Considering IVF: How it Reworks Female Hormones
Our bodies have natural, built-in systems to protect us from having too many babies. IVF can override some of these mechanisms to help those with infertility conceive.
To lower your chances of having too many babies at a time, your natural cycle will grow many ovarian follicles just to ovulate a single egg. This is orchestrated by a tight system of hormonal control by a trio of conductors: The hypothalamus (a higher center in your brain), the pituitary gland in your brain and your ovaries.
Normally, your menstrual cycle is controlled by the hormones FSH and LH, which are released by the pituitary gland, and estrogen and progesterone, made and released by your ovaries. The small gland called the hypothalamus makes a hormone called GnRH (gonadotropin releasing hormone), which controls the amount and timing of FSH and LH release. Your hormones work together to direct your ovaries to grow follicles, ovulate and prepare the uterine lining for embryo implantation and early pregnancy.
In an IVF cycle, where your eggs are harvested from the ovaries and fertilized outside the body (or in vitro), your doctor will rewire this system in the following ways:
► Suppress your natural system. First, your doctor will suppress your GnRH hormone by giving you GnRH agonists (GnRHa), such as Lupron or Triptorelin, or antagonists, such as Antagon and Cetrotide, to override the entire brain-ovary control.
► Stimulate your ovaries. Then, you’ll take medications to stimulate your ovaries to develop multiple eggs in a process called controlled ovarian stimulation. Some common medications used are injectable FSH, such as Follistim or Gonal F. Some may include a mixture of FSH and LH, such as Menopur or Repronex.
► Hold off spontaneous ovulation. Normal cycles experience a quick surge of LH before ovulation. Based on your clinical profile, your doctor might also ask you to take an LH-antagonist to hold off spontaneous ovulation, so that your eggs can remain in your ovaries to be harvested by your doctor. (If ovulation occurs, the eggs will be “lost” and the IVF cycle will need to be cancelled.)
► Prepare the uterus to receive the embryo. Last, the main hormone that maintains the uterine lining is progesterone. After embryo transfer, when your doctor places the fertilized eggs into your uterus for implantation, you may be given progesterone supplements, such as Endometrin, Crinone or Prometrium. This is to help prepare your uterus to receive the embryo.
When you're making the decision about whether or not to try IVF, there's a lot to consider. Check out our map to get connected with IVF providers who are working with us to make IVF more affordable and accessible for more patients.
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