Approximately every month, an egg is released from a woman’s ovaries in a process called ovulation. To naturally conceive, this process must coincide with the presence of sperm in the female reproductive system, following unprotected sexual intercourse.
If ovulation occurs regularly at monthly intervals, the likelihood of conception is high. However, in 18–25% of couples experiencing infertility, the woman has some form of ovulatory dysfunction. This means that she does not ovulate spontaneously, or ovulates at irregular intervals, potentially going many months between ovulation. This reduces the chances of the sperm fertilising the egg, which minimises the likelihood of conceiving naturally.
Ovulation induction is a fertility treatment that stimulates the growth of an egg within the ovary and triggers its release. Having control over the ovulation process means that our fertility specialists know the exact time a woman is releasing an egg. This allows sexual intercourse to be timed accordingly, which increases the likelihood of successful natural conception.
Clomiphene citrate is an oral medication that increases the level of two hormones in the female body, LH and FSH, which stimulate the development of an egg and initiate its release. Your fertility specialist will advise you to take the clomiphene citrate tablets on Day 2–3 of your menstrual cycle (i.e. Day 2–3 of your period). You will then need to take the tablets for 5 consecutive days. After this you will be monitored closely with blood tests and ultrasounds to determine how many eggs are developing and when you are expected to ovulate, or when you should trigger ovulation with an injection of the hormone, hCG.
FSH is one of the naturally occurring hormones in the body that are responsible for stimulating eggs to mature in the ovaries. By injecting this hormone for 8–14 days, we promote this process artificially. Once your eggs have matured, we will give you an injection with another medication called hCG (human chorionic gonadotropin) to trigger ovulation. You will be monitored closely with blood tests and ultrasounds to determine how many eggs are developing and the best time to trigger ovulation.
Artificially inducing ovulation carries the risk of stimulating the ovaries to release too many eggs. This, in turn, means there is a possibility of twins, triplets and so on. While couples may approach this idea with enthusiasm, having a multiple pregnancy increases the risks to both mother and baby.
Therefore, we try to avoid this outcome by using blood tests and ultrasounds to monitor the number of eggs that are developing. If too many eggs are due for release at any given time, we will simply recommend that you abstain from sexual intercourse. Nevertheless, multiple pregnancy is still a potential outcome of ovulation induction treatment.
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