Ovarian Stimulation

Fertility Treatment Options

Key Points

Different medications can be used to stimulate the ovaries to produce follicles and mature eggs.
Medication can be used to trigger the development of one egg (followed by timed intercourse or IUI), or the development of several eggs (followed by egg collection and IVF).

What is Ovarian Stimulation Medication?

Stimulation medication is used to stimulate the ovaries to develop and mature follicles which contain the eggs.

It can be used to induce a normal menstrual cycle (i.e. a cycle in which a single, mature egg is released) in anovulatory woman (i.e. a woman who is not ovulating). Women can then time intercourse to ovulation or have intrauterine insemination to achieve conception.

It can also be used as part of IVF to stimulate the ovaries to produce several ovarian follicles and multiple mature eggs at the same time. These eggs will be collected and fertilized in the lab before being transferred into the uterus.

Gonadotropins

These are gonadotropin containing compounds used in ovarian stimulation. Gonadotropins are the main ovarian stimulation agents used in IVF.

FSH (Follistim, Gonal-f, and Bravelle): All FSH preparations require injections that 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 oestrogen levels) and ultrasound monitoring (measuring follicular growth).

FHS + LH (Menopur, Repronex, hMG): contain equal amounts of both FSH and LH. Doctors often prescribe these medications because they have LH activity, and it is thought that LH is essential to the follicles ability to produce oestrogen. Given by subcutaneous injection once or twice a day. Doses vary depending on patient response and type of treatment.

Side effects of gonadotropins are generally minor but may include discomfort at the injection site, headaches and fatigue.

Clomiphene (Clomid)

Clomiphene triggers the hypothalamus and pituitary gland to release GnRH (gonadotropin releasing hormone), FHS and LH. These hormones will trigger the ovaries to develop more eggs. It remains the first line treatment for anovulatory infertility and the most commonly used pharmaceutical in ART. In addition to treating anovulatory infertility, it is used to treat infertility related to endometriosis. It is used in conjunction with normal sexual intercourse, IUI and IVF. Common dosage is between 50mg to the maximum dose of 200mg daily. Side effects include hot flashes, blurred vision, nausea, bloating, and headache.

Letrozole (Femara)

Letrozole is increasingly used to induce ovulation. It is as safe as clomiphene. Among women with PCOS, especially those with obesity, letrozole may work better. A 2014 study found that 27.5 percent of women with PCOS who took letrozole eventually gave birth, compared to 19.1 percent of those who took clomiphene.

If you are trying to find the right clinic to start fertility investigations or to help you getting pregnant, click on the image below and know the fertility clinics that are our partners.