This fact sheet explains the process of ovulation induction, which is commonly used as a first line of treatment to improve the chances of pregnancy for women who have irregular or infrequent menstrual cycles.

What is ovulation induction?

When an egg is released from one of the ovaries, this is known as ‘ovulation’. In women with regular menstrual cycles, this happens approximately once a month.

In some women, the follicles that hold the eggs don’t mature regularly and so the woman ovulates irregularly, rarely or not at all.

Ovulation induction is a straightforward fertility treatment that involves taking oral or injectable medication to stimulate regular ovulation. The medication is usually taken at the beginning of the menstrual cycle and the body’s response is monitored through the cycle using ultrasound. The clinician can then see when you are due to ovulate and therefore the best time for intercourse or insemination.

How is ovulation induction achieved?

The medications and dosages to induce ovulation are tailored to suit you as an individual. Your clinician will advise when you should start medications to stimulate the ovaries and will recommend a program of monitoring by ultrasound scans and sometimes blood tests.

The fertility drugs that you may need to take to induce ovulation include:

Follicle Stimulating Hormone (FSH – Puregon/Gonal F) daily injections stimulate the ovary to produce egg-containing follicles and encourage those follicles to mature.

Clomiphene citrate (Clomid) or Letrozole tablets trick the pituitary gland into producing more follicle stimulating hormone to help follicles develop. They are usually taken from day 2 to day 6 of the menstrual cycle.

Human Chorionic Gonadotrophin (hCG – Ovidrel/Pregnyl) injections are used once the follicles are mature to start ovulation.

Will I need other treatment combined with ovulation induction?

Every couple is unique and, depending on your fertility history and the man’s semen analysis, you may need additional treatments to increase your chance of becoming pregnant.

In simple cases, inducing ovulation and recommending sexual intercourse at the right time to coincide with that ovulation may be all that are needed. This is called Timed Sexual Intercourse (TSI) and the clinician will tell you the best times for intercourse based on your ovulation stimulation treatment and ultrasound scans.

Ovulation induction can also be combined with Intrauterine Insemination (IUI)(see separate fact sheet). This involves extracting sperm from the man’s semen sample, concentrating them in the laboratory and placing them directly into the uterus to coincide with ovulation. This approach can be useful even if the man’s semen analysis is not quite ideal as we can concentrate the sperm in the lab.

For IUI, the man usually produces a fresh semen sample at the Life Fertility Clinic, but it can also be used with thawed frozen samples including donor sperm.

A few hours later, once the sperm has been prepared, the woman attends the clinic for insemination, which is a simple procedure using a thin catheter inserted through the cervix (similar to having a pap smear).

Does ovulation induction have any risks?

For most women, ovulation induction is a straightforward process but, like all medical treatments, it has some risks.
The main risks are:

OHSS (Ovarian Hyper-stimulation Syndrome) – This is a rare problem where a woman over-responds to the ovulation induction and can experience symptoms including pain, bloating, nausea and vomiting. Symptoms range from mild to severe and, in worst cases, need urgent hospital treatment.

We minimise the risk of OHSS by monitoring your treatment cycle with ultrasound scans, and sometimes blood tests. If we see potential for OHSS to develop, we adjust or discontinue the medication. Your doctor will explain the symptoms to watch out for so you can let him/her know immediately if you experience anything worrying.

Multiple Pregnancy – When the ovaries are stimulated, it is possible for more than one follicle to mature and release an egg at the same time. This could result in a multiple pregnancy. Our ultrasound monitoring checks for this and we adjust or stop medication and/or recommend abstinence from intercourse if we see too many follicles developing.

Contact Life Fertility Clinic

The friendly and professional team at Life Fertility Clinic are happy to answer any other questions you may have about ovulation induction.