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melindamusil
06-06-2013, 02:27 AM
1)What hormones or other medicines are used to induce egg production in a woman who is going to have her eggs harvested?

2)How many eggs can be harvested each cycle?

3)Assuming she is not/does not become pregnant, how frequently could the eggs be harvested? Monthly/every cycle?

In my story, the bad guys intend to harvest eggs from my FMC to use for their nefarious purposes. They do not plan to impregnate her a la in vitro fertilization; they just want to harvest as many eggs as they can for as long as they can. They are not concerned with the long term effects on her health. (I assume it is not good for you to perpetually get the hormone injections!)

PorterStarrByrd
06-06-2013, 02:33 AM
Damn ! I thought this was a farm question ...

ebbrown
06-06-2013, 03:16 AM
1)What hormones or other medicines are used to induce egg production in a woman who is going to have her eggs harvested?

2)How many eggs can be harvested each cycle?

3)Assuming she is not/does not become pregnant, how frequently could the eggs be harvested? Monthly/every cycle?

A typical regimen for a woman who has never done IVF/IUI (Invitro Fertilization or Intrauterine Insemination) is as follows: (Keep in mind, when you say egg harvesting, I am assuming you mean sucking the eggs out with a needle through the vaginal wall, which is what egg retrieval is. The medication schedule is essentially the same for IUI and IVF) Stage 1: baseline ultrasound to count the number of antral (resting) follicles. Then comes Downregulation with at least 1 month BCP(oral contraceptives). Lupron, a medication used to prevent ovulation, is also introduced, and this is maintained until a short time before egg retrieval. Lupron is given by sub-q injection into the abdomen 1 or 2 times per day. Stage 2: Another ultrasound to check follicle number (these are the potential number of eggs that can be stimulated. This number can indicate how successful a cycle will be, or how responsive a woman will be to the stimulating medications. 6 follicle is the minimum most IF docs want to see to continue; less than that, it is too much risk for the amout that might be viable. A nice number to see is 12-18. 20+ gets you into the territory where they worry about overstimulations, which is very dangerous.) Now the stimulating medications start. These are medications such as Gonal-F, repronex, (injectible, sub-q 2x per day in the belly) and some docs also combine injectibles with Clomid (a first line ovarian stimulant that is in pill form). Patients typically stim for 7-15 days; any more than that, you risk frying yer eggs. Stage 3: Ultrasounds throughout, usually every other day until most of the follicles are in the 16-20 mm size range. The Lupron from earlier keeps them all the same size. (Ovaries usually grow several eggs per month naturally, and one becomes a lead follicle and the rest die off, so only the big one ovulates.) Once one egg gets too big, the body wants to naturally have an LH surge and ovulate; the medications keep you from ovulating until they have plenty of eggs at viable harvesting sizes.
Stage 4: When the eggies are ready, the stimulations medications stop, and the doc gives specific instructions as to when to give yourself an Intramuscular shot of HCG. HCG is the pregnancy hormone, yes, but when used in this manner it mimics the body's natural surge of LH(the hormone that makes you ovulate, very chemically similar in structure to HCG). When given HCG in this manner, it is nearly 99% certain the woman will ovulate within 24-40 hours. So then the doc will time the egg retrieval for about 30-36 hours after your HCG shot. Stage 5: Your eggs are ready to be sucked out with a needle through the vaginal wall. Mild sedation such as demeral and versed are used for this. I think they used propofol on me one time. Hopefully the eggs are perfectly ripe, and you get 8-18 mature eggs.
A cycle lasts about 2.5-3 months. It takes a month to downreg, a few weeks for stims, and then you must wait to see if you are pregnant. Most women will take a full 2 weeks of progesterone injection or suppositories until they have a scheduled blood HCG test. Home pregnancy tests or blood tests taken before that time will test false/misleading positive, because the woman has been injected with HCG. It takes a good 11 days to rid your body of the HCG hormone before you can guess it is from a new pregnancy. So it would be very unlikely a woman could harvest eggs more than one every 3 months. (If there was a way to do it more frequently, I would have found it, haha.)

In my story, the bad guys intend to harvest eggs from my FMC to use for their nefarious purposes. They do not plan to impregnate her a la in vitro fertilization; they just want to harvest as many eggs as they can for as long as they can. They are not concerned with the long term effects on her health. (I assume it is not good for you to perpetually get the hormone injections!)

One other thing to mention about undergoing this procedure frequently; OHSS (Ovarian Hyperstimulation Syndrome). Basically the ovaries are in crazy mode, swell up like basketballs, your fluid balance goes haywire, and you risk ovarian torsion and death from shock.

Haha, yeah, hope that helps...there's a lot to that procedure. (I started out in medschool hoping to do infertility medicine, and that interest grew the more I had personal eperience with it. Then some English teacher told me I should be writing.) :Shrug:

wendymarlowe
06-06-2013, 10:11 AM
Another note - most agencies which work with egg donors and surrogates don't want women over the age of 28-30, because the quality of the eggs starts to deteriorate at around that time and the risk of complications rises. Actually donating eggs will knock you off your feet for a day or two (sometimes more) and leave you sore for a while afterwards; the shots are also a pain and can produce mild but long-term effects like cramps and aches. You can't go through a donation cycle if you're pregnant (obviously) or breastfeeding, because of the hormones, but women who have had at least one child are more sought for egg donations because it means they don't have any of the weird, rare conditions which would prevent safe ovulation.

melindamusil
06-06-2013, 11:11 PM
Thank you!! This helps a lot, since I've never been pregnant or dealt with IVF issues. Luckily I don't think I need to explain too much of the medicine, but I feel much better knowing what would happen. (Incidentally, I hadn't even thought of the ultrasound, but that would actually work perfectly!)



(I started out in medschool hoping to do infertility medicine, and that interest grew the more I had personal eperience with it. Then some English teacher told me I should be writing.) :Shrug:
Yea, for me it was my sister. What can you do? :Hug2: