1.Ovulation induction
Ovulation induction with timed intercourse is a common, non-invasive medical approach to assist couples facing infertility. It's recommended for women with ovulatory disorders or unexplained infertility, aiming to enhance natural conception by precisely timing intercourse. Challenges like anovulation is overcome in this. Close monitoring done by a fertility specialist is crucial for safety and effectiveness.
Healthy Singleton Pregnancy: The ultimate goal of ovulation induction is to achieve a healthy singleton pregnancy, minimizing the risks associated with multiple pregnancies.
- Initial assessment
- Ovarian stimulation
- Ultrasound monitoring
- Hormone monitoring
- Luteal Phase Support
How Does It Work?
Medication Combination: Typically, a combination of oral fertility medication with or without injectable fertility hormones, like follicle-stimulating hormone (FSH), human menopausal gonadotropin (HMG) is used. This combination encourages the ovaries to produce one or more mature follicles.
Mature Follicles: Each mature follicle contains one egg capable of being fertilized. In cases where women do not have regular menstrual cycles and do not ovulate normally, the aim is to produce one mature follicle to restore normal ovulatory function.
2. Superovulation:
For women with regular menstrual cycles and ovulation, controlled ovarian hyperstimulation is employed to "superovulate" them. Stimulation more than one follicle is referred to as “Superovulation.” This process increases the likelihood of pregnancy by producing more than one mature follicle each month.
3. Controlled ovarian hyperstimulation
Controlled ovarian hyperstimulation was originally designed for multifollicular development to obtain multiple oocytes and thereby increase the number of embryos.
But here come the era of individualized controlled ovarian stimulation. We tailor the stimulation protocols and gonadotropin injection doses suitable for individual response (individualization of ovarian stimulation or iCOS).
It is important to realise that some women respond the same for COH and mild stimulation or minimal stimulation protocols. Decision of mild stimulation for such women decreases the burden , stress during treatment and cost of treatment without compromising the success rates.
Many other stimulation strategies are targetted even for women with low AMH or AFC like pooling cycles , dual stimulation/double stimulation based on the patient’s need.
Fertility Rates: Controlled ovarian hyperstimulation aims to restore monthly fertility rates to that of a 20-year-old woman, which is approximately 20% per month.
Multiple Pregnancy: The occurrence of multiple pregnancies, such as twins or triplets, can range from 1-30% of pregnancies resulting from controlled ovarian hyperstimulation. This variation depends on factors like the age of the patient, family history and the number of mature follicles obtained.
