Follicle Stimulating Hormone, or FSH, is an important hormone monitored during the surrogacy process. Naturally occurring, it secretes from the pituitary gland and, along with Luteinizing Hormone (LH), plays an incredibly important role in normal female reproduction. The primary purpose of FSH is to stimulate the growth of the ovarian follicle in the development of eggs. The pituitary gland receives messages from the ovaries and the developing egg and releases FSH to stimulate the growth of a dominant follicle (containing an egg), which is subsequently ovulated.
In the beginning stages of the menstrual cycle, FSH stimulates many eggs to start growing from their immature, dormant state. During this initial phase, the largest, most developed follicle containing the most mature egg starts secreting Estradiol which will trigger ovulation so that the most mature egg can be released for potential fertilization. The immature eggs will also be released at the same time.
Menopause: The Increase of FSH and the Decline of Egg Count
Women are born with a number of eggs, ranging from 1-2 million. By the time a woman reaches puberty she has around 400,000 eggs remaining. During a woman’s reproductive lifespan, she should have an average of 400 ovulatory cycles, during which the 400,000 eggs will be relased. As a woman gets older, these dormant eggs eventually deteriorate in genetic quality and can cause their baby health problems should they conceive. Also as the ovaries age, the pituitary gland senses this change and has to secrete higher amounts of FSH to achieve the monthly ovulation. At one point, when all eggs are exhausted, menopause manifests and the serum FSH levels are extremely elevated, but to no avail. In the premenopausal years, this decline in number and quality of eggs can be checked by measuring circulating blood FSH levels. The higher this level is, the poorer the prognosis to conceive.
How FSH works in the Surrogacy Process
Following the menstrual period, you will begin Controlled Ovarian Supra-ovulation with daily injections. During this time you will also continue taking other medication to prevent ovulation prior to surgical retrieval. You will make several visits to the doctor’s office to monitor your ovarian response by transvaginal ultrasound and by blood tests, which measure your hormone levels. In the unfortunate event that you are not responding well to the stimulation medication, the mediation dosage will continue to be adjusted. In a typical situation, after 8 – 13 days of stimulation medication, enough eggs should have reached the maturation range. At that point, you will be instructed to take in intra-muscular injection to induce the final maturational changes in the eggs and prepare them for retrieval approximately, about 36 hours later.
FSH’s Effect on Eggs
As a general rule, the younger the woman and the higher the complement of eggs to start with determine the number of eggs that will reach maturity under the influence of FSH. As a typical example, a 25-year-old woman can produce 20-30 eggs after receiving stimulation medications for about two weeks.
In general, FSH and other fertility hormones administered under controlled medical supervision are very safe to use in the surrogacy process. The patient is closely monitored by ultrasound examinations and blood hormone levels until the time of egg retrieval, which involves the harvesting of all the maturing eggs from both ovaries.
The Side Effects of FSH
FSH has a tendency to disappear quickly, in addition to having a short half-life in the body. Some minor side effects are not uncommon while taking these fertility hormones. These include headache; mild nausea or stomach pain; mild numbness or tingly feeling; mild pelvic pain, tenderness, or discomfort; stuffy or runny nose, sore throat; breast swelling or tenderness and premenstrual like symptoms.
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