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Ovulation induction

Ovulation Induction

 An integral part of any form of assisted reproductive technology is ovulation induction, the medical procedure to stimulate your ovaries to produce mature eggs (occasionally multiple eggs) in a cycle. In medical terms ovulation induction is also referred to as “enhanced follicular recruitment” or “controlled ovarian stimulation”. Ovulation induction not only revs up your follicles to produce eggs, but also controls the time of your ovulation. Ovulation inductions protocols are always carried out through medication or hormonal therapy, therefore they imply certain risk for the female body.

In about 25% of infertile couples the problem is the lack or infrequency of female ovulation, which is regulateded by some hormones called Gonadotrophins (produced by the brain). Problems may derive from the production of these reproductive hormones or from the ovary itself. What are the factors that can inhibit natural ovulation?

  • Hypothalamic dysfunction – two hormones that are responsible for ovulation are produced in the hypothalamus: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). If the hypothalamus fails to function properly, the result may be a hormonal imbalance and the inability to ovulate.
  • Polycystic ovary syndrome (PCOS) – It is the most common condition that may lead to female infertility. The abnormal functioning of the hypothalamus, the pituitary gland and the ovaries in conjunction cause the hormonal imbalance and the cysts.
  • Prolactine overproduction – It decreases estrogen levels, which may lead to infertility.
  • Premature ovarian insufficiency – An autoimmune response or some environmental impact damages the ovaries and the eggs, which condition also calls for artificial ovarian induction.

Why is Ovulation Induction Done?Ovulation_Small

  • For women who do not ovulate properly ovulation induction can offer a chance to conceive in a natural way.
  • During assisted reproduction (e.g.: intrauterine insemination), the more mature eggs can be harvested in a cycle, the higher the chance of a successful pregnancy is.

Natural Ovulation Induction

Two families of medications are used in most ovulation induction protocols, Clomiphene Citrate and Gonadotropins, but many patients are reluctant to take these drugs because of the numerous side effects. Before starting any hormone-assisted procedures, women often turn to natural ovulation induction methods such as:

  • Nutrition (grapefruit juice, soy products)
  • Dietary supplements (fertility vitamins and teas containing vitex (chasteberry)
  • Acupuncture
  • Massage
  • Reflexology
  • Meditation, brain control and stress relief


Medical Ovulation Induction Protocols

Ovulation induction with Clomiphene Citrate

This agent stimulates the pituitary gland to increase the production of FSH, which will result in ovulation, sometimes even multiple ovulation within a cycle. Clomiphene is taken in pill form and administered between the 2nd and 6th day of your menstrual cycle (for 5 consecutive days). Sometimes this form of ovulation induction is accompanied by progesterone therapy when the patient has very unpredictable cycle.

Ovulation induction with Gonadotropin

FSH therapy is designed to stimulate the follicles to mature eggs and their release. These hormones along with additional hCG are used in a most drastic ovulation induction procedure called superovulation, to induce multiple egg production.

Ovulation Induction in POCS (Polycystic ovary syndrome) may happen with Gonadothropin and an insulin lowering medication called Glocophage (metformin). This medicacion is able to normalize the endocrine imbalances that are responsible for POSC. Ovulation induction in POCS usually starts with clomiphene therapy, then if no results are achieved continued with the gradual introduction of metformin therapy. Doctors stress the importance of constant ultrasound monitoring, to prevent a potential side-effect called ovarian hyper-stimulation.