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Primordial follicle initiation and development varies by species; in the canine primordial follicle formation occurs 17–54 days post birth. At 17 days, primordial follicles, each of consists of a small oocyte (with no zona pellucida) and a single layer of flattened pre-granulosa cells, can first be observed in the cortical layer of the ovary.
These multiple follicles can be taken out by oocyte retrieval (egg collection) for use in in vitro fertilisation (IVF), or be given time to ovulate, resulting in superovulation which is the ovulation of a larger-than-normal number of eggs, [2] generally in the sense of at least two.
Transvaginal oocyte retrieval is more properly referred to as transvaginal ovum retrieval when the oocytes have matured into ova, as is normally the case in IVF. It can be also performed for egg donation , oocyte cryopreservation and other assisted reproduction technology such as ICSI .
Controlled ovarian hyperstimulation is generally part of in vitro fertilization, and the aim is generally to develop multiple follicles (optimally between 11 and 14 antral follicles measuring 2–8 mm in diameter), [5] followed by transvaginal oocyte retrieval, co-incubation, followed by embryo transfer of a maximum of two embryos at a time. [6]
The underlying mechanism is that, with the GnRH antagonist protocol, initial follicular recruitment and selection is undertaken by endogenous endocrine factors prior to starting the exogenous hyperstimulation, resulting in a smaller number of growing follicles when compared with the standard long GnRH agonist protocol. [9]
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Growth of follicles can be seen in subsequent autografts, mature eggs can be retrieved and IVF carried out making it a good candidate for fertility preservation. Drug free IVA may alternatively be used. This is the same as IVA however no drugs are used to stimulate the Atk pathway, only ovarian cortex fragmentation is used. [3]