Ovulation induction, also known as controlled ovarian hyperstimulation (COH), is used to improve chances for pregnancy. Ovulation induction is often used before intrauterine insemination (IUI) or in vitro fertilization (IVF). The procedure involves the controlled stimulation of the woman’s ovaries by use of medications. This increases the number of eggs that can be fertilized.
Who is a candidate for ovulation induction?
- Cervical factor infertility
- Unexplained infertility
- Mild endometriosis
- Male factor infertility
- Anovulatory infertility
- Persistent infertility in spite of other treatments
What medications are used with ovulation induction?
Ovulation induction allows for precise timing of artificial insemination, where sperm are placed into the uterus through the cervix. Medications will induce ovulation of many eggs. Clomid (clomiphene citrate) is an oral medication used for this procedure. An injectable medication can be use, containing follicle-stimulating hormone (FSH) or human menopausal gonadotropins (hmg) which induce multiple egg development. Human menopausal gonadotropin is given at the time selected by your doctor to mature the eggs and bring on an ovulatory response.
Are ovulation induction medications safe?
FSH, hmg, and Clomid all have been used extensively and are proven safe and effective when administered at a certified fertility clinic. No increase in birth defects and congenital abnormalities has been associated with any of these medications. You will also receive GnRH antagonist by daily injection to enhance the ovarian response. The side effects of Clomid include hot flashes, headaches, mood changes, and vaginal dryness.
Do ovulatory stimulation drugs work?
Clomid with IUI has an 8-10% success rate per cycle when used for unexplained infertility of 3 years duration, with only an 8% chance of multiples (twins, triplets, etc.) Gonadotropin with IUI has a 15-18% success rate when used for unexplained infertility of 3 years duration, with a 15% chance of multiples.
What can I expect during ovulation induction therapy?
During the time you are takin medicines to induce ovulation, you will be carefully monitored to improve success of pregnancy and ensure your safety. In addition to a clinical examination, you will be monitored using:
- Laboratory tests – Blood samples are taken to assess for hormonal response of the ovaries during ovulation induction. The blood is drawn early in the day for estradiol levels at intervals scheduled by your fertility specialist.
- Ultrasound scans – This noninvasive technique assesses the size and number of ovarian follicles. A vaginal probe is inserted to emit sound waves. The computerized device takes pictures for evaluation, and the images are recorded in real-time.
How is artificial insemination performed?
Artificial insemination involves placing sperm directly into the woman’s uterus. Studies show that artificial insemination can improve chance of pregnancy for couples with unexplained and male infertility, especially when combined with ovulation induction. Intrauterine insemination involves the use of a small catheter to insert sperm through the cervix and into the uterus. Around 14 million sperm are deposited using IUI.
After the male partner gives a semen sample, the specimen is prepared using specialized laboratory techniques to collect the most active and motile sperm. Preparing the sperm takes around 2 hours, but the actual insemination only takes a few minutes.