Women with anovulatory infertility generally undergoes ovulation induction. Studies show that about 30-40 percent of infertile women face ovulation problems. The ovaries should produce eggs, and a single egg has to be released during the menstrual cycle, especially in the middle of it, to help fertilize, and get implanted on the uterus lining to cause pregnancy. Ovulation induction is possible through medications.
What is Ovulation Induction?
Women who fail to ovulate on their own undergo hormonal therapy to stimulate the development of eggs and ovulate or release. The ovulation induction process is simple and straightforward that the patient is administered injectable or oral medication at the start of the menstrual cycle and monitored using ultrasound. The clinician informs you the time you are due to ovulate, and suggests the ideal time for intercourse or insemination.
Also, Read: Ovulation Detection for Beginners
How Is Ovulation Induction Performed?
Before performing ovulation induction, you should have thorough evaluation. If there are any underlying hormonal disorders, they need to be treated first. Then, you have to undergo some medications as suggested by your doctor to induce ovulation. You will be advised when to start medications, as well as monitoring through ultrasound scans and blood tests.
Some fertility drugs that you may have to take for ovulation induction are:
Clomiphene Citrate
An oral medication, clomiphene citrate is given for ovulation induction by stalling estrogen receptors. The effect of this artificial medication induces the body to stimulate the growth of follicle stimulating hormone (FSH) thinking that the estrogen levels are low. The anti-estrogen medication is also used for superovulation in women by using it as a fertility agent. Once the drug is administered, the patient needs monitoring, and it includes blood estrogen levels, ultrasounds and urinary luteinizing hormone.
Human Menopausal Gonadotropin
A combination of two hormones, luteinizing hormone (LH) and follicle stimulating hormone (FSH), human menopausal gonadotropin (hMG) helps with the stimulation of egg development in women who have extremely irregular ovulation or who do not ovulate instantly or who ovulate but want to develop more eggs in one cycle. The variable uses of the medication hardly offers any fixed dosage regimen. When compared to other oral medications, hMG is a stronger ovulating agent, and hence, it needs individual patient cycles.
This ovulation-induction medication is given while undergoing in vitro fertilization (IVF) and intrauterine insemination (IUI). It requires monitoring through ultrasound and blood estrogen measurement to avoid any complications.
Also, Read: Understanding Ovulation Induction
Follicle Stimulating Hormone
The purpose of follicle stimulating hormone (FSH) medication is to induce the growth and development of several eggs in the patient during a menstrual cycle. Generally, FSH is used alone, or sometimes with hMG to help superovulation induction. There is no recommended dosage for FSH, and therefore, the patient cycle has to be individualized. Monitoring through estrogen-level and ultrasound tests can help avoid complications in the women administered with FSH.
Human Chorionic Gonadotropin
Called hCG, human chorionic gonadotropin can help the eggs undergo final maturation, and it also triggers ovulation, i.e., the release of mature eggs. Moreover, with this medication, the corpus luteum can be induced to secrete progesterone for preparing the uterus lining to enable the implantation of the embryo. Once the hCG is administered, it triggers ovulation, which will happen in 36 hours. It is a self-administered medication.
Patients for Ovulation Induction
There are several women patients for ovulation induction, and among them women with no ovulation and women with irregular ovulation are mostly benefitted. They are administered different fertility medications based on their appropriate etiology. Women who have unexplained infertility with regular ovulation can also be subjected to ovulation induction treatment, wherein the number of ovulations per cycle is increased to give them an opportunity to become pregnant. In case of women undergoing an IVF procedure, ovulation induction is undertaken for maximizing the production of eggs.
For women with polycystic ovary syndrome (PCOS), they are generally given Clomid or Clomiphene Citrate to induce ovulation. Though they respond well to this, there are a few options too. For instance, administering metformin, which is used to treat diabetes, will help improve ovulation in women with PCOS for PCOS affects glucose metabolism and insulin.
The other option is ovarian drilling, which involves a laparoscopy. The ovary undergoes a surgical treatment, where holes of 4mm length are drilled in the ovary to facilitate ovulation. About 65-85 percent of patients with PCOS have found this treatment effective for it triggers natural ovulation. This invasive process has the risk of laparoscopy.
As for any treatment in combination with ovulation induction, it depends on the couple and their fertility history, as well as the male partner’s semen analysis. Clinics combine ovulation induction with the IUI treatment. Though ovulation induction is a straight process, it also possesses some risks. Some women may experience ovarian hyper-stimulation syndrome (OHSS) owing to over-responding to the ovulation induction. The other possibility of risk is multiple pregnancy.
