Treatment Options

Ovulation Induction

Ovulation induction medications, often referred to as fertility drugs, are used to stimulate the follicles in your ovaries resulting in the production of one or more eggs in a cycle.

Ovulation Induction

Ovulation induction medications, often referred to as fertility drugs, are used to stimulate the follicles in your ovaries resulting in the production of one or more eggs in a cycle. The medications also control the time that you release the eggs or ovulate, so sexual intercourse, intrauterine insemination, and in-vitro fertilization procedures can be scheduled at the most likely time to achieve pregnancy.

There are risks associated with the use of ovulation induction medications including an increase in the chance for multiple births and the development of ovarian cysts. A rare side effect that may occur is Ovarian Hyperstimulation Syndrome (OHSS); symptoms include severe pain in the pelvis, abdomen and chest, nausea, vomiting, bloating, weight gain, and difficulty breathing. The medications most commonly used in fertility treatment are clomiphene citrate, Letrazole, gonadotropins, and hCG.

The purpose of “super-ovulating drugs” is to stimulate the ovaries to produce more than one egg. Follistim, Gonal-F (FSH), and/or Menopur (HMG) are given as an injection once or twice a day to recruit multiple eggs.

Commonly-used Medications

Tablets

Clomiphene Citrate
Letrazole
Gonadotropins
Human Chorionic Gonadotropin (hCG)

Injections

Follistim
Gonal-F (FSH)
Menopur

Ultrasound

After receiving tablets and/or injections for approximately five days, a transvaginal ultrasound will be performed at RFC. Our specialist will use ultrasound waves to project a white image on the monitor to monitor the number of follicles and their development. Follicles are round sacs of fluid within the ovaries. Therefore, the follicles appear as dark circles on the ultrasound screen. Most follicles should contain an egg; however, the eggs cannot be seen during the ultrasound. In some cases, the follicle has no eggs and in others the follicle contains more than one egg. The number of follicles, therefore, does not correspond to the number of eggs.

Treatment

Treatment begins on approximately Day 2, 3, or 4 of your menstrual cycle. You may undergo frequent blood samplings to determine your estradiol level. This level is used to individualize your medication treatment for that afternoon and the following morning. Estradiol is produced by the lining of the follicle. Additional laboratory testing, such as LH, FSH, and/or progesterone levels, are used to monitor follicular development. After physician review of your estradiol numbers, you will be notified of any change in your medication dosages.

Retrieval

When your fertility doctor determines that you are ready for retrieval, you will be given instructions on how to administer an injection of hCG, Ovidrel, or Novarel. This injection is given late in the evening approximately 35 hours prior to retrieval. This medication ripens the developing eggs and initiates ovulation. Ovulation occurs about 42 to 48 hours from the time of injection if you do not have an egg-retrieval procedure. Many patients experience abdominal discomfort after the hCG due to ovarian enlargement and are convinced that they are ovulating. Rest assured that we are monitoring you very closely, and the chance of ovulating prior to retrieval is extremely slim, and almost zero if you are receiving Lupron, Antagon or Cetrotide.

Sexual abstinence too long before retrieval (more than five days) or relations too close to retrieval (24 hours) could possibly decrease the quality of the semen sample. If you did not have sexual relations the day before hCG, we recommend that you do the day of hCG. If your husband has a low sperm count you may need a 4-5 day period of abstinence. Your fertility specialist will discuss this with you early in your cycle, should you have any questions regarding this matter.