What is Ovulation?
Ovulation is that stage of a woman’s menstruation cycle when the ovarian follicle releases an egg. Ovulation is critical because a woman is most fertile during this time and likely to conceive. Conception happens if the egg that travels down the fallopian tube meets the sperm and becomes fertilized. for women facing the problems related to fertility needs the Best IVF Doctor in India. Most women attain their puberty around the age between 10 to 15 and at the same time, they start ovulating. The ovulation stops when the woman reaches her menopause. Typically, ovulation occurs 14 days before the start of your period. So on an average, it is normal for women to ovulate i.e. release the egg from the ovaries anywhere from 12-18 days before their period starts.
What is Ovulation induction treatment?
There are cases where women menstruate without ovulating or do not ovulate normally. In such cases, doctors prescribe medication to induce ovulation by encouraging eggs to develop in ovaries and be released, increasing the chance of pregnancy through timed intercourse or artificial insemination. This is called ovulation induction treatment. This treatment option is most commonly used for women with PCOS, endometriosis, unexplained infertility, and ovarian dysfunction. In order to benefit from the treatment, the woman must have a normal uterine cavity, at least one normal fallopian tube, and her partner must have a normal sperm count.
For induction purpose, doctors may prescribe orally ingested medications or injectable medications along with intrauterine insemination (IUI). The aim is ideally to use safe but highly efficient stimulation methods to achieve high success rates for conception while minimizing the risks of triplets or more. Doctors also use blood tests and ultrasound method simultaneously to decide the best time for conception. Women with PCOS often react very sensitively to fertility medication, the possibility of multiple follicle production and multiple pregnancies increases. Therefore, regular monitoring with ultrasound method and hormone measurements is vital to ensure that only one or two follicles are developing.
The method of ovulation induction allows an egg to mature and be released by the ovary. Compared to ovarian stimulation for IVF and ICSI that aims to produce many eggs for collection, ovulation induction aims to stimulate just a couple of eggs in women who are not ovulating normally.
Naturally, without any induction or stimulation, a woman typically ovulates a single egg each month. On rare circumstances, a woman’s ovaries may spontaneously release 2 eggs in any given cycle, which can lead to non-identical twins. By stimulating ovulation, multi-follicular growth and ovulation can be targeted for the ovulation of multiple eggs in one cycle. When several eggs are ovulated at once, the chances of conception are also boosted.
Ovulation Induction Medication
When ovulation does not occur, then doctors prescribe medications with the onset of menstruation to stimulate egg production in ovaries. If tablets are not working for you, then your doctor may recommend fertility injections to induce egg production. Here are a few common medications that are known to regulate or trigger ovulation and prescribed by doctors to treat anovulation or the cessation of ovulation.
- Gonadotropin: Human gonadotropins help eggs mature and to push for their release during ovulation.
- Human menopausal gonadotropin: These medications are usually injected to stimulate the ovary to produce multiple eggs for ovulation.
- Clomiphene citrate: This is an oral medication that works by increasing pituitary secretion of FSH and LH hormones and thus, stimulating ovarian follicles.
- Letrozole: Letrozole temporarily lowers a woman’s level of the hormone progesterone to stimulate ovum production.
- Metformin: For women with PCOS, metformin is commonly used as an induction medication to treat insulin resistance and increase the chances of ovulation.
- Ovarian drilling: Also in women with PCOS, this invasive treatment may be used by doctors that require laparoscopy to be carried out. In ovarian drilling, 4mm length holes (usually 4 per ovary) are drilled into the ovary to help induce ovulation.
- Bromocriptine and Cabergoline: These medications are used in cases of hyperprolactinemia.
The fertility drugs used for induction not only increase your chances of having twins or triplets but may also trigger some side effects, including:
- Heavy periods
- Vaginal dryness
- Abdominal pain
- Hot flushes and mood swings
- Tenderness in the breasts
- Increased urination
It is best to consult your doctor if any of the side effects turn severe so that he/she may prescribe an alternate medication to you.
Your induction treatment usually begins on day three or four of your menstrual cycle and lasts approximately eight to ten days. The doctor will tell you how to take your medications at home. The total number of sessions with the Best IVF Doctor in Delhi will approximately be two to four clinic appointments for blood tests and/or vaginal ultrasounds to monitor your response and adjust your medication dose accordingly.