Ovulation Induction

What causes an ovulatory problem?

An ovulatory problem can be triggered by a wide variety of underlying issues. It may involve overproduction or underproduction of any of a range of hormones. It may also be caused by ovarian failure which occurs when a woman’s supply of eggs is depleted. Ovualtion induction is not possible for women with ovarian failure.

How does a doctor diagnose an ovulatory problem?

Usually, if a woman is menstruating regularly, she is also ovulating, but this isn’t always true. A number of tests can help determine whether ovulation is occurring and help pinpoint the reasons for ovulatory problems. These include basal body temperature charts, as well as blood tests and urine tests to measure hormone levels.

How are anovulatory problems treated?

The most common treatment for ovulatory problems is ovulation induction. Usually, a doctor will begin ovulation induction with clomiphene citrate, an oral medication.

In a normal cycle, the hypothalamus releases a hormone called gonadotropin-releasing hormone (GnRH) at the beginning of the follicular phase. If too little or too much is released, normal follicle development will not take place and ovulation will not occur. Clomiphene citrate initiates the release of GnRH, which in turn causes the pituitary gland to release more follicle stimulating hormone (FSH) and luteinizing hormone (LH). These two hormones stimulate the growth of ovarian follicles, which contain eggs. If clomiphene citrate therapy is ineffective after three to four cycles medications containing FSH ma be prescribed.

Are any other treatments available?

Ovualtion induction can be performed in conjunction with artificial insemination (AI) to improve the chances for conception. AI involves placing sperm directly into a woman’s reproductive tract around the time of ovulation. It is often used in cases where the woman has poor or absent cervical mucus, or the man has low sperm count or sperm motility.

There are several types of AI, identified by where in the reproductive tract the sperm is placed:

·       Intracervical insemination – sperm is placed into the cervix

·       Intratubal insemination – sperm is placed into the fallopian tube

·       Intrauterine insemination – sperm is placed into the uterus

Of these, intrauterine insemination (IUI) is the most common. If AI or IUI do not lead to success, the doctor may recommend a more advanced approach such as in vitro fertilization (IVF).

Is ovulation induction performed for reasons other than ovulatory problems?

Ovulation induction may also be done as part of an IVF cycle, even if the woman does not have an ovulatory problem. In these cases, the doctor will want to stimulate the follicles to produce multiple eggs, to increase the possibility that at least one will become fertilized. This process is known as superovulation or controlled ovarian hyperstimulation.