Ovulation Induction 

This is done to help a woman ovulate. If a woman is ovulatory, the medication is given to help her ovulate multiple eggs during the month so as to increase her chances that one of the eggs will fertilize and result in a viable pregnancy.

Ovulation Induction consent form

Clomid

Clomid (generic name Clomiphene Citrate) is a medicine used to induce ovulation in women who are anovulatory or to increase the number of eggs at ovulation in ovulatory women. It is helpful in many women who have menstrual irregularities, which is commonly caused by a failure to ovulate.

Clomid works as a selective estrogen receptor modulator. It blocks estrogen receptors in the brain making the brain “think” that the ovaries are not producing estrogen. Therefore,the brain releases more follicle-stimulating hormone (FSH). This hormone acts on the ovaries and causes the ovaries to mature one (or sometimes several) follicles which will then be ovulated.

	Clomid handout
	Clomid Protocol handout

 

Femara

Femara (generic name letrozole)is a medicine used to induce ovulation in women who are anovulatory or to increase the number of eggs at ovulation in ovulatory women. It is helpful in many women who have menstrual irregularities, which is commonly caused by a failure to ovulate.

Femara works by decreasing the estrogen blood level thereby making the brain “think” that the ovaries are not producing estrogen. Therefore,the brain releases more follicle stimulating hormone (FSH). FSH causes the ovaries to mature one (or sometimes several) follicle which will then be ovulated. Approximately thirty percent of women who do not ovulate on Clomid, will ovulate after taking Femara.

	Femara handout
	Femara Protocol handout

 

Gonadotropin Injections

Gonadotropins are medications that are given by injection to stimulate the ovaries to develop one (or multiple) follicles to maturity. They include: pure FSH (Gonal F, Follistim, Bravelle) and hMG, a combination of FSH and LH, (Menopur, Repronex).

These medications are given to women to help them ovulate or to women who are trying to increase their chances of conceiving if they are already ovulatory. In other words, with the use of gonadotropin injections, several mature follicles, each with an egg inside of it presumably, will grow to maturity and be ovulated. These medications are also used to stimulate multiple eggs to grow to maturity for in vitro fertilization (IVF) treatment.

	Gonadotropin handout
	Gonadotropin Protocol handout

Cycle Monitoring for follicle growth by ultrasound

Performed around Cycle Day 8-16
In some cases, especially if a woman’s menstrual period is irregular, she may not be ovulating. The purpose of monitoring with blood work and an ultrasound exam is to determine if a woman is ovulating and ifthe events surrounding ovulation are occurring normally. Blood work testing includes an estradiol, LH and progesterone levels which can determine how close to ovulation a woman is, or if she has already ovulated.

In addition,the estradiol level helps assess the quality ofthe egg prior to ovulation. The ultrasound exam is useful for assessing the size of the follicle which is what supports the growing egg and for determining the thickness of the uterine lining. Abnormalities in these findings could help to explain why a woman may have difficulty conceiving.

	Follicle Monitoring handout
	Ovarian Hyperstimulation Syndrome handout