Ovulation Induction

Ovulation Induction is a method of treatment used for women who either don't ovulate (release an egg) or don't ovulate regularly. Fertility drugs (tablets or injections) are used to help women to ovulate and so that they have the chance to conceive naturally. The most common groupings include drugs, which work on the brain, drugs which stimulate the pituitary gland and those which act directly on the ovaries themselves.

The woman's natural cycle and follicular tracking (ultrasound monitoring) are used to help assess the day of ovulation and couples are then advised the best time to have intercourse.

The medications can result in up to 60% of ovulation.

Clomiphene Citrate (Clomid)

How it is taken: In pill form [one tablet of 50 mg – four tablets of 200 mg] a day between day two –six of the cycle).

Effect: Indirectly stimulates ovaries into producing eggs.

What it is for: To stimulate and/or regulate ovulation.

Possible Side Effects: Hot flushes, mood swings, nausea, breast tenderness, insomnia, increased urination, heavy periods, spots, weight gain. May also increase ovarian cancer risk slightly if taken for over a year.

Metformin

How it is taken: Tablets with the build-up of dosage to two-three tablets per day.

Effect: Used in the treatment of polycystic ovary syndrome, particularly for obese patients.

What it is for: Can stimulate ovulation.

Possible Side Effects: Nausea, vomiting, diarrhea, abdominal pain, metallic taste, itching, allergic reactions and rarely hepatitis.

Gonadotrophins

(Follicle-stimulating hormone (FSH), Gonal-F, and Puregon Luteinizing hormones (LH), such as Menogon, Menopur, and Merional)

How it is taken: Injections (one per day) When eggs are mature, you are given an injection of human chorionic gonadotrophin (hCG) hormone to trigger release of an egg(s)

Effect: Stimulates the ovaries to produce eggs

What it is for: To stimulate ovulation before treatment cycles, or for polycystic ovary syndrome (PCOS) where Clomid hasn't worked

Possible Side Effects: Over-stimulation of the ovaries (OHSS); risk of multiple pregnancy when used for ovulation induction, allergic reactions and skin reactions Also, for infertility due to pituitary gland failure and some male infertility.

Are There Any Risks to Ovulation Induction?

Generally, ovulation induction is a simple and direct process, though it may be accompanied by some risks. These are:

Ovarian Hyperstimulation Syndrome (OHSS)

This condition is rare when a woman undergoing ovulation induction over-responds to it. She experiences nausea, pain, bloating and vomiting. Her symptoms may be mild or severe, and could possibly include hospital care.

At Kamineni Fertility Centre, we reduce the risk of OHSS by monitoring the patient’s treatment cycle by carrying out ultrasound scans, and blood tests. If the patient shows the potential for OHSS developing, the medication is suitably adjusted.

Multiple Pregnancies

When the ovaries are stimulated, the follicles could mature and release an egg simultaneously. As a result, the woman can have several pregnancies. With ultrasound monitoring, this can be checked and the medication adjusted. The couple is advised to abstain from sex if the doctor finds several follicles growing.