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It is believed that after stimulation and obtaining oocytes, woman’s supply of follicles decreases, they will not remain in the ovaries and menopause may soon begin.
These are vain experiences. To dispel them, let’s talk about how the ovaries work.
If we consider the normal menstrual cycle, without a stimulation cycle, only one follicle ovulates in it (less often two). There is such a misconception that it is the only one that is consumed during this cycle.
In fact, this is not the case. Every woman with the beginning of the menstrual cycle in growth (recruiting) starts a certain number of follicles – this is called a pool. This pool may vary depending on the woman’s age. At the age of 25, the leading follicle can ovulate, escaping the growth of the remaining 25–30 follicles, which subsequently go into atresia (reverse development), after 40 years, from only 2-3 follicles, the choice of the leading one and ovulation occurs. Under the influence of follicle-stimulating hormone (FSH), one follicle is selected from this pool, which begins to grow faster than all the others and to produce estradiol. This leads to a decrease in the production of FSH and inhibition of the growth of the remaining follicles. This one follicle grows and ovulates, and all the rest, included with it in the same pool, go into reverse development and die. Therefore, in each menstrual cycle, each woman consumes a certain number of follicles – the same pool.
What happens in the IVF program, what is the essence of stimulation?
We use a follicle-stimulating hormone preparation and support the growth of all follicles (usually 11-12 days), which is a normal cycle that would go backward. So in the IVF program, we can use those follicles that in any case would have been consumed in this cycle. Therefore, neither stimulation nor obtaining oocytes can affect the depletion of the ovarian reserve.