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- Over 25 years of experience in assisted reproduction methods including ovulation induction.
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Induction of ovulation or follicular maturation
One of the preconditions for a successful pregnancy is the maturation and ovulation of the egg. If this does not occur naturally, maturation and ovulation of the egg can be achieved through drug therapy. This refers to the induction of ovulation, or the treatment of follicular maturation. The treatment is needed if the woman’s menstrual cycle is abnormal or absent. If the woman’s own menstrual cycle is working, hormone therapy can be used to support the development of the follicle and the ovulation of the egg.
The principle behind ovulation induction is to stimulate ovulation by stimulating the ovaries with hormone medication to produce one follicle and one mature egg per cycle, which is fertilized after sexual intercourse. The hormones can be administered as tablets or injections under the skin. Tablets (clomiphene citrate or aromatase inhibitors) are often used as the first drug. Occasionally too little pituitary hormone (gonadotrophins FSH and LH) is secreted: in this case, tablets cannot be used. The cause may be the treatment of pancreatic tumors (surgery and radiation), severe underweight or excessive physical activity (anorectics, endurance athletes, etc.), but often the cause is unknown. With underweight, weight gain alone can often restore normal menstrual cycle and fertility. Conversely, if gonadotrophin levels are elevated, this is an ovarian disorder in which medication is of no use.
Treatment with tablet drugs is often quite simple: tablets are usually taken in the beginning of the cycle for five days. The progress of ovulation treatment is monitored every few days by ultrasound and, if necessary, with hormone tests on a blood sample. It is important that the sexual intercourse is scheduled to occur at the time of ovulation. The urine test (LH test, available at the pharmacy) or an ultrasound examination can be used as an aid in timing.
Gonadotrophin treatment is necessary if the treatment with tablets is ineffective or if pituitary hormone secretion is too low. Gonadotropin therapy is initiated on days 2-5 of the cycle by injecting 50-100 units (IU) of FSH daily. During treatment, the response to treatment is monitored by ultrasound (number and size of the follicles and thickness of the endometrium). Monitoring improves the chances of conceiving and reduces potential risk factors (multiple births). If ovulation is not achieved with tablet therapy or pregnancy has not begun within 4-6 cycles, other treatments should be considered. Often artificial insemination is the next step. You can read more about artificial insemination here.