What is Ovulation induction?
Ovulation induction is stimulating the ovaries to produce eggs.
In each menstrual cycle, in a woman with regular periods, one egg is produced and released from the ovary around the middle of the cycle. If this egg is fertilized by sperm in the tube and implants in the womb, then pregnancy happens.
Who requires ovulation induction?
Around 30-40% of women, who have trouble conceiving, have problems with egg formation. Either they ovulate infrequently or don’t ovulate at all. So these women require ovulation induction. Some of the causes of infrequent or no ovulation may be:
- PCOS- polycystic ovarian Syndrome in which mature eggs are not formed.
- Thyroid disorders- can also lead to problems with ovulation
- Obesity/ Overweight women
- Excessive exercise
The factor which is leading to a problem with egg formation may be corrected first. This can sometimes lead to the restoration of regular cycles and spontaneous pregnancy. If still, the problem persists, then ovulation induction needs to be done.
Some women who ovulate regularly but still have trouble conceiving and all other factors are normal, are also given medication to stimulate the formation of good quality eggs and to increase the number of eggs formed to 1-3.
How is Ovulation Induction done?
Ovulation induction involves the use of medicines or injections which are started from between the second to the fifth day of the menstrual cycle. Then serial transvaginal ultrasound is done to check the growth of the egg in the ovaries. This is known as follicular monitoring.
When the mature egg is formed, an injection is given to trigger the release of the egg.
Around the time when the egg is released, either you can try naturally or intrauterine insemination (IUI) can be done.
The medicines most commonly used include-
- Clomiphene citrate
- Aromatase inhibitors- Most commonly Letrozole is used.
- Gonadotropins-Injections of FSH and LH are given
What are the benefits of Ovulation induction?
- Ovulation induction is a low cost method for attaining a pregnancy
- It is non invasive
- Minimal side effects if used judiciously
So it is one of the first line methods of treatment.
What are the side effects associated with ovulation induction?
- Hot flashes
- Mood swings
- Breast tenderness
- Weight gain
- Blurred vision
- Nausea etc.
These problems are temporary/ transient and after the treatment cycle, they subside. Mostly they don’t require any additional treatment.
If multiple follicles are formed, there is a risk of having multiple pregnancies like twins/ triplets, etc. So if many eggs are formed, the doctor may take the decision of canceling the cycle.