Controlled Ovarian Stimulation
Ovulation Induction with, or without, Intrauterine Insemination (IUI)
Managing ovulation induction is an art that is enhanced by a doctor’s experience. Dr. Selub has over 25 years of experience using ovulation inducing medication and is an expert in this field. She is, therefore, able to guide your treatment efficiently and safely, and, of course, handle any complications, should they occur.
Ovulation induction involves stimulating the ovary to produce one or more eggs. Female infertility is often a result of woman’s failure to ovulate, failure to ovulate regularly, or failure to ovulate healthy eggs. The cells around the egg that secrete female hormones into a woman’s bloodstream as the egg matures may not always function properly. Sometimes the amount of hormones secreted may not be sufficient to properly prepare the uterine lining so that it will be receptive to a fertilized egg, or embryo. This can result in repeated pregnancy loss. Ovulation induction is often used to correct this cause of infertility when other reasons for recurrent miscarriage are not identified. Low ovarian reserve can also be the cause of ovulation problems associated with recurrent pregnancy loss.
Ovulation induction is also used in circumstances where the exact cause of infertility is not known. Endometriosis-associated infertility, not associated with anatomical damage to the fallopian tubes or surrounding structures, can also be treated by ovulation induction. In such cases, the woman uses ovulation inducing agents to “superovulate” the ovaries, or cause multiple eggs to mature, instead of the one egg that usually matures per menstrual cycle. By combining superovulation with Intrauterine Insemination (IUI) timed to coincide with ovulation, the sperm are given more “targets.” It is hoped that pregnancy will result because multiple, mature, and, perhaps, healthier eggs are available after superovulation. Though superovulation combined with timed intrauterine insemination does not guarantee that a woman with unexplained, mild male factor, or endometriosis-associated infertility will conceive in a given treatment cycle, the chance for pregnancy to occur is higher than the infertile woman’s background rate of conception.
Failure to have any ovulatory cycles (anovulation) or to have only very irregular ovulatory cycles (oligoovulation) are among the most common causes of infertility. The causes of these types of disorders are quite diverse, and may include problems with the central nervous system or pituitary gland, problems within the developing follicles or ovary, or both. Low ovarian reserve is a common reason an infertility patient may be ovulating irregularly. Polycystic Ovary Syndrome (PCOS) is the diagnosis for the vast majority of women who fail to ovulate regularly. Central nervous system problems, thyroid problems, and premature ovarian failure are first ruled out with blood tests. Women with PCOS usually have plenty of egg-containing follicles in their ovaries, but for hormonal reasons, are unable to release eggs on a regular basis. This syndrome is often quite amenable to treatment with ovulation inducing drugs.