Learn about ovulation induction, a key infertility treatment that stimulates ovulation, enhancing your chances of pregnancy.
Dr Abdul
Ovulation induction is a highly successful infertility treatment in India, helping couples improve their chance of conception. Ovulation induction, one of the less invasive infertility treatments, has a 20 to 40% success rate per cycle. With 3 to 6 cycles, your chances of a successful conception increase to almost 60 to 80%.
In this article, we help you learn more about ovulation induction protocols and their risks.
Ovulation induction is a female infertility treatment for those who face irregular or absent ovulation. The treatment uses a mix of injectable and oral medicines to increase the chances of a successful pregnancy.
It is a straightforward process and begins with a detailed examination of your medical history and fertility tests. This helps your doctor customise a treatment plan suited to your health needs. Female infertility disorders like Polycystic Ovary Syndrome (PCOS), an absence of a proper diet or excessive physical activity can cause anovulation.
Medicines like clomiphene citrate, gonadotropins, and letrozole regulate or stimulate egg development. Sometimes, using a combination of other treatments like intrauterine insemination (IUI) and in vitro fertilisation (IVF) can also improve fertility. The end goal of a female infertility treatment protocol with ovulation induction is to help you ovulate and get pregnant.
Sometimes, your body can act as a barrier between you and your dream to conceive. While there are many tests required to know what causes female infertility, the following symptoms of infertility in women are the most common signs that ovulation induction might be needed.
Anovulatory Cycles
Anovulation happens when no egg is released from your ovary. This results in irregular or no periods. Ovulation induction helps regulate the release of eggs, improving your chance of a successful pregnancy.
Polycystic Ovarian Syndrome (PCOS)
Did you know that PCOS affects nearly 22.5% of women in India? PCOS, or hyperandrogenic anovulation, refers to a condition where elevated male hormones (androgens) along with irregular or no ovulation disrupt the normal menstrual cycle. It is marked by irregular periods, weight gain, and anovulation.
Ovulation induction in PCOS helps regulate ovulation, improving the chances of a successful pregnancy.
Unexplained Infertility
While some infertility disorders are identifiable and treatable, others remain undiagnosed even after extensive testing. In such cases, ovulation induction is often the first line of treatment.
Contraindications for Ovulation Induction
Despite medical advancements, certain medical conditions are not suitable for ovulation induction.
Large ovarian cysts can interfere with your body’s response to ovulation induction drugs, reducing their effectiveness.
Endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, can also hinder the response to ovulation induction, especially in severe cases.
Blocked fallopian tubes prevent eggs from reaching the uterus, making ovulation induction ineffective for conception.
A history of Ovarian Hyperstimulation Syndrome (OHSS) may make ovulation induction risky, as it could trigger
Uterine abnormalities or conditions like ovarian cancer can render ovulation induction unsuitable, potentially reducing the success of the procedure..
Ovulation induction protocols use specific drugs to help treat infertility in women. They are:
Clomiphene Citrate
This oral drug helps stimulate your pituitary gland in the brain to increase the production of both follicle-stimulating (FSH) and luteinising hormone (LH). It improves the development of eggs and regularises ovulation in women with hormonal imbalances.
Letrozole
Letrozole, also known as Femara, is another oral drug used during an ovulation induction treatment protocol. It is used for women suffering from PCOS. The drug has proved to be very effective in stimulating ovulation and improving the chances of conception. Many doctors also administer Letrozole as an alternative to Clomiphene in case of side effects from the latter.
Gonadotropins
Unlike other ovulation induction medicines, Gonadotropins are an injectable drug that directly stimulates the ovaries. It helps increase the production of sex hormones— testosterone in men, and oestrogen and progesterone in women.
Gonadotropin injections include a mix of FSH and LH, which may improve your chance at conception.
Sometimes, ovulation induction medications do not work or are not advisable. Therefore, alternatives are used. One of them is Laparoscopic Ovarian Drilling (LOD.) It is a minimally invasive surgery also known as ‘whiffle ball’.
Laparoscopic Ovarian Drilling
If you have PCOS, your ovaries may have a thick outer layer that can lead to increased production of testosterone. In cases that cannot be treated through medication and injections alone, LOD is used to make small holes in the ovary. The small incision allows doctors to use a camera to observe your ovaries. The effects of drilling are temporary, usually lasting from 6 months to 2 years.
Ovarian drilling helps break the thick outer barrier and reduce the amount of testosterone produced. It is a one-time treatment that helps regulate your monthly menstrual cycles by getting your ovaries to release an egg. It also increases your chances of getting pregnant.
Monitoring Ovulation Induction Treatment
Ovulation induction treatments use drugs and injections as a part of therapy. These help stimulate egg development and release in infertile women. Despite the treatment being safe and minimally invasive, monitoring the ovary’s response is essential. It reduces the risk of unnecessary complications.
Since no one dosage works for all patients, a combination of blood oestrogen (E2), ultrasound, and urinary luteinising hormone (LH) is used and monitored in all patients.
Risks and Side Effects of Ovulation Induction
The journey from infertility to parenthood is filled with both risks and challenges. While the end goal is rewarding, the experience can take a toll on your physical and mental health. Here are some common ovulation induction side effects:
You may experience bloating and discomfort in your abdomen caused due to enlarged ovaries. This is also known as Ovarian Torsion.
Hormone-stimulating drugs can trigger hot flashes and mood swings.
Ovulation induction stimulates the increase of oestrogen levels in your body. This can cause breast tenderness, nausea, headaches, and fatigue.
Injectable drugs like Gonadotropins can cause redness, swelling, or pain at the injected site.
You may also be more likely to carry twins or triplets, which may increase pregnancy complications.
A rare but possible side effect of ovarian induction is Ovarian Hyperstimulation Syndrome (OHSS). It can cause fluid build-up in the abdomen and chest making breathing difficult.
Success Rates and Considerations
Pregnancy is more than just a sign of fertility in women. It is an experience that helps give you the power to bring new life into the world. Ovarian induction treatments help countless couples realise this dream of theirs. It allows couples dealing with infertility issues to conceive naturally without the need for additional assisted reproductive treatments.
The success of your treatment is defined by factors like age and overall health. The ovulation induction success rate is commonly around 20 to 25%. Healthier women have a higher chance of successful conception, up to almost 40%.
Ovulation induction is a beneficial option for infertile women wishing to conceive or those suffering from conditions that make it difficult for them to conceive naturally. It is not only less complex as compared to other infertility treatments but also more cost-effective, giving couples a ray of hope at parenthood.
FAQs
Infertility in women can arise from various factors, including ovulation disruptions, hormonal imbalances, age-related decline in fertility, weight-related lifestyle issues, uterine conditions like fibroids or polyps, and unexplained infertility. Habits such as smoking, excessive alcohol consumption, and stress can also contribute. Underlying conditions like thyroid disorders, endometriosis, and blocked fallopian tubes can affect fertility as well.
A.) There can be many reasons for a failed treatment. The most common causes are stress, PCOS, weight issues, and disorders in the pituitary or thyroid gland. In severe cases, ovulation may also fail due to an ovary failure.
A.) Usually, ovulation begins within 36 hours of the HCG shot, which is taken after the egg has matured and is released from the follicle.
A.) If your body responds well to the hormone-stimulating drugs, you can continue the treatment for 6 cycles. However, it is important to remember that multiple cycles expose you to continued risks and side effects from the drugs. You are also at risk of multiple pregnancies after continuous ovulation induction treatment cycles.
A.) Understanding your body and menstrual cycle is the first step to learning your ovulation cycle. Irregular or absent periods, difficulty in getting pregnant even after trying for a year, and excessive weight gain are common symptoms. You can also get a health check-up to confirm the diagnosis.
After ovulation induction, you may try to conceive naturally with your partner. If natural conception is challenging, assisted reproductive techniques like intrauterine insemination (IUI) or in vitro fertilisation (IVF) may be considered. Your doctor will guide you on the best approach based on your unique situation.
