Infertility Treatment: What Is Ovulation Induction?

Ovulation induction is a highly successful infertility treatment in India, helping couples improve their chance of conception. Ovulation induction, one of the less invasive infertility treatments, has a 20 to 40% success rate per cycle. With 3 to 6 cycles, your chances of a successful conception increase to almost 60 to 80%. 

In this article, we help you learn more about ovulation induction protocols and their risks.

Ovulation induction is a female infertility treatment for those who face irregular or absent ovulation. The treatment uses a mix of injectable and oral medicines to increase the chances of a successful pregnancy. 

It is a straightforward process and begins with a detailed examination of your medical history and fertility tests. This helps your doctor customise a treatment plan suited to your health needs. Female infertility disorders like Polycystic Ovary Syndrome (PCOS), an absence of a proper diet or excessive physical activity can also cause anovulation. 

Medicines like clomiphene citrate, gonadotropins, and letrozole regulate or stimulate egg development. Sometimes, using a combination of other treatments like intrauterine insemination (IUI) and in vitro fertilisation (IVF) can also improve fertility. The end goal of a female infertility treatment protocol with ovulation induction is to help you ovulate and get pregnant.

Sometimes, your body can act as a barrier between you and your dream to conceive. While there are many tests required to know what causes female infertility, the following symptoms of infertility in women are the most common signs that ovulation induction might be needed.

Anovulatory Cycles

Anovulation happens when no egg is released from your ovary. This results in irregular or no periods. Ovulation induction helps regulate the release of eggs, improving your chance of a successful pregnancy. 

Polycystic Ovarian Syndrome (PCOS)

Did you know PCOS affects almost 22.5% of women in India? PCOS, a type of hormonal imbalance, is also known as hyperandrogenic anovulation. It is marked by irregular periods, weight gain, and anovulation. PCOS causes elevated androgens, or male hormones, in your body, disturbing the normal menstrual cycle. 

Ovulation induction in PCOS helps regulate ovulation and the likelihood of a pregnancy. 

Unexplained Infertility

While some infertility disorders are identified and treatable, many are not. It is possible that your cause of infertility may not be defined even after all diagnostic tests. In such cases,  ovulation induction is the first line of treatment.

Contraindications for Ovulation Induction

Despite medical advancements, certain medical conditions are not suitable for ovulation induction. 

• The presence of large ovarian cysts can complicate your body’s response to ovulation induction drugs.
• Endometriosis is a rare condition where tissue similar to the lining of your uterus grows outside the uterus. Women with severe endometriosis may not respond well to ovulation induction treatments.
• If you have blocked fallopian tubes, ovulation induction drugs will not be able to help improve your chances of conception. It is because your eggs will not be able to reach the uterus for fertilisation.
• If you have a history of Ovarian Hyperstimulation Syndrome (OHSS), ovulation induction might trigger its return.
• Any uterine abnormalities or diseases like ovarian cancer can make ovulation induction unsuitable for many. It may disturb the success of the procedure.

Ovulation induction protocols use specific drugs to help treat infertility in women. They are:

Clomiphene Citrate

This oral drug helps stimulate your pituitary gland in the brain to increase the production of both follicle-stimulating (FSH) and luteinising hormone (LH). It improves the development of eggs and regularises ovulation in women with hormonal imbalances. 

Letrozole

Letrozole, also known as Femara, is another oral drug used during an ovulation induction treatment protocol. It is used for women suffering from PCOS. The drug has proved to be very effective in stimulating ovulation and improving the chances of conception. 

Many doctors also administer Letrozole as an alternative to Clomiphene in case of side effects from the latter. 

Gonadotropins

Unlike other ovulation induction medicines, Gonadotropins are an injectable drug that directly stimulates the ovaries. It helps increase the production of sex hormones— testosterone in men, and oestrogen and progesterone in women.

Gonadotropin injections include a mix of FSH and LH, which may improve your chance at conception.

Sometimes, ovulation induction medications do not work or are not advisable. Therefore, alternatives are used. One of them is Laparoscopic Ovarian Drilling (LOD.) It is a minimally invasive surgery also known as ‘whiffle ball’.

Laparoscopic Ovarian Drilling

If you have PCOS, your ovaries may have a thick outer layer that can lead to increased production of testosterone. In cases that cannot be treated through medication and injections alone, LOD is used to make small holes in the ovary. The small incision allows doctors to use a camera to observe your ovaries. The effects of drilling are temporary, usually lasting from 6 months to 2 years.

Ovarian drilling helps break the thick outer barrier and reduce the amount of testosterone produced. It is a one-time treatment that helps regulate your monthly menstrual cycles by getting your ovaries to release an egg. It also increases your chances of getting pregnant.

Monitoring Ovulation Induction Treatment

Ovulation induction treatments use drugs and injections as a part of therapy. These help stimulate egg development and release in infertile women. Despite the treatment being safe and minimally invasive, monitoring the ovary’s response is essential. It reduces the risk of unnecessary complications. 

Since no one dosage works for all patients, a combination of blood oestrogen (E2), ultrasound, and urinary luteinising hormone (LH) is used and monitored in all patients. 

Risks and Side Effects of Ovulation Induction 

The journey from infertility to parenthood is filled with both risks and challenges. While the end goal is rewarding, the experience can take a toll on your physical and mental health. Here are some common ovulation induction side effects:

• You may experience bloating and discomfort in your abdomen caused due to enlarged ovaries. This is also known as Ovarian Torsion.
• Hormone-stimulating drugs can trigger hot flashes and mood swings.
• Ovulation induction stimulates the increase of oestrogen levels in your body. This can cause breast tenderness, nausea, headaches, and fatigue.
• Injectable drugs like Gonadotropins can cause redness, swelling, or pain at the injected site.
• You may also be more likely to carry twins or triplets, which may increase pregnancy complications.
• A rare but possible side effect of ovarian induction is Ovarian Hyperstimulation Syndrome (OHSS). It can cause fluid build-up in the abdomen and chest making breathing difficult.

Success Rates and Considerations 

Pregnancy is more than just a sign of fertility in women. It is an experience that helps give you the power to bring new life into the world. Ovarian induction treatments help countless couples realise this dream of theirs. It allows couples dealing with infertility issues to conceive naturally without the need for additional assisted reproductive treatments. 

The success of your treatment is defined by factors like age and overall health. The ovulation induction success rate is commonly around 20 to 25%. Healthier women have a higher chance of successful conception, up to almost 40%.

Ovulation induction is a beneficial option for infertile women wishing to conceive or those suffering from conditions that make it difficult for them to conceive naturally. It is not only less complex as compared to other infertility treatments but also more cost-effective, giving couples a ray of hope at parenthood.