Differences Between Downregulation and Direct Stimulation

Ovarian suppression (down-regulation) prevents spontaneous ovulation and suppresses or reduces the occurrence of spontaneous LH surges. It also enables pharmacological enhancement of follicular recruitment, thereby yielding a greater number of mature follicles. Ovulation induction involves administering ovulation-stimulating medications to promote multiple follicular development and ovulation from the ovaries. However, inappropriate use of these drugs may trigger ovarian hyperstimulation syndrome (OHSS). Even if pregnancy occurs, there is an increased risk of fetal malformations, as well as potential adverse effects such as dizziness, nausea, and hepatic or renal dysfunction. Before undergoing in vitro fertilization (IVF), it is advisable to first optimize overall health status. Women should achieve optimal glycemic control, maintain blood lipid and blood pressure levels within ideal ranges, and avoid obesity—otherwise, pregnancy may be complicated by additional health issues.