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What Is Ovulation Induction?

Penn Fertility Care specialists induce ovulation through the use of fertility drugs to replicate a naturally-produced hormone called follicle stimulating hormone (FSH), also known as a pituitary gonadotropin. FSH stimulates the development of the ovarian follicles located in the ovaries. Each follicle contains an egg. When a woman ovulates, an egg is released.

The medications produce multiple eggs in one cycle and also control the time the eggs, or ovulate, are released so sexual intercourse, intrauterine insemination (IUI) and in vitro fertilization procedures can be scheduled at the most likely time to achieve pregnancy.

For women with regular 28-day cycles, ovulation usually occurs on days 13 to 15. For women with irregular cycles — between 27 to 34 days — ovulation is usually difficult to predict. Therefore, the use of an at-home ovulation detection test should begin on day 10 and continue until ovulation is indicated or through day 20.

If a woman is not having an IVF procedure, then, once ovulation is detected, a woman can either have intercourse with her partner or, if recommended, do an intrauterine insemination. The goal of IUI in place of intercourse is to increase the number of sperm that reach the fallopian tubes and, presumably, increase a woman's chance of becoming pregnant.

Risks and Quality Control

Quality control during the ovarian stimulation process is very important. Sometimes the ovaries become "over-stimulated" and too many follicles get ready to release an egg. If over over-stimulation occurs, then the cycle is usually cancelled, as it can lead to an extreme number of eggs being fertilized.

We have improved our quality control by using ultrasound equipment to detect the number of ovarian follicles. Fertility drugs such as Clomiphene or FSH must be monitored and adjusted by a fertility specialist to ensure proper follicular development, to appropriately time ovulation and IUI, and to reduce the chances of a multiple pregnancy and its side effects. Recent studies of IUI suggest that the best results are achieved when insemination is coupled with ovulation induced by fertility medications.

Research and Clinical Trials

We are currently initiating an NIH-funded study to determine if the rate of multiple gestations after ovarian stimulation with gondotropins or other medications such as Clomiphene or the aromatase inhibitor Letrozole can be reduced.

This treatment is not for everyone with unexplained infertility. The success of IUI relies on the natural ability of sperm to fertilize an egg. IUI should not be used in women with severely damaged or blocked fallopian tubes.

Other fertility treatment options include in vitro fertilization (IVF), reproductive surgery, egg donation, embryo donation, surrogacy and more.

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