Ovulation Induction through Fertility Medications
Fertility drugs are used to stimulate, regulate, and correct ovulatory problems. These medications are used during a treatment cycle, which includes ovulation, induction, cycle monitoring, triggering ovulation, and determination of pregnancy with a blood test. The two types of cycles are in vitro fertilization (IVF) and intrauterine insemination (IUI).
Why do women need ovulation induction?
Around 25% of infertile women have ovulation difficulties. These problems include the inability to produce a fully mature egg or failure to release the egg (ovulate). Fertility drugs are used to temporarily correct these ovulatory problems and increase chance of conception.
Who needs ovulation induction using fertility drugs?
Ovulation induction is used for:
• Women with polycystic ovary syndrome (PCOS).
• Women with inadequate production of luteinizing hormone and/or follicle stimulating hormone.
• Women with obesity, thyroid disorders, or eating disorders.
What is Clomid?
Clomid has been around a long time and used often. This drug works at the level of the hypothalamus (in the brain) to compete for estrogen-binding sites. The hypothalamus will read lower estrogen levels and then signal the pituitary to produce follicle-stimulating hormone (FSH), which stimulates the ovaries. Studies show that Clomid works best during the first three ovulatory cycles.
What is gonadotropin?
The gonadotropins are hormones that stimulate the ovaries to produce follicles (sacs which contain eggs). These substances are manufactured and released by the pituitary gland, which is at the bottom of the brain. The two main gonadotropins are FSH and luteinizing hormone (LH). The drugs that contain genetically engineered hormones include Menopur, Repronex, Bravelle, Follistim, and Gonal-F.
How is hCG administered?
Human chorionic gonadotropin (hCG) is given to mimic a surge of LH, as well as to stimulation ovulation following an injection of FSH. During stimulation, the patient must come to the office for blood tests and sonograms.
How are hormone drugs administered?
Most hormonal agents can be self-administered by subcutaneous injection into the thigh or abdomen. These medications are given using a pen injection system supplied by manufacturers. These injections must be given at the same time every day, preferably between 7 pm and 9 pm.
What are the side effects to fertility drugs?
Fertility drugs have several side effects. These may include:
• Multiple gestation (15%)
• Ovarian hyperstimulation syndrome (OHSS) (2.5%)
• Ectopic pregnancies (2%)
• Ovarian torsion (<1%)
• Mood swings
• Abdominal discomfort
• Nausea and vomiting
What complications are associated with fertility drugs?
OHSS is an excessive response by the ovaries to the fertility drugs. This can cause changes in vascular permeability and ovarian enlargement, leading to electrolyte disturbances, blood clots, and fluid in the abdominal cavity.
How does ovulation induction work?
Follicle-stimulating hormone release is induced by Clomid or Femara, or using subcutaneous injections of FSH. These drugs trick the brain into thinking the ovaries are not properly working, so the pituitary releases more FSH. This causes multi-follicular development.
What are trigger shots for ovulation induction?
To induce the rupture of the follicle and improve progesterone production, the fertility specialist will administer a trigger injection. This is done when the follicle reaches maturity, which is determined by size of follicle on ultrasound and bloodwork for LH level surge. An egg is released 24-42 hours after the trigger shot is given, which is optimal time for intercourse or artificial insemination.