Ovulation Induction

Problems with ovulation is one of the most common causes for fertility issues in women1. If an egg is not released from the ovary, then it can’t get fertilised in order to make a baby. While it may be concerning if you’re not ovulating regularly, (sometimes due to a fertility related condition such as PCOS) there is a treatment available that could help encourage ovulation in order to get pregnant through intercourse. Here we’ll explore the treatment called ovulation induction and how it works. 

What is ovulation induction?

Ovulation induction is a medical treatment that helps encourage ovulation. It’s also known as stimulated cycles, as you take medication that stimulates the production of eggs in your ovaries. The response of the medication is monitored by ultrasound, and intercourse would be advised when the follicles in your ovaries reach an appropriate size.

Why is ovulation induction needed?

Ovulation induction is a common treatment that can be administered if a woman isn’t ovulating naturally. Reasons for not ovulating could be due to:

  • Stress. Stress can disrupt your reproductive hormone production, so that the hormone meant to trigger ovulation may not be produced2
  • PCOS (polycystic ovarian syndrome). PCOS may cause raised levels of LH (luteinising hormone). LH is what triggers ovulation, however abnormal levels can have a negative impact on your ovaries3.  
  • Thyroid hormone disruption. Low or high levels of thyroid hormones can disrupt your reproductive hormones which may contribute to missed or irregular ovulation4
  • Irregular cycles. With irregular cycles it can be harder to determine when you’re ovulating when your cycle length varies month to month2.

How is ovulation induction performed?

In some cases, medication can be administered to help stimulate ovulation5. The two main types of ovulation induction include: 

  • An oral medication, such as clomid, tamoxifen or letrozole. These act by increasing the production of FSH (follicle stimulating hormone) which will in turn stimulate follicle growth and ovulation.  
  • Daily injections of gonadotropins. Drugs like Menopur or Gonal F contain FSH which would help stimulate follicle growth.

Both of these regimens would require ultrasound scans to monitor the response in the ovaries. The ultrasound may be performed with a transvaginal wand that goes through your vagina and presses upwards to visualise your ovaries. You may need to attend multiple appointments over the course of a few days in order to be monitored accurately. When the dominant follicle in your ovary has reached the appropriate size intercourse is advised or a trigger injection could be administered to facilitate the timing of intercourse.

What are the risks of ovulation induction?

Response to the treatment is very individual and sometimes cycles may be cancelled if the response is insufficient or too strong. If you respond well to the treatment, your doctor may recommend continuing treatment for up to six consecutive cycles. 

Some medication can cause undesirable side effects like bloating, nausea, headaches and hot flashes. Always consult with your doctor if you have any concerns regarding the medication. 

How do I access ovulation induction?

If you have any concerns about your menstrual cycle or have a known cause of ovulation problems like PCOS, you should get in touch with your GP if you’re trying to conceive. Your GP can arrange to have some tests done to determine if you’re eligible for ovulation induction.

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