Written by
Monica Karpinski
Medically reviewed by
Kelda Gould
Fertility Nurse • BN in Adult Nursing
Stimulation, or “stims” as it’s sometimes called, is the part of your IVF cycle where you take medicine that encourages your ovaries to grow more eggs.
It’s a crucial part of your treatment. During a natural menstrual cycle, only one egg usually grows to maturity. But with stimulation, we can potentially collect more eggs, which could increase your chances of success.
If you’re feeling apprehensive about taking stimulation medicines, remember that your clinic is there to help. At ARGC, we will guide you through each step: during stimulation, we will do daily blood tests and regular scans to monitor your progress. We will tell you exactly which medicines and doses to take on each day.
Here’s what you can expect from the process.
You will take a carefully tailored combination of medicines to support follicle growth (follicles are sacs the eggs grow in) while preventing the eggs from being released too soon. We want to make sure they are at the right level of maturity when we collect them.
Your doctor will confirm the exact schedule of medicines that’s best for you personally. Here at ARGC, your medicine schedule is tailored to you individually, and adjusted daily depending on how you’re responding.
We take a particularly thorough approach to stimulation. We’ll monitor you every single day throughout via blood tests, plus regular ultrasound scans every 2-3 days. This is so we can keep a close eye on your follicle development and adjust your treatment in real time, if we need to. Towards the end of stimulation, we may need to see you twice per day (more on this below).
Good to know: At ARGC, we monitor you for a complete natural menstrual cycle before we build your stimulation treatment plan. This allows us to understand your body’s unique rhythms and patterns, so we can put together a medication schedule that best supports you. We call it your pre-treatment assessment. Learn more about the IVF process at ARGC.
That depends on the approach your clinic recommends. There are two main options: a long or short protocol. Your doctor will confirm which is best for you based on your unique situation.
But generally speaking, here at ARGC, we might recommend a long protocol for younger people who have a good amount of eggs left in their ovaries (ovarian reserve).
A long protocol takes about 4-5 weeks in total, while a short protocol takes around 10-14 days. For the former, there’s an extra preparation stage at the start where you take medicines to suppress your natural hormones. We’ve explained it all below.
Here’s how stimulation is usually structured for long and short protocols.
This step lasts 1-2 weeks
During the preparation phase, you will take specific downregulation medicines to quieten your ovaries and suppress your natural hormone production.
This gives us more control over your cycle. It lets us manage follicle growth more precisely as well as preventing premature ovulation. Plus, it makes it more likely that your follicles will develop at an even, coordinated rate.
You will come in for scans and blood tests around 2-3 times during this phase. We will check your hormone levels and confirm when you’re ready to move to the next stage.
Good to know: If you’re on a long protocol, you’ll generally continue to take downregulation medicines throughout the entire stimulation phase. By the way, this is the same downregulation medicine used in short protocols.
For those on a short protocol, the stimulation phase starts on either the first or second day of your period.
If you’re doing IVF with us, contact us on either day. You’ll then come in for an appointment where we will do a blood test and scan. This is so we can make sure there are no cysts or other factors (like certain hormone levels being too high) that could interfere with your treatment. You’ll also meet with one of our clinic nurses to review your treatment plan.
Our clinical team will review your results and call you that evening to confirm whether you can start the next phase of medication.
Then it’s time to take stimulation medicines, as laid out in your plan. Medicines are taken daily, often as injections you can do at home.
At ARGC, you will come in every day during this week for scans and blood tests. Every afternoon or evening, one of our nurses will call you with your daily blood test results. They will tell you which exact doses of medication to take the following day, based on how your follicles are developing.
As your follicles grow and mature, you will keep coming in for daily blood tests and regular scans. Though at this stage, you may sometimes need to come in twice per day for testing. This is because your follicles are reaching their final stages of growth. At this phase, your hormone levels and follicle size can change quickly from one day to the next. And there’s a natural risk that your body may release the eggs too soon.
By seeing you so often, we can closely monitor your progress and make immediate, precise adjustments to your medication schedule and treatment plan as needed. We can tightly control your hormone levels to prevent premature ovulation.
Usually 10-14 days after you start talking stimulation medicine
When your follicles are mature enough, you’ll be given what’s called a trigger shot. It’s a hormonal medication that brings your follicles into the final stage of maturity, which is when they’re ready for collection. With our thorough monitoring, we’ll be able to pinpoint the exact right moment to give you the shot.
Precision is everything at this step. Your trigger shot needs to be timed perfectly, so that we can make sure we’re collecting your eggs during the ideal window.
Here’s what to know about egg collection, including how to prepare for it.
Yes, there can be. Some people get side effects from taking the medicines, including hot flushes, headaches, nausea, fatigue, bloating, and bruising or soreness at the injection sites.
We’ve written a thorough guide to IVF risks and side effects if you’d like to learn more.
It’s important to take care of yourself while going through stimulation. Here are some of the most common do’s and don’ts we’re asked about.
During your first week of stimulation, avoid vigorous exercise like lifting heavy weights or doing bouncing movements. It’s advisable to avoid swimming, too: there’s a general risk of infection when using a public pool. At this stage, it’s just not worth chancing it.
We recommend stopping all exercise during your second week, aside from light walking. This is because your follicles are reaching their largest sizes and we want to minimise discomfort and any potential complications.
Should you experience sudden, severe pain in your lower stomach and pelvis during stimulation, seek help right away.
Baths aren’t something we specifically advise against. But there are risks around infection it’s important to be mindful of.
As a refresher: to minimise the risk of infection, it’s best to avoid public pools and spas.
You should also steer clear of saunas and steam rooms. The heat might make you feel dizzy and uncomfortable.
If you’ve had a hysteroscopy or a procedure to drain a cyst, we recommend avoiding any sort of bathing until you’ve recovered. That includes having a bath in your own home as well as using a pool, hot tub, or spa. It’s because the risk of infection is higher after a procedure.
Yes, this is generally fine. But make sure you’re using barrier protection once stimulation begins. This is to prevent natural conception happening while you’re taking fertility medicine. These medicines aren’t meant to be used during pregnancy and some may pose risks for the baby.
When you have IVF with us, we’ll be right there with you for every single day of stimulation. We will carefully monitor your progress and give you clear advice on what to do next. Many of our patients say they find it comforting to receive this level of care.
We work in this way to give you the best possible chance of becoming a parent.
Wondering whether ARGC is right for you? Our advisory calls are free, no-obligation, and led by someone who can answer your specific questions about treatment, costs, and what to expect. Book a call to get started.
Fertility Nurse • BN in Adult Nursing
Kelda Gould is a Registered Nurse specialising in fertility care. She holds a degree in Biochemistry and has over a decade of clinical experience spanning general nursing, outpatients, first response, and fertility care.
What happens during stimulation?