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Stimulation ovarienne

Stimulation ovarienne

Principe de la stimulation ovarienne simple

Spontanément, sans aucun traitement, une femme fabrique 1 ovule par mois (sur l’ovaire droit ou l’ovaire gauche).
La stimulation ovarienne a pour but d’optimiser la croissance et la maturation d’1 (ou 2) ovule(s) sur les ovaires, de déterminer le moment propice pour déclencher l’ovulation, et donc d’augmenter les chances d’obtenir une grossesse.
La stimulation ovarienne permet d’optimiser les chances de grossesses in VIVO (dans les trompes de la femme, la fécondation restant « naturelle, non assistée).
Elle peut vous être proposée dans 3 cas :
– Afin de réaliser un test de glaire (cf. premiers bilans)
– Afin d’optimiser le cycle naturel et de mieux « cibler » les rapports sexuels les plus fécondants (cf. fiche stimulation simple)
– Afin de réaliser des inséminations intra utérine (cf. fiche Insémination intra utérine)

Protocole

Les 3 phases du cycle sont optimisées successivement
1. La croissance folliculaire
Des injections sous cutanées d’hormones aident à la croissance folliculaire. Ces injections sont débutées entre J3 et J7 selon les cas et doivent être administrées jusqu’à ce que le ou les follicules (1 ou 2 ) aient atteint leur maturité. Certaines femmes n’ont besoin que de 4 jours de piqûres, d’autres de 25 jours de piqûres… La surveillance de cette stimulation se fait classiquement par des échographies transvaginales et des dosages hormonaux (estradiol, LH, progestérone) dont la fréquence dépendra de la réponse de vos ovaires aux hormones.
Les doses d’hormones peuvent être modifiées en cours de stimulation. Une réponse insuffisante ou trop importante (risque d’une grossesse multiple) peut amener votre gynécologue à interrompre votre traitement.

2.L’ovulation est optimisée et déclenchée
Lorsque le ou les 2 follicules ont atteint la bonne taille, que le taux hormonal est suffisant, et que l’endomètre est favorable (aspect + épaisseur), l’ovulation est provoquée par une hormone de déclenchement. Il s’agit d’1 injection sous cutanée d’1 ampoule d’Ovitrelle® ou d’1 injection intra musculaire d’1 ampoule d’HCG® 5000 UI. Le jour et l’heure de l’injection vous seront précisés lors de la dernière consultation ou par téléphone.

3.La phase lutéale est « soutenue »
Votre gynécologue pourra vous prescrire 10 jours de progestérone par voie orale par voie vaginale afin d’optimiser la phase post ovulatoire.

4. Le test de grossesse
Une ordonnance vous sera donnée afin de faire un test de grossesse sanguin 15 jours après le déclenchement de l’ovulation.

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