IVF Guide – Follicle Number ≠ Egg Number
I believe that many IVF sisters have the same question, why is the number of follicles in the ultrasound examination different from the number of eggs obtained after the egg retrieval surgery? Are follicles equal to eggs? In fact, in the known part of the reason to see, IVF just in the egg retrieval link, may be damaged about 10%, can be very sure to tell you that the number of follicles does not represent the number of eggs retrieved.
So what is the reason for the high number of empty follicles found at egg retrieval? Today we will take you to find out.
Follicle count ≠ actual number of eggs retrieved
First of all, the number of follicles can be said to be the most concerned part of IVF sisters, because we often say that the number of basic follicles is directly related to the success rate of IVF. So how much difference will there be between the number of follicles monitored by ultrasound and the number of eggs retrieved in the end? Let’s take a look at the real feedback from three clients:
Client A
When I underwent follicle monitoring during ovulation, my doctor told me that the number of eggs I was eligible for retrieval through ultrasound was predicted to be only six. However, after going through the night shot and egg retrieval procedure, my egg retrieval result was 10, and the final result of the sac raising had 2 blastocysts of 4aa, and 1 successful implantation, which was a pleasant surprise for me.
Client B
When I did IVF for the first time, I went to a very famous public hospital. During the pre-checkup, the ultrasound examination showed that there were about 12 follicles on both sides of my body, but I didn’t realise that there were only 6 usable eggs retrieved at the end. Moreover, it was easy for other people to get too many eggs retrieved before they get ovarian stimulation or ascites, while I had ascites even though I had retrieved only 6 eggs. Later, I went to the doctor for another consultation and was told that the number of follicles in the ultrasound does not mean the number of eggs that can be used in the end, or the actual number of eggs retrieved should be used as the basis.
Then I tried again, and after 2 cycles of ovulation, I finally got a blastocyst that could be transferred, and now I am still adjusting my body, waiting for my body to reach the best condition before transferring.
Client C
My follicle count was around 10, and the result of egg retrieval was 11, which is not a big difference. The happiest thing is that 6 of them were screened and 2 of them were 5aa, I was successfully transplanted in March this year.
In fact, from the feedback of the above 3 clients, it is not difficult to see that the number of follicles in IVF during the preliminary follicle monitoring can seldom be linked to the final number of eggs retrieved, the number of follicles may be more or less, which is a very common phenomenon in the IVF process, how to improve the follicles far less than the number of eggs retrieved this phenomenon? Let’s read on.
Reasons affecting the number of eggs retrieved
It is actually normal that the number of follicles should be approximately equal to the number of eggs retrieved at the end of the day, but there are a number of reasons that can affect the outcome of the egg retrieval, resulting in a loss of at least 10 per cent of the number of eggs retrieved. Here is a breakdown of the 3 known reasons.
Timing of Night Shot (Egg Breaking Shot)
Night injections are designed to promote the maturation and shedding of eggs, which is why they are also known as ‘egg-breaking injections’. The medication is either chorionic gonadotropin (HCG) or a short-acting gonadotropin-releasing hormone agonist (GnRH-a), and the injections are usually given at night, which is why they are known as ‘night injections’. ‘.
Because night injections affect the outcome of egg retrieval, and it is no exaggeration to say that sometimes they can even directly affect the success rate of IVF, fertility doctors will require IVF mothers-to-be to have the injections administered at the exact time, dosage, and site.
[If the nocturnal injection is given too early
At this time, the follicle’s morphology and function are not fully mature, there are not enough LH receptors on the follicular granulosa cells to respond appropriately to HCG, the oocyte mound complex is not loose enough and tightly wrapped around the oocyte, the egg cannot be dislodged by negative pressure suction during the egg retrieval, which results in a low rate of egg retrieval, and ultimately, it may also affect the maturation rate of the oocyte, which can adversely affect the rate of fertilisation and the rate of oocyte cleavage.
[If the nocturnal injection is given too late
It is very likely that the oocytes have already overdeveloped and matured, and if the drug is given at this time, the quality of the eggs is likely to be reduced. Or the eggs may even have been discharged early, and even if the eggs are obtained, the most appropriate time for fertilisation will have passed.
High number of empty follicles
Empty follicles in IVF mainly refer to the situation where the follicles can be observed on ultrasound and appear to be developing normally, but when the eggs are retrieved, it is found that there are no eggs in the follicles and the follicles are empty. If an empty follicle is encountered during IVF, it will lead to a reduction in the number of eggs retrieved, and thus a reduction in the number of embryos formed, which will ultimately affect the success rate of IVF.
Empty follicles include pseudo-empty follicles and true empty follicles. Pseudo-empty follicles are mostly caused by insufficient duration of action or uncomfortable dosage of ovulation stimulating medication, resulting in the inability of normal ovulation, which may normally result in the discharge of eggs after a cycle of medication adjustment; while true empty follicles are mostly caused by genetic mutations, which result in the inability of normal ovulation even after the use of ovulation stimulating medication.
The reasons for a higher number of empty follicles are about the following:
1、Abnormal ovarian function, resulting in impaired egg fertilisation or the formation of empty follicles;
2、Empty follicles can occur when the eggs are atretic, but the follicles are still stimulated by hormones to continue to grow and mutate;
3、Improper or excessive use of ovulation stimulating drugs can also lead to the situation of empty eggs;
4、Abnormalities in the endocrine system, making the follicles lack of biologically active HCG, and finally causing empty follicles.
Egg removal surgery
From the body to remove the eggs, the doctor uses the egg extraction surgery is usually two kinds: one is abdominal egg extraction, one is vaginal egg extraction, but no matter which kind of egg extraction surgery will cause some damage to the number of eggs, just the difference between more and less, so the procedure for the doctor’s requirements are very strict.
The number of eggs retrieved in IVF is directly related to the doctor’s technical level, but it should be noted that this is not the main factor, in order to ensure that the number of eggs retrieved in IVF, the most important thing is to regulate the ovarian function, only ovarian function is good, there are more basic follicles, the number of eggs retrieved will be more.
In fact, the number of available eggs is less than the number of follicles, which is mainly due to the quality of the eggs. Therefore, it is recommended to regulate the ovarian function and improve the quality of eggs, which is the key to improve the success rate of IVF.