Ovulation Induction (OI)

Ovulation Induction (OI)

If a woman has attained puberty and does not ovulate by herself, ovulation is induced with drugs. The lifestyle habits, like immoderate alcohol consumptionsmoking, stress, fluctuations in weight and Polycystic Ovarian Syndrome (PCOS) are the general causes of failure in ovulating resulting in infertility.

There may be other fertility issues too, that include the thyroid gland, pituitary gland disorders and high prolactin levels. In certain cases, ovulation  failure may be because of the ovarian failure. This may happen after the treatment for cancer or may be because of the beginning of the menopause.

If case you are a woman having irregular periods, follicle tracking is done with the help of ultrasound scans and your hormones are examined. These assessments may help your treating doctor to know your most fertile time of the month to improve the chances of achieving pregnancy naturally.

Much before your ovulation problems can be cured; it is pertinent to carry out some tests to know the cause. These tests may include:

It is also essential to make sure that your ovary is able to respond to the medications. One probable reason of your failed ovulation is the ovarian failure, better known as the menopause.

In case of high FSH (> 10) concentration level and low AMH concentration level, if measured at the beginning of your menstrual cycle, you are prone to ovarian failure. In such cases, fertility treatment does not work successfully.

If ovulation does not happen, medications may be given as your menstruation begins to help stimulate egg production. In case orally taken pills are not effective, then higher potency medicines may be injected to stimulate your egg production in the ovaries.

Ovulation is induced by using one of two main drug therapies:

  • Clomiphene, also known as Clomid, tablets enhances the follicle stimulating hormone (FSH) production by the pituitary gland. Sometimes, alternatives such as, Tamoxifen and Letrozole tablets, are used. The therapy helps in the egg growth. One tablet of 50 mg is usually given each from the 2nd to the 6th day of your periods. If your menstrual cycle is irregular, your periods are induced by giving Type “O”, Norethisterone tablet.
  • Gonadotropins: The featured element of this therapy is Follicle Stimulating Hormone (FSH). And, these are normally given by injection. Examples of these hormonal injections are Gonal F, Menopur and Puregon. These hormonal injections are given every day beginning with a dose of 75 IU each day.

The response to these hormonal drugs is observed by ultrasound scans.  After the follicles have gained an appropriate size, either bed-partnering is advised or hCG injection is given that facilitates the copulation timing and attaining pregnancy.  Or, Intrauterine Insemination (IUI) is performed.

The responses to these treatments vary from individual to individual and are generally unpredictable.  In case the response, during the monitoring, is found to be too weak or too strong, the cycle may have to be cancelled and started again appropriately.

In case the response to the drugs is found to be satisfactory, treatment generally is continued for six cycles.  And, these treatment cycles are performed one after the other without giving a break.

The potential side effects are largely related to the drugs.

Multiple pregnancies are a risk of ovulation induction treatments.

  • In about 10% of cases, patients undergoing treatment with Clomiphene, there is a chance of bearing twins.
  • And, this percentage goes up to nearly 20% in the patients undergoing treatment with gonadotropins.
  • The percentage of bearing triplets are only in around 1% of cases.

If your pregnancy is carefully monitored, the risk of bearing multiple pregnancy can be reduced but cannot be completely eliminated.

Other treatments for women having Polycystic Ovary Syndrome (PCOS)

Women having PCOS generally have difficulty in ovulating.  In such cases, Clomid is given as the first line of treatment.  The response this hormonal therapy has usually been found to be encouraging.

However, two other treatment choices may also be used:

  • Metformin

This medicine is useful in the treatment of Diabetes.  The women having PCOS get greatly benefitted with this and their ovulation improves considerably. This happens because PCOS is known to have an effect on insulin and glucose metabolism.

This is a surgical procedure wherein a laparoscopy is needed to be carried out. Four holes measuring 4mm in length are drilled into each of the two ovaries that help improving ovulation.

In about 60% to 85% percent of women having PCOS, the procedure triggers natural ovulation. This is a pervasive procedure that has all the risks of laparoscopy. The procedure rarely causes forming of scar tissue or adhesion in the ovarian region.

Infertility Treatment FAQs – Part II: 11- risk factors of  both male and female infertility?

Infertility Treatment FAQs – Part III: What are Female Infertility risk factors?

Infertility Treatment FAQs – Part IV: What are Male Infertility risk factors?

Infertility Treatment FAQs – Part V: What are causes of Female Infertility?

Infertility Treatment FAQs – Part VI: What are causes of Male Infertility?

Infertility Treatment FAQs – Part VII: Female Infertility Symptoms

Infertility Treatment FAQs – Part VIII: Infertility Symptoms in Men

Infertility Treatment FAQs – Part IX: Infertility Treatment in India

Infertility Treatment FAQs – Part X: Evaluating Female Infertility

Infertility Treatment FAQs – Part XI: Evaluating Male Infertility

Infertility Treatment FAQs – Part XII: What infertility treatments are available?

Infertility Treatment FAQs – Part XIII: Male Infertility Treatments and drugs

Infertility Treatment FAQs – Part XIV: Female Infertility Treatments

Infertility Treatment FAQs – Part XV: Assisted Reproductive Technology

Infertility Treatment FAQs – Part XVI:  Gamete Intrafallopian Transfer (GIFT)

Infertility Treatment FAQs – Part XVIII: Zygote Intrafallopian Transfer (ZIFT)

Infertility Treatment FAQs – Part XXI:  Sperm Morphology

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