Ovulation Medicine for Ovulation Induction and Superovulation
Some causes of infertility can be effectively treated with ovulation medicine known as ovulation induction - or superovulation therapy combined with timed relations or artificial insemination.
Ovulation induction therapy is focused on achieving a healthy ovulation and
depending on the diagnosis, the ovulation of multiple eggs. Inducing
the release of more than one egg can dramatically increase a woman's
per cycle chance of pregnancy. Ovulation medicine is used to induce
ovulation; increasing the number of eggs a woman produces each month
(normally it is one). At the appropriate time, sperm are introduced
into the vagina/cervix through timed relations or into the uterine
cavity by a process called intrauterine insemination
or IUI also known as artificial insemination).
How Ovulation Induction Therapy Works
- The first step in superovulation therapy is to administer medications
which should enhance the development of a mature egg(s) produced
by the ovaries.
- During the normal reproductive cycle, two hormones
- follicle stimulating hormone (FSH) and luteinizing hormone
(LH) - are required to initiate and complete the process of
egg maturation. Medications are administered to women either
orally or by injection to increase levels of both LH and FSH.
- Fertility is then further enhanced by monitoring the development
of eggs in the ovary using an ultrasound. These ultrasounds are
most commonly performed transvaginally and allows the doctor to
monitor the development of follicles. Follicles are fluid filled
sacs within which an egg develops.
- Once the follicle or follicles have reached the appropriate size
to contain a mature egg a single injection is given to trigger ovulation.
This helps us provide optimal timing for fertilization and hopefully
a pregnancy.
- The patients are then instructed to have timed relations over
the next two days to coincide with the superovulation. If the patient's
treatment plan requires intrauterine insemination and not timed
relations, the intrauterine insemination is then performed within
the next two days. With intrauterine insemination, the semen sample
is prepared in a way that allows us to place an enriched, highly
motile concentrate of sperm directly into your uterus through the
cervix. This procedure involves the use of a very small tube to
pass the sperm beyond the cervix to optimize sperm delivery. By
performing a well timed intrauterine insemination (IUI) with prepared
concentrated semen from your partner or a donor we have optimized
timing and sperm delivery to give the best sperm concentration around
the egg and the best chance for success.
- Following two days of insemination we will confirm adequate hormone
concentration to support implantation using a simple blood test
5-7 days later. If these levels are low your Doctor will recommend
hormonal supplementation.
As a result of this treatment path there is an increased likelihood that ovulation will occur at the right time and that sperm will reach the egg(s) to complete fertilization and hopefully a pregnancy. For many couples the chances of pregnancy approaches 20% with a single month of therapy.
Medicine used for Ovulation Induction and Superovulation Therapy
- Clomiphene citrate - (Clomid® or Serophene®) is a pill
which can be taken orally to induce ovulation and the process of
egg maturation. We monitor the effect of this medication on the
ovaries using an ultrasound.
- Gonadotropins - are injectable medications which are taken
using a very small needle for injection beneath the skin. These
ovulation medications are known by the following trade names:
- Gonal-F®
- Follistim®
- Bravelle®
- Menopur®
These superovulation medications are all different forms of Follicle Stimulating Hormone - the most important hormone for the development of healthy eggs. Follicle Stimulating Hormone (FSH) is naturally made by your body in the pituitary gland and by giving yourself additional FSH you can help your own body improve egg production.
Injectable medicines are more powerful than the oral medication and
tend to produce a larger number of eggs. To assess the process of
egg maturation while you are being treated with these medications,
several (2-3) ultrasounds and blood samples are needed to monitor
the safety and likelihood of success of these ovulation medications.
Medications Used to Induce Ovulation (Egg Release)
Your body naturally releases another hormone call Luteinizing hormone to trigger egg release. There are two additional medications we use to do this at the best time in your ovulation induction cycle:
- hCG (human chorionic gonadotropin) This is an ovulation
medicine given via injection which can be used to trigger egg release.
Commercial brands are known as:
- Ovidrel® -this is a synthetic human pregnancy hormone which can be used to trigger egg release. It is available as a pre-filled injection on a very small needle.
Medications used to support implantation and an early pregnancy
Your body naturally releases two additional hormones which support implantation and an early pregnancy known as estrogen and progesterone. Some women do not produce enough of these hormones and we recommend supplementation to optimize the chances for a pregnancy. These medications are called:
- Estrace® This is a form of estrogen which can be taken orally to support implantation and early pregnancy
- FemTrace® This is another preparation of estrogen which can be taken orally to support implantation and early pregnancy
- Prometrium® This is a form of progesterone which can be taken orally to support implantation and early pregnancy
- Endometrin® This is a form of progesterone which can be taken orally to support implantation and early pregnancy
Learn more about intrauterine insemination (IUI)
Contact
us for more information about ovulation medicine for ovulation induction/superovulation.
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