Ovulation Induction (OI) and Superovulation (SO)

What is ovulation induction (OI)

Injectable medications called gonadotropins are often necessary for fertility treatments. Ovulation induction (OI) refers to the use of injections to help the ovaries release a single egg per month. This approach is geared towards women who do not have regular periods. To be a candidate for ovulation induction you must have a normal uterine cavity, at least one normal fallopian tube, and your partner must have a normal sperm count.

What is superovulation (SO)

Superovulation is a term to describe the use of injectable fertility drugs (gonadotropins) to stimulate the ovaries to produce multiple mature eggs, rather than the single egg that normally develops each month.

When to consider superovulation

You might benefit from superovulation if you:

• Have irregular or absent periods that do not respond to simpler medications like clomiphene or letrozole. Polycystic ovary syndrome is the most common condition preventing ovulation.
• Have unexplained infertility and wish to try superovulation therapy in order to increase the number of eggs produced in each cycle—thus increasing the chance of conception.
• Have decreased ovarian reserve and want to try superovulation before moving on to IVF.

How does it work?

During a natural menstrual cycle, you release hormones from the pituitary gland (LH & FSH) causing the growth of a follicle–the fluid space in the ovary where the egg grows. Although several follicles grow each month, in a natural cycle only one becomes mature enough to ovulate its egg.

With superovulation you take gonadotropins (natural forms of FSH and/or LH) by injection to stimulate the growth of multiple eggs. During your treatment, your doctor will carefully monitor you with blood tests and ultrasounds to minimize any complications.

What to expect during treatment

Your treatment usually starts on day three or four of your menstrual cycle and lasts eight to ten days. A nurse will teach you and your partner how to give the injections at home.

Super Ovulation consists of the following 5 phases.

Step 1 – Stimulation

Your treatment usually starts on day three or four of your menstrual cycle with daily injections of the medication and lasts eight to ten days. A nurse will teach you and your partner how to give the injections at home.

Step 2 – Monitoring

You will likely have three to four clinic appointments for blood tests and/or vaginal ultrasounds to monitor your response and adjust your gonadotropin dose.

Step 3 – Ovulation

When the blood tests and ultrasounds indicate one to four mature follicles your doctor will administer a second medication (hCG) to trigger ovulation. You will usually ovulate 36 to 48 hours after this final injection.

Step 4 – Fertilization

You will then have sexual relations over the next 2 days if you are trying to conceive naturally. If you are having intrauterine insemination (IUI) it will be done during the same time.

Step 5 – Pregnancy

You will have a simple blood test 5 to 7 days later to measure your hormone levels. Two weeks later you can take a pregnancy test. If it is positive, we will continue to monitor it with early ultrasounds until week 10 to ensure everything is developing normally.

What are the success rates for superovulation?

Superovulation typically produces pregnancy rates of 10 –20 % per cycle, depending on a person’s age, diagnosis, and duration of infertility. For those with certain ovulatory disorders, ovulation induction treatment may even restore normal fertility rates of 20 –25 % per month. If you do not become pregnant within the first three treatment cycles, we will discuss other treatment options with you.

To increase the chances of pregnancy, superovulation is often performed in conjunction with intrauterine insemination (IUI) link

What are the side effects?

Because your ovaries will be stimulated to produce more than one follicle at a time, you may find that your usual menstrual period symptoms are exaggerated. You may experience bloating, breast tenderness, cramping, pelvic twinges or heaviness, fatigue and headaches.

Risks can include:

• Overstimulation
• Multiple pregnancies
• Ovarian Hyperstimulation Syndrome (OHSS)
• Cancelled Cycle

While most women produce one to four mature follicles during this treatment, in some cases the ovaries over stimulate and produce too many mature follicles. We try to minimize this by frequent monitoring and dose adjustments.

Cost

See fee page.