Ovulation induction uses hormonal medications, both oral and injected, to stimulated egg development and release. For women who do not ovulate naturally, the goal of this therapy is to produce a single, healthy egg. A second use of ovulation induction is for women with unexplained infertility to increase the number of eggs reaching maturity to 2-5 in a single cycle to increase the chances for conception. An additional injection of hCG is commonly used to trigger final maturation and release of egg cells and this treatment is generally combined with intrauterine insemination (IUI).
It is important to be aware that this treatment does carry risks including multiple gestation (twins, triplets and higher order multiples, ~30-35% chance), ovarian hyperstimulation, and significant cost and time commitment. Ovulation induction should only be used after a complete and thorough evaluation and correction of any underlying hormonal disorders such as thyroid dysfunction. It is also essential to ensure that the fallopian tubes are healthy and normal prior to undertaking ovulation induction. A maximum of 3-4 lifetime ovulation induction cycles is recommended.
More recently, in the mid-90s, evidence developed to suggest there may be an advantage to treating even ovulatory women with fertility medications. These women with "unexplained infertility" may have subtle challenges with ovulation and the use of medications may induce the maturity of 2-3 eggs versus only one. This treatment can improve the quality and quantity of the ovulation, thus enhancing pregnancy rates. Ovulation induction, in ovulatory women, is always combined with intrauterine insemination (IUI). Ovulation induction should only be used after a complete and thorough evaluation. All underlying hormonal disorders (such as thyroid dysfunction) should be treated prior to the use of ovulation induction with fertility drugs.
- Synthetic forms of gonadotropin hormones (FSH and LH)
- Injectables – both intramuscular (IM) and subcutaneous (SQ)
- Requires close Ultrasound and Estradiol level monitoring
- Goal is to stimulate the release of 3 – 5 eggs/ cycle
- Pregnancy rates = 30% -- 35% / cycle
- Multiple pregnancy rate = ~30% -- 35% chance
Maximum Cycles recommended = 3 – 4 per lifetime
Potential Ovulation Induction Complications
- Injection site bruising
- Ovarian Hyperstimulation Syndrome (O.H.S.S.)
- Multiple gestation