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Stimulation of Follicle Production

IVF Step 2: Stimulation of Follicle Production

You will be given drugs to encourage the formation of follicles in the ovaries.  These are given by injection and the nurses will discuss how these drugs are given.   If you are taking down regulated drugs, you will need to carry on taking these throughout the stimulation process.

A follicle is simply an immature egg, surrounded by a sac of fluid, which develops within the ovary.  As the follicle develops it grows until it is 18 to 20 mm when the egg is mature.  It is at this size that the follicle will be triggered by hormones from the pituitary gland to rupture and release the egg (ovulate).

During the IVF cycle, drugs are given to encourage the development of follicles in the ovary.   The drugs do however stimulate the ovaries to produce more follicles than would normally grow in a menstrual cycle.  The number of follicles that develop depends on many factors, including your age and the hormone test results.   An average patient will hopefully get 8 to 10 follicles.   The drugs that stimulate follicle production are called Merional, Menopur, Gonal F and Fostimon.  They are administered by daily subcutaneous injections.  The nurses will give you all the information that you need to perform the injections and a DVD to watch to help you.

Your drug regime will be personal to you, taking into account the results of your blood tests. It is vital that you ask the nurses if you are not sure about the dose or the injections, as if you make a mistake it can be difficult to rectify.

How will I be monitored to ensure I am responding to the drugs appropriately ?

All parts of your cycle will be closely monitored using vaginal ultrasound scanning techniques.  A probe, called a transducer is placed into the vagina.   The probe is covered with a condom to reduce infection and a gel for lubrication.   The probe sends out sound-waves which reflect off the body structures.  A computer receives these waves and uses them to create a picture of the uterus and ovaries.   The scan is painless and safe.

If you have a down regulated cycle, a scan will be arranged approximately two weeks after the down regulation appointment to determine if the down regulation drugs are effective.  If the ultrasound scan shows that there are no developing follicles in your ovary, and the lining of your womb (endometrium) is thin, then you will be given a date to commence the injections to stimulate growth of the follicles.

Approximately, five to seven days after commencing the stimulation injections we will perform another ultrasound scan.    We will count and measure all the follicles seen and measure the endometrium, the lining of the womb.   The dose of stimulation drug may be changed depending upon the response by the ovaries.   A nurse will discuss your progress with you after the scan and answer any queries you may have.

Page Last Modified: 1st February 2017


The Hull Andrology Unit has relocated its services from Hull Royal Infirmary to a new purpose built facility on the Hesslewood Office Park from Friday 1st October 2021.

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