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In this episode, a quick visual helps explain how egg retrievals really work, how these procedures affect your fertility and egg supply, and other common concerns.
Today, we're going to be exploring the question that I get asked all the time: "Do fertility treatments deplete my egg supply sooner?"
Take a look at this drawing. Each month, a certain number of follicles are removed from the ovary and started in the menstrual cycle. Here's day one of the menstrual cycle. How many follicles removed from that ovary each month depends on your body and that particular cycle.
As women, we are born with all of the eggs that we're ever going to have. They're sitting in the ovaries, and then they come up and are removed each month (or withdrawn) from our finite egg supply to get started in the cycle.
Somewhere around Day 5-7 of the menstrual cycle, one of these follicles (eggs) becomes dominant. It acquires the most follicle stimulating hormone (FSH) receptors, and will continue to grow, but these other little follicles then just get reabsorbed.
So let's say this is the one that becomes dominant. They are still removed from your egg supply that month, and nine extra are removed from your egg supply, just to use one.
This one will go on to ovulate and hopefully be fertilized, but these are still removed from your egg supply that month. It's just that they're not "used."
When we give you medications for ovarian stimulation, we're not removing more from the ovary. All we're doing is keeping these follicles. They still start that cycle like always.
In this particular instance, we removed 10 eggs from your egg supply. When we give you medication, it has to be before dominant follicle formation and that's why we're so particular about you coming in at a certain point in your cycle.
Perhaps we can salvage maybe three to five of these eggs. So instead of nine extra eggs not being used, maybe only three or four extra eggs aren't used, and the other three or four go on to still be players in this cycle.
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The short answer is no, we're not using more of your egg supply.
Whatever your body takes that month from your ovary is what it would normally take (with or without fertility treatment intervention). What we're trying to do is to take more of that particular "cohort" of eggs from the ovary and keep them from being reabsorbed by the body.
This allows more of them to develop dominant follicles.
In an intrauterine insemination (IUI) cycle or a timed intercourse cycle, we maybe want three to five of those follicles to become dominant.
In an IVF cycle, where we have more control over how many eggs fertilize and implant, and you're not at such great risk for hyper-stimulation and high order multiples, we will take many of those follicles (over 20 of those follicles) to then be used as dominant follicles in that cycle.
Hope that helps! If you're still unsure about how the process works or want more clarification, don't hesitate to reach out to your nurse or doctor.
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