Ovulation induction is the stimulation of the ovaries to produce and release eggs for fertilization. Infertility in women can commonly be attributed to anovulation, a condition where ovulation does not occur. Infertility can also be due to a woman’s inability to ovulate regularly whether or not she has her monthly period, or also the failure to ovulate eggs that are viable and healthy.
Within the ovary, the cells that secrete estrogen, progesterone and other hormones may be deranged and not function normally, resulting in a poorly developed endometrium within the uterus. If the uterus cannot receive a fertilized egg, the pregnancy is lost. Ovulation induction, therefore, is performed to correct the hormone imbalance and prevent miscarriage from occurring.
Women who fail to have ovulatory cycles (anovulation) or fail to have very irregular ovulatory cycles (oligoovulation) comprise the largest group of women dealing with female-factor infertility. These disorders may have one or several diverse origins, such as problems with the central nervous system, pituitary gland, ovary, follicles or both.
Polycystic ovarian syndrome is the most common cause of anovulation and oligoovulation. Also, certain diseases of the central nervous system, thyroid, and premature ovarian failure must be identified or ruled out by laboratory examinations to ensure that the appropriate course of action is followed. These women usually have plenty of egg-containing follicles in their ovaries, but for hormonal reasons, are unable to release eggs on a regular basis. This syndrome is often quite amenable to treatment with ovulation inducing drugs.
Ovulation induction is also used for patients with unknown causes of infertility, such as endometriosis. Endometriosis-associated infertility, which is not caused by anatomical damage to the fallopian tubes or nearby anatomical structures, can also treated by inducing ovulation. In such cases, the fertility specialist prescribes hormone agonists or hormone analogs resulting in the maturation of more than one egg.The combination of ovulation induction with intrauterine insemination (IUI) to be performed in concert with ovulation, sperm cells have more eggs to fertilize, increasing the chances of pregnancy.
Thus, pregnancy will be achieved because of the availability of mature, more numerous, and more viable eggs. Although a woman with unexplained infertility, endometriosis-associated infertility, or infertility due to male factors is not guaranteed conception in a given treatment cycle even with ovulation induction, the chance for pregnancy to occur has been shown to be higher than without treatment.Other measures to facilitate ovulation include weight loss, which is helpful for obese patients who do not ovulate regularly.
Ovulation inducing agents can be prescribed as pills, such as with Clomiphene citrate (Clomid) or injectable gonadotropins (Repronex).Patients using clomiphene citrate may be given medications to lower insulin levels in the blood and achieve better ovarian response, especially for patients with polycystic ovarian syndrome.They may also undergo ultrasound monitoring to determine whether it is achieving the desired effect. When giving gonadotropins, your fertility specialist will require blood tests. The doctor might also recommend adjuvant therapy such as Lupron, an ovarian “down-regulation” medication.