Early menopause? Increased breast cancer risk? Some misunderstandings about IVF ovulation induction treatment...

"Nurse, my physical examination showed that I have lobular hyperplasia of the breast. This hormone drug will have an impact on ovulation!"

"Miss nurse, I have been taking ovulation-stimulating injections for several days. The doctor said that the B-ultrasound showed that I had more than a dozen eggs today. My eggs have been overdrawn in advance, and I will age prematurely!"

"Look, nurse, I've gained 10 pounds since I started taking the ovulation-stimulating injections. My belly is full of fat. I'm so worried if I keep getting fatter!"

"Nurse, during the ovulation induction treatment, you must limit exercise and increase your food intake to increase the success rate of IVF!"

Among the patients who are seen in the assisted reproductive care clinic, in the injection room of the assisted reproductive department, we often encounter patients asking similar questions, which shows that there are still some misunderstandings about the ovulation induction treatment of in vitro fertilization. Faced with some rumors and misunderstandings that patients have before ovulation induction treatment, we need to have a correct understanding and be prepared.

01

If you stimulate ovulation and retrieve eggs, the eggs will be used up in advance.

Will menopause come early?

Image source: Tang Yiran, a nursing undergraduate student at the School of Nursing, Shanghai Jiao Tong University

This misunderstanding is very common, but it is purely unnecessary. There are about 300,000 eggs on the ovaries of adolescent women. In the following decades, about 30 eggs will be closed and die every day. Even without the use of ovulation-inducing drugs, only one egg can mature and ovulate in each menstrual cycle of a woman. However, this does not mean that only one egg in the ovarian reserve is used in one menstrual cycle. In fact, one menstrual cycle usually recruits a large number of follicles, and the most sensitive one matures and ovulates under the action of hormones in the body, while other eggs in the same batch die. The purpose of the ovulation-inducing injection is to make these eggs that would otherwise die grow and mature. This is a kind of "turning waste into treasure and recycling resources". It will not consume the "inventory" of eggs, so it will not cause menopause to come early or aging to occur prematurely.

As the name implies, ovulation induction therapy refers to the use of appropriate ovulation induction drugs under the guidance of a doctor to promote the simultaneous development of multiple follicles in one menstrual cycle to increase the chance of pregnancy. It is mainly aimed at women who do not ovulate or have ovulation disorders, and has clear indications. Like other treatments, IVF ovulation induction therapy can also cause some side effects, such as dizziness, nausea, abdominal distension, breast tenderness, depression, etc., but they are generally tolerable.

However, it is worth noting that all drugs used in ovulation induction treatment are prescription drugs. Because in vitro fertilization ovulation induction treatment is one of the key steps in assisted reproductive technology, the rational selection of treatment plans, the size of medication dosage, the length of time, the combination and complementarity of various drugs all need to be dynamically adjusted under the close monitoring of specialists, otherwise it may lead to multiple pregnancies or even ovarian hyperstimulation syndrome.

Studies have shown that compared with single-baby pregnancies, the burden on the mother's heart, liver, and kidneys will be increased in a multiple pregnancy, with a higher risk of miscarriage and premature birth; severe ovarian hyperstimulation syndrome can lead to pleural and abdominal effusion, metabolic abnormalities, endocrine disorders, etc. Therefore, although IVF ovulation induction treatment is a "waste utilization", it cannot be "developed" at will. It is safe only when used under the guidance of professional doctors in regular medical institutions.

02

Will taking ovulation-stimulating injections make people fat?

As the saying goes: Everyone loves beauty, and being fat or thin is always one of the most concerned issues for the majority of female compatriots. Some patients often complain that they gain weight after taking the ovulation injection. This phenomenon is because the ovulation injection will increase the estrogen level and retain water in the body, which will lead to weight gain or partial edema of the body. However, this phenomenon is temporary. With the end of treatment, the drug metabolism is completed, and the hormone level returns to normal, this temporary "water retention" will be discharged from the body with the water in the body, and the weight will return to normal and the edema will gradually disappear.

On the other hand, some women believe that limiting exercise and increasing food intake can improve the success rate of IVF, so they eat a lot of fish and meat, abalone, sea cucumber, shark's fin and fish maw, which naturally leads to excess energy, fat accumulation and weight gain. In fact, during the ovulation induction treatment, it is recommended to eat a balanced and light diet, appropriately increase the intake of high-quality protein such as fish, shrimp, eggs, milk and crude fiber foods such as celery and spinach, which can not only help promote follicle development, but also help maintain normal weight.

Image source: Tang Yiran, a nursing undergraduate student at the School of Nursing, Shanghai Jiao Tong University

At the same time, with the orderly use of ovulation-inducing drugs, the follicles in the female ovaries gradually grow, and the size of the ovaries also increases accordingly; therefore, during the ovulation-inducing treatment, it is recommended to do appropriate exercise every day, such as walking, jogging, yoga, etc. to increase the body's energy consumption, which can also help to quickly restore the weight to the original level after stopping the drug; however, avoid heavy physical labor and rapid twisting of the body and other strenuous exercises to avoid increasing the risk of ovarian torsion and rupture. In addition, pay attention to avoiding sexual intercourse as much as possible. In addition to increasing the risk of ovarian torsion and rupture, sexual intercourse may also cause vaginal infection and affect the smooth progress of the subsequent puncture egg retrieval and embryo transfer surgery.

03

IVF increases breast cancer risk

In recent years, there have been some false reports and rumors: ovulation induction may increase the risk of cancer; there are also gossip news saying that a certain star got breast cancer because she had undergone multiple IVF treatments. The American Society of Reproductive Medicine (ASRM) guidelines point out that: the existing data show that patients who receive IVF ovulation induction treatment have no significantly increased risk of breast cancer. In fact, breast cancer mainly occurs in women who carry breast cancer pathogenic genes. In addition, bad living habits are also a major factor in increasing the risk of disease.

Like the normal population, some IVF patients may also develop breast cancer. However, a large sample study by Swedish scientists showed that the risk of cervical carcinoma in situ and breast cancer in women undergoing IVF is actually slightly lower than that of the normal population. Therefore, IVF itself does not increase the risk of breast cancer. Don't just follow the crowd and worry about it.

Image source: Tang Yiran, a nursing undergraduate student at the School of Nursing, Shanghai Jiao Tong University

It can be seen from this that in vitro fertilization ovulation induction treatment actually only saves those follicles that should have disappeared, and adds them to the team that continues to grow, prompting them to grow into mature follicles, thereby helping patients obtain more eggs, and will not lead to the occurrence of malignant tumors of the reproductive system. The weight gain caused is also temporary, so there is no need to worry too much.

Author: Hu Yulian, head nurse, Assisted Reproduction Department, China Welfare Institute International Peace Maternity and Child Health Hospital

Review | Professor Zhang Yaqing, PhD/Postdoctoral Supervisor, Editorial Director of the Journal of Shanghai Jiao Tong University School of Medicine, Former Dean of the School of Nursing, and Vice Chairman of the Medical Science Popularization Committee of the Chinese Science Writers Association

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