Ovulation Induction (OI)

If a woman is having difficulty ovulating, then ovulation stimulation may be required. Other possible causes include thyroid disorders, elevated prolactin, and disorders of pituitary or thyroid glands. In some cases, the ovarian problem can cause ovulation problems. This could occur after cancer treatment, or as a result of premature ovarian dysfunction.

Monitor a woman who has irregular menstrual periods by using ultrasound scans (follicle tracking), hormone assessments, and/or follicle tracking. This will help determine the fertile month and increase your chances of natural pregnancy.

Before treating ovulation disorders, you must have certain tests done. These tests include an ultrasound scan and blood test to check for hormones like thyroid, prolactin, LH, and Testosterone. It is also crucial to check that the ovary can respond to the drug treatment. Menopause is another reason for unsuccessful ovulation. Ovarian Failure is most likely if there is a high FSH concentration (> 10) and a low AMH concentration at the start of a period. In such cases, fertility treatment may not be successful.

If ovulation doesn’t occur, then medication may be administered at the beginning of menstruation to stimulate eggs production. Tablets are not enough to stimulate egg growth. If this happens, then stronger fertility injections may also be needed.

You Can Induce Ovulation Using One Of These Two Main Drug Regimens.

Clomid tablets and Clomiphene (alternatives being Tamoxifen, Letrozole tablets), stimulate egg growth by increasing the production of FSH by the pituitary. The usual starting dose is 50mgs (1 tablet), taken between the 2nd and 6th days of the period. In rare cases, it may be necessary for the patient to have a second tablet called Norethisterone.

These gonadotrophins can be injected. Follicle-stimulating hormone is their active ingredient. Menopur (Gonal F), Before, and Bemfola would be examples. These injections can be given daily and begin at 75 IU.

Ultrasound scans can be used to monitor any medication’s reaction. If the follicles become large enough to allow intercourse, an injection with HCG may be recommended. This will facilitate IUI or intercourse timing. Individual responses to treatment may vary. In these cases, the cycle might need to be canceled and recommenced if necessary. The usual treatment cycle is 6 cycles unless the response is satisfactory. You can continue treatment without stopping.

Drugs are the most likely to cause side effects. Multiple pregnancies increase the chance of side effects from ovulation inducer treatments. Twins can occur in 10% of cases when Clomiphene is used, and 20% when gonadotrophins are used. Triplets could also be possible in 1% to 1% of cases. Multiple pregnancies are less likely if you monitor your pregnancy closely.

How Long Does Ovulation Induction Take?

Your fertility clinic may order an HSG (hysterosalpingogram) to determine if you have fallopian tubes open before initiating ovulation. After that, your doctor may prescribe you medication to induce fertility. There are many options for fertility drugs. Clomiphene, also known as Clomid, can be taken in tablets. This medication is usually taken between days 4 and 8 of the cycle. Injections of follicle stimulate hormone (FSH), can be started as early as day 4 or 5 and continued daily until you reach the middle of your cycle (day 13). To make it easy for you to do the injections at home, a nurse will guide you.

Blood tests will take place during this period to determine when your uterus is fully developed. The appropriate time is when a trigger injection of human chorionic gonadotropin, (HCG), stimulates the ovulation process. IUI results in insemination within 36 to 48 hours. The success of fertility may be confirmed by pregnancy testing on day 28.

Other Treatments Women With PCOS

Clomid is the first-line treatment for PCOS. This is recommended for women who are not ovulating. There may be two additional treatment options.

Metformin, a medication for the treatment of diabetes that has the added benefit of improving ovulation among some women who have PCOS. This is because PCOS can affect insulin and glucose metabolism.

Ovarian drilling. This is a surgical procedure that requires a laparoscopy. To increase ovulation, holes of 4mm are drilled into the ovary. This procedure could trigger natural ovulation, which may occur in between 60% and 85% of women who have PCOS. This is an invasive procedure and comes with the risks associated with laparoscopy. Rarely, scar tissue may form in the ovary.

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