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Following ovulation, LH stimulates the formation of the corpus luteum. Estrogen has since dropped to negative stimulatory levels after ovulation and therefore serves to maintain the concentration of FSH and LH. Inhibin, which is also secreted by the corpus luteum, contributes to FSH inhibition.
The risk is further increased by multiple doses of hCG after ovulation and if the procedure results in pregnancy. [ 2 ] Using a GnRH agonist instead of hCG for inducing final oocyte maturation and/or release results in an elimination of the risk of ovarian hyperstimulation syndrome, but a slight decrease of the delivery rate of approximately 6%.
Administering recombinant hCG in addition to an FSH-preparation has no significant beneficial effect. [18] The hCG is the FSH extracted from the urine in menopausical women. Clomifene, in addition to gonadotropins, may make little or no difference to the live birth rate but may lower the probability of ovarian hyperstimulation syndrome. [19]
FSH levels in this time is often called basal FSH levels, to distinguish from the increased levels when approaching ovulation. [17] FSH is measured in international units (IU). For Human Urinary FSH, one IU is defined as the amount of FSH that has an activity corresponding to 0.11388 mg of pure Human Urinary FSH. [18]
FSH secretion begins to rise in the last few days of the previous menstrual cycle, [3] and is the highest and most important during the first week of the follicular phase [4] (Figure 1). The rise in FSH levels recruits five to seven tertiary-stage ovarian follicles (this stage follicle is also known as a Graafian follicle or antral follicle ...
Ovarian follicle activation can be defined as primordial follicles in the ovary moving from a quiescent (inactive) to a growing phase. The primordial follicle in the ovary is what makes up the “pool” of follicles that will be induced to enter growth and developmental changes that change them into pre-ovulatory follicles, ready to be released during ovulation.
Femara is an alternative medicine that raises FSH levels and promote the development of the follicle. [38] For those women that, after weight loss, are still anovulatory, or for anovulatory lean women, ovulation induction using the medications letrozole or clomiphene citrate are the principal treatments used to promote ovulation.
High FSH strongly predicts poor IVF response in older women, less so in younger women. One study showed an elevated basal day-three FSH is correlated with diminished ovarian reserve in women aged over 35 years and is associated with poor pregnancy rates after treatment of ovulation induction (6% versus 42%). [16]