Ovulation induction

Anovulatory failure (a menstrual cycle during which the ovaries do not release an egg) or ovulation disorders are some of the main causes of infertility in the female. These are usually caused by an imbalance of hormones. The most common causes of failure to ovulate are stress, weight fluctuations and Polycystic Ovarian Syndrome (PCOS). Other causes may include disorders of the pituitary gland, thyroid gland and raised prolactin levels.

Treatment for these conditions is relatively simple and effective at restoring normal ovulation. Before any treatment can be offered, it’s very important to perform certain tests in order to establish the actual cause. These tests include an ultrasound scan of the ovaries and womb, and blood tests to measure a range of hormones including thyroid, prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone and other androgens (male hormones). In some cases failure of ovulation is due to¬†ovarian failure. This may occur following treatment for cancer or may be the start of the menopause – premature ovarian failure. In this case if the hormone, FSH level is high (more than 20 mIU/mL when measured at the start of a period), and AMH level is low (less than 1pmol/l), ovarian failure is likely. In this case drug treatment will not help, and your doctor will discuss alternative options.

If there are no indications in the medical history of any problems with the fallopian tubes (eg, no history of abdominal surgery, pelvic inflammation and/or history of Chlamydia infection), a test for tubal patency (to check that the fallopian tubes and open) may be deferred until ovulatory cycles have been achieved for three months.

If, however, injections of gonadotropins are required, assessment of the tubes by either X-ray examination (HSG) or ultrasound test (Hycosy) would be carried out.

If you are not ovulating, then drugs may be administered with the onset of menstruation to stimulate egg production. This would initially be in tablet form, but if this is not effective then more powerful fertility injections may be necessary to stimulate egg production in the ovaries.

Ovulation induction medications, often referred to as fertility drugs, are used to stimulate the follicles in your ovaries resulting in the production of multiple eggs in one cycle. The medications also control the time that you release the eggs, or ovulate, so sexual intercourse, intrauterine insemination (IUI), and in vitro fertilisation (IVF) procedures can be scheduled at a time that is most likely to achieve a pregnancy.