What is Ovulation Induction?
Ovulation induction is a form of treatment which involves stimulation of the ovaries to bring about development of a ripened egg which can then be fertilised by a normal act of intercourse. Ovulation induction is used to treat women who do not ovulate or who ovulate irregularly. Ovulation induction can be used for women who have been diagnosed with Hypothatic Pituitary failure or women with Polycystic Ovarian Syndrome (PCO) and consequently may not be ovulating (Annovulatory)
The second use of ovulation induction was to increase the number of eggs reaching maturity in a single cycle to increase chances for conception. The initial agents for this treatment (used first for IVF and only later for simpler treatments) were injectable medications. These agents carry an increased risk of multiple gestation, ovarian hyperstimulation, and increased cost and time commitment.
^ Ultrasound picture of a polycystic ovary from a woman with PCOS – polycystic ovarian disease. These women do not develop mature follicles or ovulate without medication treatment. About 12 immature follicles (black circles) are seen here
^ Ultrasound photo of a polycystic ovary after Clomid treatment. Some mature size follicles are now present, as well as some small ones
Medications for Ovulation Induction
The four major types of drug therapy for ovulation problems include Clomid (Serophene, clomiphene citrate), injectable gonadotropins, GnRH pump, and bromocriptine.
These 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 may be prescribed either alone or in combination. These drugs, called 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. HCG or Human Chorionic Gonadotrophin is a drug which enables the egg to further mature. It also aids the release of the egg in the follicle. Timed intercourse will be suggested so that sperm will be present when the egg is released from the follicle, in order for fertilization to take place in the fallopian tube.
How is induction of ovulation performed?
Ovulation induction, in ovulatory women, is always combined with intrauterine insemination. Ovulation induction should only progress after a complete and thorough evaluation. All underlying hormonal disorders (such as thyroid dysfunction) should be treated prior to resorting to ovulation induction with fertility drugs
A careful selection of treatment regimens combined with diligent monitoring can bring excellent results. For women with ovarian failure or extremely very poor quality eggs there is not currently any drug available to allow a reasonable chance of conception with any type of ovarian stimulation. Egg donation is the only realistic option for getting pregnant with premature ovarian failure.