In normal reproduction, a woman’s ovary usually releases one egg each cycle. Eggs develop in small fluid spaces (follicles) in the ovary. As follicles grow, the hormone estradiol is produced. When estradiol reaches a certain level, another hormone, LH (luteinizing hormone) is released. The LH release is the driving force necessary for final maturation and release of the egg, or ovulation.
When a patient chooses COH, the medical team helps them proceed through this sequence of biological events. Various hormone medications are administered during a COH treatment cycle. These hormones are to enhance the growth and maturation of several follicles so as to improve the chances of fertilization. Further medications are sometimes required to trigger ovulation.
There are two ways in which ovarian stimulation is monitored, blood tests and ultrasounds.
Blood tests – Blood tests allow team members to follow the growth and development of follicles. Blood is tested for estradiol and LH which will help to indicate when follicles are mature.
Ultrasound Examination – Through vaginal ultrasounds, the physician/nurse can count and measure the largest follicles as they develop. As follicles grow, the ultrasound will help to show when patients are approaching ovulation.
Insemination – AART recommends IUI in conjunction with a COH cycle as a means of further enhancing the probability of conception.