Ovulation Induction
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 multiple eggs in one cycle. The medications also control the time that you release the eggs, or ovulate, so sexual intercourse, intrauterine inseminations, and IVF / ICSI procedures can be scheduled at the most likely time to achieve pregnancy.
The most commonly prescribed fertility drugs include:
Clomiphene Citrate
If your basic infertility work-up indicates that you are not ovulating regularly or if you are ovulating very late or early in the cycle, clomiphene citrate is the most commonly used fertility drug.
Clomiphene Citrate is used to induce ovulation, to correct irregular ovulation, to help increase egg production, and to correct luteal phase deficiency. Clomiphene comes in 50/100 mg tablets. The usual starting dose is one tablet starting from day 2, 3, 4, of your cycle for 5 days. Ovulation usually occurs on cycle day 12 to 18. If clomiphene is not giving the desired outcome injectable hormones are prescribed.
Follicle Stimulating Hormone (FSH)
Follicle Stimulating Hormone (FSH) is used for the treatment of ovulation disorders and to stimulate follicles and egg production for Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), or other Assisted Reproductive Technology (ART) procedures.
FSH preparations require injections. Injections start on day 2, 3, or 4 at 75 IU (international units) to 225 IU or more per day. Dosage may be adjusted as the cycle progresses. This will be determined through blood (measuring estradiol levels) and ultrasound monitoring (measuring follicular growth).
Human Menopausal Gonadotropin (hMG)
Human Menopausal Gonadotropins (hMG) is used to stimulate the development of follicles in women who do not ovulate regularly and to stimulate ovulation for Intrauterine Insemination (IUI), in-vitro fertilization (IVF) and other assisted reproductive technology (ART) procedures.
hMG comes in ampules of 75IU (international units) or 150 IU(FSH and LH 1:1). It is given as subcutaneous/Intramuscular injection daily. Doses vary depending on patient response and type of treatment.
Gonadotropin-Releasing Hormone Agonists (GnRH agonist)
GnRH agonists are synthetic drugs that cause the release of FSH and LH initially but with continued use quickly suppress these hormones. Continued use of GnRH agonists suppresses FSH and LH thereby creating a clean slate on which to create a controlled ovarian hyperstimulation cycle for IVF/ICSI or other Assisted Reproductive Technology (ART) procedures. GnRH agonists are used to prevent premature release of eggs in IVF/ICSI and to treat endometriosis or to shrink fibroids.
Gonadotropin-Releasing Hormone Antagonist (GnRH antagonist)
GnRH antagonist is used in controlled ovarian hyperstimulation cycles for IVF/ICSI or other assisted reproductive technology procedures. The drug is given by subcutaneous injection, usually starting on cycle day 4 of stimulation. It is given in combination with ovulatory stimulating drugs to control premature LH surge.
Progesterone
Progesterone is a natural hormone which is given after ovulation to improve the quality of the uterine lining. It can be taken as oral tablets, by vaginal suppository/gel or by intramuscular injections.
Other drugs like Aspirin, Cabergolin, Heparin etc are used when indicated.