Patient's question:
I did an ovary monitoring test, and the results showed that the eggs did not grow at all and disappeared. There is a problem with ovulation. Then the doctor gave me four injections of Urofollitropin, but the follicles did not grow at all. I want to know if this can still be treated? If not, can I do a donor egg IVF? How much does this cost? Where can it be done? What conditions are required to do this?Doctor's answer:
The causes of anovulation are diverse, but the symptoms are the same. Whether in a natural cycle or with medication-induced ovulation, some individuals have follicles that grow beyond 2 cm but still do not ovulate, continuing to grow and even exceeding 4-6 cm. In some cases, ovulation does not occur even in the following menstrual cycle, a condition known as luteinized unruptured follicle syndrome (LUFs). Why does this phenomenon occur? Some people experience this for several months in a row, becoming a mystery that baffles many patients and doctors. Clinically, it has been observed that some individuals have obvious underlying conditions, such as endometriosis, polycystic ovary syndrome, or pituitary or hypothalamic diseases. For these individuals, treating the primary condition can resolve the issue. However, for others, it is not easy to quickly identify the cause or etiology, which makes treatment challenging.Regarding anovulation with an unknown cause, Antai Hospital has developed an interventional therapy: tracking and monitoring the follicles, puncturing them with ultrasound guidance once they mature, and then proceeding with artificial insemination. This method often achieves pregnancy within the same month, allowing the underlying condition to be identified and treated after giving birth.
In reality, the ovulation mechanism is very complex, especially at the moment of ovulation, where hormonal and local ovarian changes are subtle. First, LH must reach a peak level, and second, the follicle must be sufficiently tense. In a natural cycle, usually only one follicle develops, and ovulation occurs when LH levels reach around 90. If this threshold is not met, LUFs may occur. In contrast, during ovulation induction, multiple follicles develop, and the body's own LH production is insufficient to trigger ovulation. Exogenous HCG (which contains 50% LH) must be administered to achieve ovulation. Generally, 1000 units per follicle is ideal, with a maximum of no more than 15000 units. If exogenous HCG is insufficient, it can also lead to LUFs.
Another contributing factor is sexual intercourse. During a female's orgasm, a significant release of LH occurs, and strong uterine contractions help mature follicles to rupture. Clinically, anovulation falls into two main categories: luteinized unruptured follicle syndrome (LUFs) and delayed ovulation, where the time of follicle rupture is postponed, leading to overripe eggs. Both conditions prevent pregnancy, but both can be addressed with interventional puncture to aid conception.
This is precisely the principle: "The causes of anovulation are numerous; if (eager to conceive), do not seek the cause; interventional puncture for fertilization; treat the immediate issue first, then address the root cause." If you still have questions, feel free to ask again or contact us.