Many women do not ovulate and therefore need medical treatment to stimulate ovulation. The most common cause of this is Polycystic Ovary Syndrome (PCOS).
Medications are given to stimulate the growth of eggs (oocytes). These include tablets containing clomiphene citrate e.g. Clomid, Fertomed, Clomihexal or fertility injections containing FSH (Follicle Stimulating Hormone) e.g. Gonal-F, Menopur. The treatment is carefully monitored using both ultrasound scans and blood tests. The follicles containing eggs can be easily seen on ultrasound scan. A follicle is a structure that produces an egg. The follicle also produces female hormone: estrogen and progesterone.
Ovulation is triggered by using an injection called HCG (Human Chorionic Gonadotrophin) e.g. Ovidrel, Pregnyl. This is used to determine exactly when intercourse should occur.
In PCOS high insulin levels in the blood inhibit ovulation, and research has shown that insulin sensitizing medications such as Metformin can be used to improve ovulation rates. These medications are usually used in the treatment of diabetes. Part of the standard investigations for PCOS now include a fasting blood test for glucose (sugar) and insulin levels.
The most common side effects of Clomid tablets are headaches and hot flushes. Multiple follicles may develop during clomiphene citrate treatment which can result in multiple pregnancies. Therefore it is very important that the treatment is monitored with ultrasound to know exactly how many eggs are produced. One of the options that may be offered if too many follicles develop during treatment is to convert the timed intercourse cycle to IVF (in vitro fertilitzation) to avoid multiple pregnancy.