Tuesday, March 8, 2011
Let's Talk Hormones!
I'm going to do my best to follow in the footsteps of my health class teacher to explain the ovarian cycle and how it relates to egg donation. The chart above is a great illustration of what really goes on with respect to hormones. As you can see, there are four main hormones that control the female reproductive system. Follicle Stimulating Hormone(or FSH) stimulates the growth of immature follicles in the ovary. The follicle is an oval shaped structure, filled with fluid and cells, where a single oocyte (or egg) develops. The second hormone is called Luteinizing Hormone (or LH), which triggers ovulation when the egg reaches maturity. As you can see on the chart, there is a huge surge of LH in the middle of the ovarian cycle, which is when the egg leaves the ovary and the woman is able to get pregnant. The third hormone is Estrogen, which is responsible for overall regulation of the female reproductive cycle. Finally, we have Progesterone, which is responsible for preparing the female body for pregnancy. Progesterone levels rise after ovulation, and build up the wall of the uterus to make it more suitable to an embryo if it is fertilized. If a pregnancy does not occur, progesterone levels drop and the woman gets her punctuation. Simple enough right?
When I'm chosen by a recipient couple to donate my eggs, I'll have to take two different injections to prepare my ovaries to develop multiple follicles. The results of my ultrasound indicated that I have 17 follicles available, which makes me a good candidate to donate eggs. (Acceptable donors need to have between 15 and 30 follicles.)By taking shots of pure FSH, marketed under the names Follistim and Gonal-F, my ovaries will grow many more follicles and mature eggs than it normally would. I'm expecting to take a shot of Gonal-F daily, injected by yours truly, for about 2 weeks. During that time, I'll have to make trips out to Shady Grove every 1-3 days so we can monitor the amount & size of my growing follicles. This gives the clinic an idea as to how many eggs I'll be able to donate. There may be some physical discomfort during this phase... If you can imagine, the normal follicle is about 1 centimeter in diameter and only one matures to this size during normal ovulation. However, if I have SEVENTEEN of these babies growing to 1cm each, making my ovary into a huge raspberry-like structure, it's pretty big! When my follicles reach the size the doctor's feel is adequate, I'll give myself a single intramuscular shot in the bum of pure LH, marketed under the names Lupron or Luveris. This triggers my body to plan to release the eggs, and 36 hours after this "trigger shot" I'll be in the stirrups for retrieval.
Side note about my ovarian cyst: Nurse Connors told me that my estrogen levels were slightly higher than average, probably due to the cyst. However, she said I shouldn't be concerned with it's presence, because it is so tiny and they typically go away on their own. A follicle that is larger than normal is deemed a cyst... I think it has to be over 1 centimeters in diameter. Mine is only 1.3cm - pretty tiny. So as for now I'm in the clear!