Ovulation Induction (OI) Treatment for Infertility
An irregular menstrual cycle makes it difficult for a couple to conceive a baby. If you’ve been trying for a baby with no success, we have good news. Ovulation induction is a treatment that can improve the chances of pregnancy. You can opt for ovulation induction drugs or Ayurvedic medicines for ovulation induction.
What Is Ovulation Induction?
Nearly 40% of infertile women have problems with ovulation. But, there are remedies for this problem. Oral or injectable medications can help to stimulate the development of oocytes or eggs. The goal of ovulation induction is to increase the likelihood of conception by producing multiple eggs. Several forms of fertility treatments also use ovulation induction such as Intrauterine insemination (IUI) and In vitro fertilisation (IVF).
Normally, the process of ovulation produces just one egg. Ovulation induction stimulates multiple follicles in the ovaries and results in several eggs maturing at the same time. Ovulation induction in PCOS is a common treatment for the condition which is characterized by many ovarian cysts, irregular or missed periods and excess levels of androgens.
Women undergoing ovulation induction are frequently evaluated by the doctor using ultrasound and blood tests to monitor the development of follicles and the right time for egg retrieval or insemination.
Who Is Suitable for Ovulation Induction Therapy?
- Ovulation induction is suitable for women who have an absent or irregular ovulation cycle.
- It is the most common treatment for women with PCOS, a condition that interrupts ovulation.
- Women undergoing IVF are also treated with ovulation induction so that multiple eggs can be released for harvest and use in lab fertilisation.
- Women who experience unexplained infertility but have a regular ovulation cycle are also treated with ovulation induction to improve their odds of conceiving.
Doctors usually go through a number of factors before deciding on the use of ovulation induction. Some of these are:
- Disorders such as PCOS that directly interfere with normal ovulation
- Levels of hormones such as FSH, AMH and LH
- Conditions that have an indirect impact on ovulation such as obesity, eating disorders and thyroid disorders
- Amount of physical exercise
If women continue to experience irregular ovulation after the ovulation induction treatments, superovulation may be tried as the next step. Superovulation involves the use of human chorionic gonadotropin (hCG) hormone to release mature eggs.
What Is the Procedure of Ovulation Induction?
The ovulation induction procedure has four steps:
The ovulation cycle is assessed by a fertility specialist using blood tests. Ultrasound scans are used to observe follicle development in the ovaries along with the appearance of the uterine lining and its thickness.
Medication is used to stimulate the ovaries to prompt the growth of follicles containing eggs. The specialist decides the most appropriate medication or a combination of it and discusses it with the patient undergoing the treatment.
The cycle is monitored closely for follicle development using ultrasound and blood tests. This step is important to lower the chances of multiple pregnancies.
4. Artificial Insemination or Timed Intercourse
As the ovulation day approaches, the specialist performs artificial insemination. This is a relatively simple procedure that involves introducing sperm into the uterus. Alternatively, the couple can have sexual intercourse just before ovulation to maximise the chances of pregnancy.
What Medications Are Used for Ovulation Induction?
Medications used in ovulation induction treatments regulate the reproductive hormones and improve a woman’s chances of ovulation. Some of the most commonly used ones are:
- Clomiphene citrate or Clomid is used to stimulate ovulation in case the pituitary gland is functioning normal but monthly changes in the hormones do not occur. Clomid works by making the body think that the estrogen levels are inadequate, in turn prompting the pituitary gland to release Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) to the ovary. This stimulates the development of follicles and egg maturation. After Clomid usage is stopped, the LH surge will cause ovulation after 36 hours.
- Aromatase inhibitor, also known as Letrozole or Femara, is another medication used for OI. Letrozole works similar to Clomiphene citrate, hence it is often used as an alternative for the latter. Letrozole is also highly effective in women with PCOS.
- Gonadotrophin ovulation induction happens through two important hormones – Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). These hormones are normally produced by the pituitary gland and regulate egg production. Since their role in egg development is so crucial and powerful, gonadotrophin administration requires frequent monitoring compared to Letrozole and Clomiphene citrate. Gonadotrophins also carry with them the risk of multiple pregnancy and OHSS.
- Insulin-sensitizing agents, popularly known as metformin, are useful for PCOS patients who suffer from diabetes.
What Are the Benefits and Side Effects of Ovulation Induction?
Like all procedures, there are benefits and side effects to ovulation induction as well.
Ovulation induction, being a non-invasive treatment, is the first option used for the treatment of infertility. It is low-cost as compared to other treatments such as IVF which can burn a hole in your pocket with medication, lab testing, simple procedures and lab work. Ovulation induction can also boost the success rates of treatments such as intrauterine insemination (IUI), IVF, etc.
Risks and Side Effects
It’s also important to know that much time needs to be devoted to the treatment in the form of appointments with the doctor for ovulation induction injections, lab work and maintaining strict schedules to take the medications on time. A major risk of the treatment is Ovarian Hyperstimulation Syndrome (OHSS). OHSS can have mild to severe side effects which usually disappear in a few weeks on their own. These include:
- Loss of breath
- Weight gain
- Hot flashes
- Blurry vision
- Tenderness in the pelvic region
What Is the Success Rate of Ovulation Induction?
The success rate of healthy and fertile couples is generally 20% – 25% every month. In sharp contrast, couples who have infertility problems have a success rate of 2% – 10% per month. Factors such as diagnosis, patient’s age and duration of infertility also play a role. In some women, depending on the type of condition, the treatment can even restore fertility rates by 20% – 25%.
Ovulation Induction significantly improves the chances of pregnancy in women experiencing infertility. It also boosts the fertility rate for those couples using IVF and IUI.
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