FIGURE 2-2 Follicular growth and selection.

SOURCE: Racowsky (2006). Reprinted with permission from the author.

Thus, as Marcelle Cedars, director of the Division of Reproductive Endocrinology and Infertility at the University of California, San Francisco, noted, hormone therapy acts to increase the number of available eggs in a way that is much different from how most people assume it works. “While we talk about stimulating donors, we really misspeak,” she said. “I have to explain this to patients quite frequently because the implication is that I can make more eggs be there. The reality is what I’m doing is rescuing those eggs from the antral stage forward that would otherwise undergo atresia.” And this, she noted, is an important point in understanding what the potential risks are for women who undergo this hormone treatment.

POTENTIAL RISK OF OVARIAN HYPERSTIMULATION SYNDROME

The most common side effect of the use of fertility drugs is what is called ovarian hyperstimulation syndrome (OHSS), Dr. Cedars said. “In essence,” she explained, “ovarian hyperstimulation is exaggeration of a desired response. We want to override a mechanism of getting a single egg.” A key factor in the development of OHSS is the administration of



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