Ovulation Induction is used to maximise the potential of a patient’s own cycles in egg production and ovulation, giving them the opportunity to conceive ‘the old-fashioned way’.
If ovulation is not occurring regularly it may be necessary to give hormone tablets/injections to stimulate the ovaries. However, before these treatments are used it is important to find out why regular ovulation is not occurring, as more specialised treatment may be necessary for some women.
When using these induction agents, there is a slightly increased chance of producing too many follicles, or indeed producing so many as to call this hyperstimulation (OHSS- discussed elsewhere). Ideally one to two follicles are expected. If there are more than one or two, the cycle is very likely to be cancelled, and your specialist for ongoing treatment will reassess you.
The most common treatments used include clomiphene citrate (trade name Clomid/ Serophene), or FSH (Follicle Stimulating Hormone). Clomiphene acts by interrupting the chain reaction of stimuli to the pituitary gland and allows more FSH and LH to be released. These hormones in turn stimulate the ovaries. Clomiphene tablets are usually given for five days commencing in the first few days of a monthly cycle and ovulation is expected to occur between five and ten days later. Some women notice they have less vaginal mucus while taking Clomiphene and may not be able to use this method to detect ovulation. The chance of multiple pregnancy after using clomiphene depends on the dose and your specialist will discuss this with you.
FSH and HCG are hormones that are given by injection. HCG is used to trigger ovulation when a mature egg has developed. It is used when it is thought that the rise in the LH has been insufficient.
HCG injections are nearly always used when FSH is used. FSH stimulates the egg-maturing process and the development of the follicles on the ovaries, and is given each day from day 2 or 3 of the cycle. When the oestrogen level reaches its peak, an ultrasound will be done and the HCG injection will be given as appropriate. When using FSH it is very important to monitor its effect by regular blood and ultrasound tests as this treatment is more likely to cause a multiple pregnancy. At Fertility North FSH is given as either Gonal-F or Puregon and HCG as Pregnyl or Ovidrel.