The number of mature oocytes gathered determines the success of intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF) cycles. A sufficiently developed egg opens the door to the potential of having enough transferable embryos. One of the variables limiting the success of IVF/ICSI cycle outcomes is low mature oocyte count as a result of diminished ovarian reserve (DOR). One of the challenges faced by infertility doctors is enhancing cycle outcomes. As a solution to this, patients’ infertility doctors recommend the use of Estrace in some cases. (1)
Why do IVF patients need Estrace?
The preparation of Estrace is justified by sound physiology and is effective in some IVF patients. As a result, estrogen keeps your body from prematurely accumulating follicles. This is a typical issue, particularly in cases of inadequate ovarian reserve. More follicles are available at the beginning of your cycle when early intake is restricted.
Additionally, the follicles have the propensity to develop more synchronously as a group. The ultimate goal is to have all of the eggs mature simultaneously, which should produce embryos of hopefully higher quality. (2)
What are the reasons for lower egg yield in low responders?
You must be aware that a number of hormones play a role in how your brain and ovaries communicate with one another. These include, among others, estrogen, FSH, LH, and inhibin. The hormone inhibin, which is frequently disregarded, inhibits the production of FSH from your brain during the final week of the cycle. The primary hormone that causes your eggs to “grow” is FSH.
In the final week of the cycle, inhibin production falls along with the ovarian reserve. Your brain can start releasing FSH earlier than usual thanks to this reduction. In the final week of the previous cycle, FSH then stimulates the ovary, and by the third day of the following cycle, there are already one or two follicles that are larger than the others. (3)
How does Estrace help with egg yielding?
Inhibin is mostly replaced with estrogen supplements that block the release of FSH when Estrace priming is used. Theoretically, when your period begins, all of the follicles should be the same size if estrogen suppresses FSH. It is more likely that the follicles will grow at the same rate and be prepared for egg extraction at the same time if they are all the same size when stimulation first starts. Without a doubt, Estrace is a technique that may aid in egg laying that is secure and generally effective. (4)
Does Estrace have any side effects?
Estrace is a strong version of the hormone estrogen, and it has a lot of negative effects during in vitro fertilization. The endometrial lining of the uterus must be maintained throughout IVF in order to strengthen egg implantation during fertilization. Vomiting, bloating, stomach cramps, weight gain, chest pain, and vaginal itching or discharge are a few of the Estrace adverse effects.
The sort of artificial insemination that is carried out during IVF might vary, and this usually dictates the type of fertility medication that will be required. IVF side effects are numerous and diverse from person to person.
None of the medications used in IVF in Turkey is known to result in any fetal abnormalities, but it’s important to keep in mind that, even when no other drugs or technologies are needed for conception, about 3% to 4% of pregnancies may be complicated by an abnormality that is identified at birth. (5)
1,5- Özkan, Z. S. (2019). Ovarian stimulation modalities in poor responders. Turkish Journal of Medical Sciences, 49(4), 959-962.