down regulation cycle ivf

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Down Regulation Cycle IVF
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• he Effect It's actually quite simple if you
  remember that the downregulation does not act on
  your ovaries - it acts on your pituitary !. We
  switch your pituitary off, so that we can switch
  your ovaries on more efficiently. This allows us
  to ensure that you grow a synchronous cohort of
  follicles, so that we can retrieve a large number
  of good quality eggs at the right time - when
  they are mature, but before you ovulate
  spontaneously.The best analogy is that before
  writing on a blackboard, we need to clean it
  first. We need to stop your pituitary from
  producing its own hormones, so that we can make
  your ovaries grow lots of mature eggs which we
  can collect at the right time. Not only does this
  allow a better ovarian response, it also allows
  us to time egg collection at a convenient hour,
  so we don't have to do egg collections on Sundays
  !There was actually a Lancet article which
  described the effective use of this protocol
  published many years ago, titled - Never on a
  Sunday. Doctors do have a sense of humour ! )

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Why the problem occurs Part of the problem is
that doctors very rarely bother to explain the
biological basis behind their treatment
protocols. Even worse, most patients do not take
the time to understand the rationale behind these
meds. They assume that their doctor knows what he
is doing, so why should they meddle in this
medical nitty-gritty? They also doubt their
ability to be able to understand most of the
science behind it, because they feel it's too
complex and will go over their heads!Please do
not make this error - please don't underestimate
your intelligence. It's not very hard to figure
out what's happening if you just understand these
2 basic principles . IVF meds are used to
superovulate you - to help you grow more eggs.
This is called superovulation. We need to control
this superovulation, so that your eggs do not
burst (ovulate) before we are ready to retrieve
them. This step is called downregulation. That's
all the various cocktail of IVF meds do-simple,
isn't it? So why does it all seem so complex? For
one thing, there are many different brands of
meds available, so this complicates things.
Secondly, there are many ways of skinning a cat,
and many doctors will stick to a protocol which
works for them.
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• Precise timingIf you did ovulate spontaneously
  ( before we are ready to do the egg collection),
  we would not be able to collect your eggs, as
  they would be lost in the abdominal cavity , if
  your follicles ruptured prior to egg retrieval.
  This would be a nightmare, which thankfully never
  happens today in a good IVF clinic, because the
  downregulation is so effective.This means that
  we can precisely time egg collection to occur
  34-36 hours after the HCG trigger, and you can
  sleep peacefully , knowing that your follicles
  would never rupture prior to this time, because
  you have been downregulated.In the past, when
  downregulation was not available, doctors would
  have to do egg collections even at 2 am - 36
  hours after the spontaneous natural LH surge (
  which could occur at any time, and was not in the
  doctor's control).

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Thank You

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