Ovulation Induction is a very useful method of Infertility Treatment, provided it is applied in judicious manner.
What is Ovulation?
In the ovaries, in each month (menstrual cycle), one follicle (the sac containing the egg inside) grows and finally ruptured to release the eggs. This release of eggs is called "Ovulation".
What is "Ovulation Induction" (OI)?
OI means taking medicines to help the follicles grow and ovulate, to improve the chance of pregnancy. The medicines may be in the form of tablets or injections.
When OI can be done?
- If you have been trying for pregnancy for more than 6-12 months all the tests are normal ("Unexplained Infertility").
- If you are having PCOS (Polycystic Ovary Syndrome), where you have many follicles but there is no ovulation.
When OI should NOT be done?
- If you already tried OI for more than 6-9 months. Here OI in unlikely to succeed.
- You have been trying for pregnancy for less than 6 months. Here OI is unnecessary.
- If both of your Fallopian Tubes are blocked. Here OI will not help.
- If the husband has very low or absent sperm count / motility/ morphology. Here OI will not help.
What tests should be done before OI?
The condition of your tubes (HSG), Ovaries (AMH, TVS) and husband's sperms (Semen Analysis) should be checked. In addition, blood group, Thalassemia screening and Rubella testing should be done to ensure that your baby should not have any problem during and after pregnancy. Do not conceal from your doctor, if you received any OI before.
How OI is done?
Tablets are usually started from day 2/ 3/ 4 of the period for 5 days. Sometimes, injections may also be added, if necessary.
TVS Follicular Study is done from day 8/9, once in every 2-3 days (until day 14-16) to confirm that the medicine is working.
Is it necessary to undergo TVS Follicular Study while doing OI?
It is important to know whether the medicine given for OI is acting for you (ovaries are responding and ovulation is happening). If medicine is not working, then taking the same for several months, is the waste of time, money and energy.
If the medicine is working in the first month, as confirmed by TVS, you can take the medicine for next few months without need of further TVS.
What's the success rate of OI?
If OI is done with oral medicine, the success rate is 15% per cycle. That means, out of 100 women taking the tablet, having regular intercourse and undergoing TVS Follicular Study, 15 will conceive at the end of one month.
With Injection, the chance is 18-20% per month.
How long OI can be done?
How long you can take OI, depends on your age and the duration of infertility.
- It is useless to take the medicines for OI years after years. Pregnancy should happen within 6-9 cycles of OI.
- If oral tablets has been tried for 4-6 months, it's better to add injections for next 3-4 months.
- If still pregnancy cannot happen, it's better to consider IUI or IVF.
The couple came to us with PCOS. They wanted OI. We started Letrozole. In the first cycle TVS confirmed Ovulation. They conceived after 3rd month. She was hypothyroid, which was controlled with medicine. She delivered the baby at 37 weeks.