Diagnosis & Ways of Treatment

You can be sure that you have EFS only if they are seen through the microscope during the IVF. The sideway methods of defining ovulation (basal body temperature measuring, endometrial biopsy and analyzing of the fluid after the ovary puncture) do not identify whether there is an oocyte in your follicle or not.
The treatment of EFS is a very difficult deal, because there is no universal therapeutic way. Some specialists recommend repeating standard cycles of assisted reproductive technologies despite the treatment protocol.
If in first cycle GnRH agonists were used for the desensitization, then in the second cycle antagonists should be used.
A gonadotropin-releasing hormone agonist (GnRH agonist, GnRH–A) is a synthetic peptide modeled after the hypothalamic neurohormone GnRH that interacts with the gonadotropin-releasing hormone receptor to elicit its biologic response, the release of the pituitary hormones FSH and LH.
Gonadotrophin-releasing hormone (GnRH) antagonists are similar in structure to natural GnRH , but have an antagonistic effect (reduce the effect of GnRG in combination with it).
The treatment by means of agonists and antagonists of GnRH is more likely to be successful if it is combined with a prolongation of intervals between the procedures of ovulation induction
In cases when oocytes are impossible to aspirate from one ovary and the hCG level is too low, some doctors recommend to effect the other ovary by means of puncture and repeating of hCG injections. Some even advice to aspirate the same follicles once again.
There is an hCG trigger shot that has a synthetic version of the hormone hCG and this is sometimes used as part of a fertility treatment for women trying to conceive. It is used to help complete the eggs’ maturation process and make sure they are released. Taking hCG trigger shot you should be monitored closely. Regular ultrasounds are done to see the developing of follicles and to define the level of “readiness” of eggs.
The trigger shot can be done by a professional at the doctor’s office (this is the most preferable variant) or you can do it by yourself at home. It can be injected subcutaneously in the thigh or belly or intramuscularly. The process is not painful at all. The most important part of the shot is the timing as ovulation will happen between 12 and 48 hours after the injection. This time frame represents your peak fertile time so it is when insemination, egg harvesting, or timed intercourse needs to take place.
Your doctor can give you specific instructions on when you should take the trigger shot so that any fertility procedures can be scheduled for the most precise time. You may have slight bleeding or cramping during ovulation and you shouldn’t worry. Insemination or timed intercourse should ideally take place between 12 and 36 hours after taking the shot. It is better to have multiple rounds of intercourse or insemination as this will increase the chances of conception. In cases when the hCG trigger shot is successful, it will induce the final maturation and then ovulation of the eggs.
If this occurs with insemination or intercourse that is timed correctly, the egg may become fertilized. The hCG trigger shot will definitely affect the results of your home pregnancy tests, because all the pregnancy tests are made to define the hCG level, and if it becomes higher (naturally, of course) it is a sign of pregnancy.
So, if you take a home pregnancy test right after the trigger shot, it can probably give you the false positive result. Experts estimate that the hCG from the trigger shot may stay in your body to some extent for up to two weeks.
Because of this, most doctors recommend that you wait two weeks before taking a pregnancy test at home. In two weeks your doctor may recommend you taking a blood test. In the blood test, your doctor can also use a quantitative beta hCG test which will determine whether your levels of hCG are increasing. If they are indeed increasing, this will indicate pregnancy.
If, on the other hand, they are decreasing, this will indicate that the heightened levels are simply due to the trigger shot. Some women prefer to take a pregnancy test every day after receiving the hCG trigger shot until they no longer get a positive result. This allows them to know when the drug is sufficiently out of their system, but it still will not guarantee that you get accurate test results when checking for pregnancy.
HCG is a natural hormone that the body produces during pregnancy and because of this, most of the potential side effects of the trigger shot are very similar to those related to early pregnancy. Common side effects include mild abdominal cramps, swelling, breast tenderness and nausea.
In some cases, the hCG trigger shot will also result in more than one egg maturing and being released and this can lead to an increased chance of multiple births. You should always talk with your doctor about these risks before you take the trigger shot and keep in mind that in some cases selective reduction might be necessary so you can have a live birth with a healthy child.
You should be very attentive during the EFS treatment, because it is usually hormonal treatment (we do not mention the alternative medicine methods because the positive result after using them was not affirmed) and hormones rule all the organs and systems in our organism.
That’s why you should be very careful, choose your clinic attentively, be sure that you trust your doctor, all the details of your treatment process should be mentioned in your treatment protocol, even if they seem unimportant. An optimal, individualized and strategic protocol for controlled ovarian stimulation (COS) should be employed and the correct timing and dosage should be applied to the hCG trigger shot. The importance of individualizing COS protocol selection, precision with regard to the dosage and type of hCG trigger used, and the timing of its administration in such cases cannot be overstated.