Understanding Assisted Reproductive Technologies: Ovulation Induction

Ovulation induction is a technique in which medications are provided to women who have irregular ovulation or anovulation (absence of ovulation).

Anovulation could be caused due to nutritional problems, excessive exercise or polycystic ovarian syndrome (PCOS). Normal ovulation is considered to happen once every 28 to 35 days. If ovulation occurs less than once every 35 days or is unpredictable, it is called irregular ovulation. It could lead to unpredictability of availability of the egg to be fertilized. It is particularly useful for women with ovulation problems to help conceive in combination with either sexual intercourse or through procedures such as IUI or IVF.

What's Inside?

When is ovulation induction done?

Ovulation induction is a process and not a one time procedure. The first day of the last menstrual cycle is determined, which is day 1 of the cycle. The ovulation induction medications are taken starting day 3,4 or 5 and are usually taken for 5 days. Your doctor will closely observe the development of follicles through ultrasounds and blood tests. It is recommended to have sex around the time of ovulation or use intrauterine insemination (IUI) around that time. 

For whom is ovulation induction useful?

Usually ovulation induction is useful for women with the conditions below:

  • Disorders directly impacting the reproductive system such as PCOS
  • Irregular hormone levels, such as Follicle Stimulating Hormone (FSH), Anti-Mueller Hormone (AMH) and Luteinizing Hormone (LH). 
  • Disorders directly impacting ovulation, such as thyroid disorders, obesity and eating disorders.
  • Over exercise

How is ovulation induction done?

Ovulation induction uses a variety of hormonal medications to help regulate the hormone levels of the woman and help in ovulating. The medication varies depending on the type of cause leading to issues with ovulation. Usually women are prescribed the medicines for stimulating ovulation, and then are advised to try conceiving naturally. If that doesn’t work then usually IUI or IVF methods are employed. 

In case a woman has a number of follicles that mature but the eggs aren’t being released due to low levels of the hormone LH, then an injection is also given additionally around the day of ovulation to help the formed eggs release.

Advantages of ovulation induction

  • Ovulation induction is usually one of the first fertility treatments employed, since it is non invasive for the woman and less expensive. 
  • For severe cases of anovulation or other infertility causes, ovulation induction could be used in conjunction with IUI or IVF to achieve a successful pregnancy.

Disadvantages of ovulation induction

  • Ovulation induction hormone therapy can sometimes lead to ovarian hyperstimulation syndrome (OHSS). OHSS symptoms could be mild (moderate abdominal pain, abdominal bloating, nausea, vomiting, diarrhea, tenderness in the ovaries area) to severe (rapid weight gain, severe abdominal pain, severe nausea, blood clots, decreased urination, tender or large abdomen, shortness of breath).
  • Since it causes ovaries to release multiple eggs during a cycle, it could lead to multiple embryos getting fertilized, which could later lead to multiple pregnancies.