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  • Ovulation Induction or Superovulation

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    Ovulation Induction Superovulation

    Some causes of infertility can be effectively treated with ovulation medicine known as ovulation induction, or superovulation therapy, combined with scheduled relations or artificial means.

    What Is Ovulation Induction?

    The focus of ovulation induction therapy is to achieve healthy ovulation and, depending on the diagnosis, the ovulation of multiple eggs instead of just one each month. 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. Then, at the appropriate time, the sperm are introduced into the vagina either through scheduled relations, intrauterine insemination (IUI) or artificial insemination.

    How Ovulation Induction Therapy Works

    1.      The first step in superovulation therapy is to administer medications to enhance the development of a mature egg(s) 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. In superovulation therapy, medications are administered to women either orally or by injection to increase levels of both hormones.

    2.      The development of the eggs in their follicles (fluid-filled sacs) in the ovary is then monitored by transvaginal ultrasound.

    3.      Once the follicles have reached the appropriate size to contain a mature egg, an injection is given to trigger ovulation, providing the optimal timing for fertilization and, hopefully, a pregnancy.

    4.      Patients are then instructed to have scheduled relations over the next two days to coincide with ovulation. If, instead, the treatment plan requires intrauterine insemination, it is performed during the same two days. The semen sample containing an enriched, highly motile concentration of sperm is placed directly into the uterus through the cervix via a small flexible tube (catheter).

    5.      A simple blood test done five to seven days later confirms whether adequate hormone concentrations to support implantation exist. If the hormone levels are low, your fertility specialist will recommend hormonal supplementation.

    The goal of ovulation induction is to increase the likelihood that ovulation will occur at the right time and that the sperm will reach the egg(s) to complete fertilization and create a pregnancy. For many couples the chances of pregnancy through superovulation therapy approaches 20% with a single month of therapy.

    Medications Used for Ovulation Induction

    • 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.
    • Gonadotropinsare medications that are injected using a very small needle. 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 (FSH), the most important hormone for the development of healthy eggs. FSH is made by your body in the pituitary gland. By taking additional FSH, you can help your body improve egg production.

    Injectable medicines are more powerful than the oral medication and tend to produce a larger number of eggs. Two to three ultrasounds and blood samples are needed to assess the process of egg maturation and to monitor the safety and likelihood of success of these ovulation medications.

    Medications Used to Induce Ovulation (Egg Release)

    Your body naturally releases another substance called luteinizing hormone (LH) 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)is an ovulation medicine given by injection which can be used to trigger egg release. Commercial brands are known as:
      • Pregnyl®
      • Novarel®
    • Ovidrel®, 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 – estrogen and progesterone – which support implantation and an early pregnancy. 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®, a form of estrogen which can be taken orally to support implantation and early pregnancy
    • FemTrace®, another preparation of estrogen which can be taken orally to support implantation and early pregnancy
    • Prometrium®, a form of progesterone which can be taken orally to support implantation and early pregnancy
    • Endometrin®, a form of progesterone which can be taken orally to support implantation and early pregnancy

    Contact us for more information about ovulation medicine for ovulation induction or superovulation.

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