Fertility Basics – Ovulation Induction & "Artificial Insemination"
Fertility basics have to include knowing when to get help if you’re trying to get pregnant and it’s not working.
The recommendation for women, from ASRM (American Society of Reproductive Medicine) is one year of properly timed sexual intercourse under the age of 35 and six months over the age of 35. Properly timed intercourse means while you are ovulating– if you’re not sure when that is, there are simple formulas to use if your menstrual cycle is regular and ovulation kits to use if it is not.
One hesitation frequently expressed as the reason in delaying making an appointment with a fertility specialist (board certified Reproductive Endocrinologist) is “I don’t want too much, too fast”. An understandable concern. Keep in mind, not everyone who goes to a fertility specialist ends up having to have IVF (in vitro fertilization). There are tools that we use that are less invasive, less expensive and highly effective.
A little clarification here– you may be familiar with the term "artificial insemination". Rest assured, there is nothing artificial about an insemination. There is sperm and an egg– completely natural. An insemination, more accurately referred to as an IUI, intrauterine insemination, places the sperm so that it can meet the egg.
If you have been trying unsuccessfully to have a baby, make an appointment with a board certified Reproductive Endocrinologist. The answer may be as simple as adjusting when you have sexual relations. The answer may be as simple as just a little bit of help.
Let us help you find out what you need to have the family that you want. That’s why we’re here.
Ovulation Induction or Superovulation
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 within intrauterine insemination (IUI) can dramatically increase a woman’s per cycle chance of pregnancy.
How Ovulation Induction Therapy Works
- The first step in superovulation therapy is to administer medications to enhance the development of a mature egg(s) by the ovaries.
- The development of the eggs in their follicles (fluid-filled sacs) in the ovary is then monitored by transvaginal ultrasound.
- Once the follicles have reached the appropriate size to contain a mature egg, an injection is given to trigger ovulation.
- Patients then have scheduled sexual 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.
- A simple blood test done five to seven days later confirms whether your hormone levels are appropriate. If necessary, your fertility specialist will prescribe hormonal supplementation.
The goal of ovulation induction is to ensure that ovulation will occur at the same time that the sperm will reach the egg(s). This increases the likelihood that fertilization will occur and hopefully result in a pregnancy.
Medications Used for Ovulation Induction
- Clomiphene citrate (Clomid® or Serophene®)
- Gonadotropins are medications that are injected using a very small needle. These medications, which are used to stimulate follicle development, are known by the following trade names: Gonal-F®, Follistim®, Bravelle®, Menopur®
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®
IUI Program (Intrauterine Insemination)
What is IUI?
Intrauterine insemination (IUI) serves three basic purposes:
- IUI therapy places a high concentration of sperm into the uterus, decreasing the distance the sperm needs to travel and increasing the chance of sperm reaching the egg to achieve fertilization.
- By getting a higher number of sperm high into the female reproductive tract, it helps overcome mild to moderate male factor fertility problems.
Additionally, when combined with ovulation induction or superovulation, IUI can treat many causes of infertility. Among them:
- Ovarian dysfunction (irregular ovulation)
- Infertility associated with endometriosis (a painful inflammatory condition of the female pelvis)
- Cervical factor infertility (related to prior surgery)
- Unexplained infertility (infertility in which the exact cause cannot be identified).
- Polycystic ovarian syndrome (a common female endocrine disorder)
IUI is an effective treatment for both male factor fertility problems and unexplained infertility where all other testing is normal. For patients with unexplained infertility where all other testing is normal, intrauterine insemination (IUI) combined with ovulation induction/superovulation can as much as double a couple’s chance for pregnancy.
Most physicians recommend between three to six IUI attempts (if there are no underlying problems such as blocked fallopian tubes) before moving on to more advanced treatment.
Ovulation Induction and intrauterine insemination (artificial insemination) are a simpler, more basic way to start fertility treatment.
We know that a baby is your goal. It’s our goal too.
We’re here to help.
About Lisa Rosenthal
Lisa has over thirty years of experience in the fertility field. After her personal infertility journey, she felt dissatisfied with the lack of comprehensive services available to support her. She was determined to help others undergoing fertility treatment. Lisa has been with RMACT for eleven years and serves as Patient Advocate and the Strategic Content Lead.
Lisa is the teacher and founder of Fertile Yoga, a program designed to support men and women on their quest for their families through gentle movement and meditation.
Lisa’s true passion is supporting patients getting into treatment, being able to stay in treatment and staying whole and complete throughout the process. Lisa is also a Certified Grief Recovery Specialist, which is helpful in her work with fertility patients.
Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association (now Path2Parenthood), where she was Educational Coordinator, Conference Director and Assistant Executive Director.