Sometimes our bodies are not quite ready to build a family, even if we are. Anovulation, defined as the lack or absence of ovulation, can make it difficult for some people to become pregnant. HealthQ is a trusted source for family planning, providing fertility induction services in a caring and non-judgmental environment. Fertility induction treatments can be a beneficial first step to assist with ovulation and increase your chances of becoming pregnant. Contact HealthQ today and schedule an expert consultation to learn more.
Fertility Induction Treatment
What is Ovulation Induction?
Some people with ovaries may need prescription medication to improve their chances of conception. Called ovulation induction, these medicines encourage the ovaries to release eggs. When a person doesn’t ovulate regularly, or when a person ovulates on their own, but is having difficulty conceiving, ovulation induction medications may help their bodies release more than one egg, improving their chances of pregnancy.
Anovulation may be caused by nutritional issues, excessive exercise, or certain reproductive disorders such as polycystic ovary syndrome (PCOS). Approximately 25% of all ovarian infertility cases stem from problems with ovulation. Ovulation induction can be a beneficial and cost-effective first course of treatment to help you conceive. Your HealthQ Nurse Practitioner can determine if ovulation induction is right for you.
What prescription medications are used for ovulation induction?
Taken orally, the most commonly used medicines for ovulation induction are clomiphene citrate (CC), aromatase inhibitors (AIs) such as letrozole and anastrozole, and insulin-sensitizing agents (ISAs) such as metformin and thiazolidinedione. At HealthQ, we prescribe a CC called Clomid or an AI call Letrozole.
Frequently Asked Questions:
Q: HOW DO OVULATION INDUCTION MEDICINES WORK?
At the beginning of a normal menstrual cycle, estrogen levels are low, and in response, the pituitary gland produces ovarian follicle-stimulating hormones (FSH). As the FSH levels rise, one main egg follicle on the ovaries grows and releases estrogen. This triggers the follicle to release an egg later in the menstrual cycle.
CC and AIs work by either lowering estrogen levels, or by making the brain think they are low. CC works by helping cells resist estrogen, and AIs block androgen hormones from changing to estrogen. The drop in estrogen levels encourages the pituitary gland to produce FSH, which helps a follicle to grow and release an egg.
ISAs can be used alone or in conjunction with CC or AIs. People with polycystic ovary syndrome (PCOS) can produce too much insulin and androgens, causing irregular ovulation. ISAs assist with egg follicle growth by lowering insulin and androgen levels.
Q: HOW EFFECTIVE ARE OVULATION INDUCTION MEDICATIONS IN HELPING ME GET PREGNANT?
The success of these medicines depends on many factors. In people not already ovulating, almost 80% of people who use CC or AIs over several months will ovulate. Some people will need increasing doses of the medicines. Pregnancy rates depend on your age, the length of infertility, and cause of infertility. These medicines are generally more effective in people who do not ovulate regularly. In people who already ovulate, pregnancy rates tend to be lower especially if the medicines are not combined with other treatments like insemination. Your HealthQ Nurse Practitioner can give you specific information about your chances of getting pregnant.
Q: ARE THERE ANY RISKS IN TAKING OVULATION INDUCTION MEDICINES?
The most common risk when taking ovulation induction medicines is a multiple pregnancy, as the release of more than one egg during a menstrual cycle may be triggered. With CCs and AIs, the chance of twins is 5%-8%, and the chance of triplets or a higher-order multiple pregnancy is less than 1%. ISAs do not seem to increase the risk of multiple pregnancies.
Ovarian cysts may occur during ovulation induction. These cysts may become large and painful, but they typically do not require any treatment. If you feel unusual pain or discomfort during ovulation induction, please let your HealthQ Nurse Practitioner know. There has been no found link between ovulation induction medicines and an increased risk of ovarian cancer.
Q: WILL MY BABY BE AFFECTED BY OVULATION INDUCTION MEDICINES?
There is no known increase in birth defects in people who have taken these medicines to induce ovulation.
Q: WILL MY PREVIOUS USE OF TESTOSTERONE AFFECT MY EGG HEALTH?
A 2019 study confirmed that previous testosterone use did not affect oocyte (egg) yield. If you become pregnant while on testosterone, and plan to carry the pregnancy to term, it is important to stop taking testosterone during your pregnancy to mitigate serious harm to the developing fetus.
THE MOST COMMON SIDE EFFECTS OF OVULATION INDUCTION MEDICATIONS MAY INCLUDE:
- Irritability, mood changes
- Vasomotor symptoms
- Abdominal discomfort
- Breast discomfort
- Nausea and vomiting
- Visual symptoms
Overview of Your First Visit
At your first visit at HealthQ, we will obtain a complete medical, surgical, and reproductive history. The visit will likely include a physical examination (with a pelvic exam), blood work. If needed, you may be asked to schedule an ultrasound evaluation of the uterus and ovaries at an imaging clinic.
We realize that having a pelvic exam can be emotionally and physically uncomfortable. At HealthQ, we offer nitrous oxide to help you relax and lessen the anxiety that you may feel when having a pelvic exam. Nitrous oxide is a safe and non-addictive method of providing relaxation and pain reduction. If you choose to use it during your pelvic exam, it will be administered by a trained staff member using a sterile mouthpiece that you can easily breathe from. The effects wear off within 1-3 minutes of breathing regular air so you will be fine to drive yourself home. Nitrous oxide is not covered by insurance and requires an out-of-pocket cost ranging from $25 to $50. If you think this may be right for you, please mention this to the HealthQ staff when booking your appointment.
We may recommend that your partner/sperm donor obtain a semen analysis. We DO NOT offer that service at HealthQ but can provide information on local providers if needed. (Semen analysis is a microscopic examination of semen to determine the number of sperm [sperm count], as well as their shape [morphology] and movement [motility].)
On Your Second Visit
During a second visit, we will review the results of your blood work and imaging with you, and explain ovulation induction treatment, if appropriate.
If you do not become pregnant after 3 ovulatory cycles, we may encourage you to continue the medication or refer you to a reproductive endocrinologist for further exploration and diagnosis into the cause of infertility and other infertility treatment options.
Your HealthQ Nurse Practitioner will decide how much monitoring you may need based on your history and reason for infertility. Some people use home ovulation-predictor kits to show when an egg will be released. Your Nurse Practitioner may also have you come to the office for an ultrasound to see when an egg may be released. This can help you time penis in vagina sex or at-home donor insemination during the fertile window (the time around when the egg is released).
Schedule a private, expert consultation with a HealthQ provider today to learn more about how fertility induction may help you become pregnant.
Our mission is to provide exceptional reproductive and sexual health care to all who need it without judgement and barriers. We operate with an uncompromising belief that everyone has the right to control their body and their life.