Ovulation Induction

Ovulation Induction is a technique that uses medications to stimulate ovulation, which is the release of an egg from the ovary.

This treatment option is intended for women who have fertility issues caused by irregular or absent ovulation (for example, women with polycystic ovary syndrome (PCOS), functional hypothalamic amenorrhea (FHA), or other causes). 

Common Fertility Drugs Used for Ovulation Induction

Clomiphene citrate (Clomid) 

Clomid is an oral medication that induces ovulation by blocking estrogen receptors. This causes your body to believe estrogen is low, and it responds by producing more FSH. At low doses, Clomid can be used to get a single follicle to grow and a single egg to be released. At higher doses, it can be used for superovulation (see below). 

Letrozole (Femara) 

Letrozole is an oral medication that works by lowering estrogen production, which then results in higher FSH production by the body. Like Clomid, Letrozole can be used for both ovulation induction and superovulation. It is the first-line choice for ovulation induction in patients with polycystic ovary syndrome (PCOS), as studies have shown it is more effective than Clomid in this population of people specifically.

Gonadotropins (Menopur, Gonal-F, Follistim) 

Gonadotropins are injectable medications that are composed of either FSH, or FSH and LH. They are stronger than oral agents and are often used in people who do not respond to Clomid or letrozole. They can also be used in combination with oral medications to achieve superovulation in people aged 40 or older, when the goal is to get multiple follicles to develop. Ultrasound monitoring and blood estrogen measurements are almost always required when gonadotropins are used, in order to assess the ovarian response and minimize the risk of complications. 

Hormonally active pills or shots are given to promote the development and ovulation of an egg within the ovary. Typically, the goal for ovulation induction is for just a single egg to be ovulated, which greatly reduces the risk for multiple pregnancy. Ovulation induction can be combined with timed intercourse at home, or intrauterine inseminations in the office, depending on your specific circumstances.

“Superovulation” is similar to ovulation induction in that it uses hormonally active medications to promote ovulation. It differs from ovulation induction in that the goal is to ovulate more than one egg (typically 2-3) per cycle. It is one of the first-line treatments for unexplained infertility, where no pregnancy has been achieved despite multiple opportunities for a sperm to encounter an ovulated egg. Superovulation is usually combined with intrauterine insemination (IUI) to maximize the chances of pregnancy.