Definition and Overview

Ovulation induction, as the name implies, is a process that stimulates female ovulation through the use of medication. It is a form of hormonal therapy that promotes the development of ovum, or eggs, as well as its release. This process is mostly performed to boost the patient’s reproductive capabilities, but can also be recommended for women who do not or cannot ovulate on their own. Ideal candidates for this procedure include women with irregular menstrual cycles such as those who are suffering from endometriosis and other similar conditions.

In the field of fertility treatments, ovulation induction can be used to increase the number of eggs that mature inside the woman’s body in a single cycle, and thus increasing the chance of successful fertilization and conception. In women looking to normalize their menstrual cycles, ovulation induction produces healthy eggs.

Women suffering from PCOS, or polycystic ovarian syndrome, can also benefit from ovulation induction, even if they are not seeking for fertility treatments. PCOS patients often suffer from irregular menstrual cycles, increased body hair, and other such hormonal issues, which could be corrected with the medication used in this procedure.

Many individuals confuse ovulation induction with controlled ovarian hyperstimulation, a somewhat similar procedure (medications used in both procedures are the same) that aims to stimulate the development of mature ovarian follicles and eggs. But unlike controlled ovarian hyperstimulation, ovulation induction can be performed on women who want to take a proactive step toward improved reproductive and hormonal health, and women who want to increase their chances of successful conception.

Who Should Undergo and Expected Results

Women who are suffering from hormonal issues such as PCOS can undergo the procedure. When a patient suffers from this condition, her hormones are rendered out of balance, and can cause various problems, ranging from irregularity of menstrual cycles to fertility issues. The syndrome can also cause undesirable changes in one’s physical appearance, and eventually lead to more serious health issues, such as heart disease and diabetes.

In patients with PCOS, their ovaries produce slightly abnormal amounts of androgens or male sex hormones. Unbalanced levels of androgens and estrogens can result to acne breakouts, excessive facial and body hairs, and interrupted ovulation.

Women who are suffering from infertility issues can also undergo this treatment to ensure that more eggs reach maturity, thus increasing the chances of successful conception.

If the patient experiences PCOS symptoms such as acne breakouts, inexplicable weight gain, growth of excessive, thick, and darker hair on the face and various parts of the body, thinning hair on the scalp, irregularities in the menstrual cycle, and fertility issues, it is best to consult with a gynaecologist.

Ovulation induction, when performed properly, should resolve all the issues mentioned above.

How is the Procedure Performed?

Ovulation induction is essentially a hormone therapy that involves the use of medication. The first step in this treatment method is to consult a gynaecologist who can order several imaging tests (such as ultrasound) to confirm the cause of irregular menstrual cycles and infertility issues. The doctor will then prescribe a specific medication to address the problems.

Among the possible drug prescriptions that the patient will receive include Clomid (clomiphene citrate or Serophene), injectable gonadotropins, femara or letrozole (which are essentially aromatase inhibitors), injectable follicle stimulating hormones, bromocriptine, and GnRH pumps.

When gonadotrophins are used, the doctor will also employ vaginal ultrasound procedures to monitor the patient’s response to the drugs and examine the number of follicles present in the ovaries and whether they have matured. If the patient is seeking for improved fertility, the doctor can inject another hormone, known as hCG (or human Chorionic Gonadotrophin) to trigger the final development and release of the eggs. The doctor will then advice the patient to time intercourse at the moment of ovum release.

Possible Complications and Risks

The medications used in ovulation induction can come with various side effects. Clomid, for example, can cause hot flashes, bloating, and discomfort in the abdominal area during ovulation. In rare instances, patients reported feeling excessive tiredness, vomiting, nausea, headaches, dizziness, and a sensation of light-headedness.

Follicle stimulating hormones, on the other hand, can cause mood swings, tenderness in the breast, abdominal cramps, bloating, and nausea. These side effects can be considered normal since the body is readjusting its hormone levels, as prompted by the medication.

Increasing the number of mature follicles in the ovary can be desirable to many couples, but normal sexual intercourse will not be advised by the doctor if the number of mature follicles grew too many. A higher number of mature follicles can increase the possibility of multiple pregnancies, which might not be a welcome result to some couples.

Some studies also show that fertility medication, such as those use in ovulation induction, can be linked to cancers in the cervix, ovary, and the breasts.

References:

  • Falcone T. Women's health. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2010. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2010:section 14.

  • Fritz MA, Speroff L. Induction of ovulation. Speroff L, Fritz MA, eds. Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011:chap 31.

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