Ovulation Induction - Summary

With the exception of primary ovarian failure (the menopause), ovulatory disorders can usually be successfully treated. Ovulation induction regimens depend on the underlying cause (infertility cause).

Sometimes appropriate advice may be all that is required. When weight loss is responsible for secondary amenorrhoea (amenorrhoea causes), improved diet leading to correction of your weight may prove to be successful.

The main drugs used to overcome anovulation are clomiphene (clomiphene)(clomiphene citrate), tamoxifen (tamoxifen infertility), bromocriptine (bromocriptene), metformin (12), and gonadotrophins (gonadotrophins).

risks of ovulation induction

There are three concerns associated with drugs used to induce ovulation:

    1. They are associated with a greater chance of multiple pregnancy. The general rate of twins in the population is one in every eighty deliveries but with clomiphene, it is one in twenty or a four-fold increase. Higher order multiple pregnancies (e.g. triplets and quads) can occur with clomiphene but this is rare. Injections of gonadotrophins are more likely than clomiphene to result in multiple pregnancy.
    2. Occasionally ovulation induction can lead to ovarian hypersensitivity syndrome (OHSS).
    3. Finally, there has been concern that ovulation induction treatments may increase the chance of ovarian cancer. A comparison was made of the risk of cancer among women who received clomiphene with the risk among infertile women who did not receive it. There were 11 invasive or borderline malignant ovarian tumors, as compared with an expected number of 4.41994-01. A confounding factor is that infertility is itself associated with an increased risk. Furthermore, the risk is reduced with secondary infertility and is dependent on the causation of the infertility.2004-01Several infertility units have reported their data. Some seemed to confirm the link between clomiphene and ovarian cancer but the majority have produced reassuring results.1999-02,2004-02 2006-01

Related Medical Abstracts - Click on the paper title:-

Related Medical Abstracts - Click on the paper title:-

Ovulation Induction Monitoring

Monitoring may be required to confirm that ovulation is occurring and to ensure that too many follicles are not developing. Blood tests for progesterone levels around the twenty-first day of the cycle provide an indication of ovulation (Q9.17). Ultrasound monitoring of follicular development is helpful with tablet treatment (clomiphene and tamoxifen) and is really essential with gonadotrophins. When controlled ovarian hyperstimulation is undertaken in IVF protocols, oestradiol levels are used. The need for monitoring hormone levels in IVF protocols has been questioned.1998-01, 2006-01

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