Ovulation Induction Treatment

Ovulation induction (OI) is a fertility treatment that uses medications to cause or regulate ovulation, or increase the number of eggs produced during a cycle, to increase the opportunity for pregnancy.

Treatment Procedure

Stimulation

Ovulation induction medications include clomiphene citrate. This oral drug promotes growth of the fluid-filled sacks (follicles) containing the eggs. If you do not ovulate, or you ovulate and do not become pregnant after clomiphene therapy, other medications known as gonadotropins may be prescribed, either alone or in combination.

Gonadotropins are taken by injection under the skin. They replace natural follicle-stimulating hormone (FSH), and if they are successful the ovaries produce multiple follicles and high-quality, mature eggs.

Your hormone levels and follicular development are tracked throughout the stimulation cycle. If required, your medication protocol (the type and dose) may be altered for optimum results.

Control

Because powerful hormones are used to produce significant changes in your system, their effects are tracked by blood tests and ultrasound. These tests are used to determine a baseline – indicating your natural hormone levels – and your medication start date. For this reason, ovulation induction cycles also may be called “monitored” cycles.

Egg Release – Ovulation

When the follicles are mature, usually between 16 and 20 millimetres in diameter depending on your stimulation medication, you will take an intramuscular injection of hCG in preparation for intercourse or intra-uterine insemination (IUI).

The potential fertility improvement that this type of treatment may yield depends on the woman’s age and diagnosis and the initial male semen analysis, and should be discussed with your specialist.

Ovulation Induction Fertility Medications

Various fertility medications are available for ovulation induction, and your physician will choose the drug or combination of stimulation drugs that is best in each case. Medications include:

• Clomiphene Citrate (Clomid or Serophene) –
  Prescribed to women with infrequent periods and long ovulation cycles, it blocks the effects of estrogens and causes the body to produce more follicle- stimulating hormone.
• Human Menopausal Gonadotropin –
  Stimulating the development of multiple follicles and eggs during an ovulation cycle, hMG is derived from the urine of postmenopausal women.
• Follicle-Stimulating Hormone (FSH) –
  Stimulating development of the fluid-filled sacks containing the eggs, this drug is available in a natural form, derived from the urine of postmenopausal women, or as a “recombinant or manufactured drug”.
• Human Chorionic Gonadotropin (hCG) –
  Produced by the placenta during pregnancy and extracted from the urine of pregnant women, hCG triggers ovulation, releasing the eggs.

Who is Ovulation Induction Recommended for?

Ovulation induction treatment is recommended for:

• Women with unexplained infertility.
• Women with long, irregular or infrequent cycles.
• Women who are not spontaneously ovulating.
• Couples with no male-factor infertility.

Ovulation induction treatment is not recommended for:

• Women over 38 years of age.
• Women with tubal blockage or severe tubal damage.
• Women with severe endometriosis.
• Couples with a low sperm count or poor sperm motility/morphology.

What are the Potential Risks?

Overstimulation – Some women may experience an excessive response by their ovaries to the fertility drugs. Ovarian hyperstimulation syndrome (OHSS) occurs in a minority of women who overrespond. Symptoms include severe discomfort, nausea, vomiting, abdominal distension and dehydration. It is important that the clinic is notified immediately if any of these symptoms occur during your treatment, as hospitalisation may be required.