Assisted reproduction, which has helped millions of couples to start a family, encompasses various treatments: ovarian stimulation (ovulation induction), super-ovulation, intrauterine insemination, in vitro fertilization (IVF) and its variants, such as sperm microinjection.

 

OVULATION INDUCTION (ovarian stimulation)

Ovulation induction is usually performed in women with chronic anovulation—menstrual cycles of over 35 days. Treatment is quite simple and most often involves the use of oral agents.

The various medication options, depending on the cause of anovulation, are as follows:

Clomiphene citrate is a classic oral drug used to treat polycystic ovary syndrome or ovulatory dysfunction, once other causes—such as hypothyroidism or hyperprolactinemia— have been ruled out. The incidence of multiple pregnancies with clomiphene citrate is 6% to 12%. Another oral agent, tamoxifen, which demonstrates anti-estrogenic properties similar to clomiphene, can sometimes be used.

Metformin can be considered as a first- or second-line treatment for polycystic ovary syndrome with insulin resistance. Unlike clomiphene, it does not increase the risk of multiple pregnancies; however, 20% to 25% of cases experience digestive side effects, usually temporary, at the beginning of treatment.

Letrozole, an aromatase inhibitor—an enzyme that prevents the conversion of androgens into estrogens—can sometimes be used instead of clomiphene.

In cases of hyperthyroidism, administration of thyroid hormones is usually sufficient to regulate menstrual cycles and allow for conception. Hyperprolactinemia requires further investigation to determine the cause, and is usually corrected with dopamine antagonists, such as bromocriptine or cabergoline.

Hypothalamo-pituitary insufficiency requires a more complex treatment, such as subcutaneous injections of gonadotropins or gonadotropin-releasing hormone pulses (GnRH), depending on the cause.

 

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Superovulation

Dosage_hormoneSuperovulation involves stimulating the ovaries with subcutaneous injections of gonadotropins. Close monitoring with a series of pelvic ultrasounds are required as the incidence of multiple pregnancies is 15% to 20%.

Before IVF is considered, superovulation is sometimes offered to couples with unexplained fertility, infertility associated with minimal to mild endometriosis or mild male infertility. The fallopian tubes must be patent. It is usually combined with intrauterine artificial insemination.

 

 

You can contact FERTILYS anytime to get to know more about in vitro Fertilization (IVF)

Take the first step towards your family project by contacting FERTILYS
FERTILYS Fertility Centre – Fertility, In Vitro Fertilization, Prenatal Screening