Ovulation induction is the process by which medications are given in order to help women ovulate. For women who do not ovulate at all or ovulate irregularly we use medications to assist with the development of a mature egg. Medications used to induce ovulation include oral medications such as clomiphene citrate or letrozole, or injections called gonadotropins. Depending upon the situation, one of several infertility treatments may be recommended.
In women who do not ovulate, oral medications are often first line treatment due to ease of oral administration, fewer side effects, lower cost, decreased risk of multiple pregnancy, and reduced monitoring. If the woman has tried an oral medication without successful ovulation, the next step may be to try ovulation induction with injectable gonadotropins. Clomiphene or gonadotropins may be used along with intrauterine insemination (IUI) or in vitro fertilization.
In most cases, you will take the clomiphene or give an injection of gonadotropins once per day, in the evening (between 5 pm and 8 pm, for example). The pill is taken orally and the injection can be given under the skin in most cases. After taking the clomiphene or after a few days of injections, you may be asked to have a pelvic ultrasound to measure follicle growth, and possibly a blood test to measure hormone levels. Depending upon the results of these tests, the medication dose may be increased or decreased. Blood testing and pelvic ultrasound may be repeated during a cycle. For women who do not ovulate on their own, the goal is to have one follicle grow. It is possible that a cycle could be cancelled if too many eggs grow due to the risk of multiple pregnancies. In some situations, the cycle may be converted to in vitro fertilization, so that the clinician can control the number of embryos that are placed in the uterus.
For women who do not ovulate on their own, the goal is to have one follicle grow. It is possible that a cycle could be cancelled if too many eggs grow due to the risk of multiple pregnancies.
The side effects of these medications are usually minimal. The side effects include but are not limited to hot flashes, night sweats, sleep disturbances, headaches, fatigue, mild nausea, abdominal discomfort, and mood changes. In rare cases, ovarian hyperstimulation syndrome (OHSS) can occur, however, this is not common. See our glossary for more information on OHSS.
For women who already ovulate but have infertility, the same procedures outlined above can be utilized to increase the number of eggs ovulated per cycle. This process is called superovulation or controlled ovarian hyperstimulation (COH).
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