What should you know about ESHRE guideline ovarian stimulation for IVF and ICSI?

Ovarian stimulation is the controlled part of an IVF or ICSI cycle in which injectable gonadotrophins encourage follicles to grow. A GnRH agonist or GnRH antagonist may be used to help control premature ovulation, depending on the protocol. Ultrasound scans and hormone tests guide dose changes. When follicles are ready, an hCG trigger injection or another planned trigger helps finalise egg maturation before egg collection. The exact protocol depends on ovarian reserve, age, previous response, medical history, and treatment goals.

Before treatment, review your medicines, allergies, previous fertility cycles, and conditions such as polycystic ovary syndrome with the clinic. Learn how to store and inject each medicine, record doses, and attend monitoring appointments. Ask what symptoms are expected and how the clinic wants you to report them. An AMH test may contribute to planning, but it is interpreted alongside other findings rather than used alone. Discuss whether embryos, eggs, or another fertility option is relevant to your circumstances.

Contact the fertility team urgently for severe or rapidly increasing abdominal swelling or pain, repeated vomiting, faintness, breathing difficulty, or reduced urination during stimulation. These symptoms can signal ovarian hyperstimulation or another complication. Sudden severe pain also needs prompt assessment because ovarian twisting is possible. Follow the clinic’s emergency instructions even if symptoms begin outside appointment hours.

Ask why this protocol suits you, which medicines you will use, how monitoring changes the dose, and what would lead the team to pause or alter a cycle. Clarify trigger timing, egg collection arrangements, warning symptoms, and the plan if your response is lower or higher than expected.