The stimulation of the ovaries results in the production and release of one or more mature oocytes (eggs) and is combined either with scheduled sexual intercourse at home or with intrauterine insemination (IUI). Stimulation of ovaries can be done either with pills or injections or a combination of the two.
The treatment usually starts on the 2 or 3 day of the cycle and until the woman is ready to ovulate. The effect of the treatment is assessed with a series of blood tests and ultrasound scans. During each scan we measure the size and the development of the oocytes as well as the thickness of the endometrium (lining of the womb).
Just before the woman is ready to ovulate, an injection is given (Pregnyl or Ovitrelle) that matures the oocyte and causes ovulation. In that stage, the couple could have a sexual intercourse at home or an IUI is scheduled.
Stimulation of the ovaries is appropriate in the following circumstances:
- Women who do not ovulate e.g. women with polycystic ovarian syndrome (PCOS)
- Women who can ovulate but wish to increase the chances of conception by increasing the number of oocytes that they produce in a cycle. The aim of the treatment for these women is to produce more than one but no more than three mature oocytes due to the increase risk of having a multiple pregnancy.
Stimulation of the ovaries is meaningful only when some specific prerequisites exist:
- The woman’s fallopian tubes are patent
- There is no male factor infertility
- There is not another identified cause of female or male infertility
What medications are used?
- Serpafar or Femara are given in the form of pills from 2 to day 6 of the menstrual cycle and for 4-6 cycles.
- Gonadotrophines are given in the form of injections for 3-4 cycles and usually have better results in comparison with the pills.