of developing OHSS.
3. Ovarian Torsion
Ovarian torsion, also known as ovarian twisting, is one of the very rare cases. As the size of the ovary increases, it starts twisting on itself, due to which the blood flowing in it stops. This causes severe abdominal pain, nausea, vomiting and sometimes fever. Surgery is needed to correct this curvature.
4. Ectopic pregnancy
When a fertilized egg implants outside the uterus, such as in the fallopian tubes, ovaries, or cervix, it is called an ectopic pregnancy. Ectopic pregnancy is very rare and occurs because many women who are unable to conceive have tubal dysfunction and fertility drugs cause more eggs to be released. This increases the chance that not all fertilized eggs make it through the tubes to the uterus to implant.
Side effects of superovulation
There is definitely some risk associated with any treatment. These side effects depend on the dosage of the medicine and how your body reacts to it. Women may experience the following side effects due to superovulation:
- bleeding without periods
- mood swing
- breathing problems
- gaining weight
- upset stomach
- vaginal dryness
- hot flashes
- joint pain
- redness or swelling at the injection site
- low sex drive
These side effects can be minimized by taking the medicine at night or with food. In addition, if the treatment is done with the lowest effective dose, the side effects may also be less.
What is the success rate of superovulation?
The success rate of this treatment depends on the given factors like – treatment done in IVF, IUI , Mini IVF, diagnosis and age of the woman.
In general, the success rate of IVF is higher than the success rate of superovulation IUI. Superovulation will not be successful in women above 40 years of age and women with early ovarian failure. In such cases, doctors recommend egg donor, as the success rate of IVF with egg donor is very good. Ovarian reserve test is done to predict whether superovulation will work or not.
Superovulation definitely increases your chances of getting pregnant through IVF or IUI. Be sure to discuss this with your doctor to better understand your situation and whether superovulation is the right treatment for you.