Ovulation Induction (OI)

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Ovulation Induction Treatment

For some women, the root cause of fertility challenges is an inability to ovulate — either on a consistent basis or altogether. If your initial fertility assessment uncovers low levels of ovulation hormones (and there are no other complicating factors), then a process known as ovulation induction may be your first step. As with all treatments at Ontario Fertility Network, your medical team will review the options with you to determine your unique fertility path.
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How it Works

Each month, the potential for pregnancy is rooted in the release of a mature egg during ovulation. During the first phase, known as the follicular phase, follicle-stimulating hormone (FSH) is released from the brain. This stimulates the growth of egg follicles (approximately 10-12 each month) in the ovaries. Of these, only one matures into the dominant follicle. On day 12-14 of the menstrual cycle, another hormone called Luteinizing hormone (LH) is released from the brain to trigger ovulation. 24-35 hours later, the egg is released from the ovaries and awaits fertilization from sperm. Then, the woman moves to the second half of her cycle (the luteal phase), if the egg isn’t fertilized progesterone levels drop and her uterine lining sheds. The entire cycle then repeats.

With ovulation induction, medications are administered over the course of a woman’s menstrual cycle to encourage ovulation. For some patients, this approach — together with timed intercourse — is all that is needed to achieve a pregnancy.

The Ovulation Induction Treatment Process

Follicular Phase

Medications to promote ovary stimulation via follicle growth are used to help the ovaries release an egg. Your personal medical team will discuss the best course of action for you based on your unique circumstance.

Cycle Monitoring

Our medical team will monitor your cycle closely with blood tests and ultrasounds to check for the size and number of follicles maturing. This is a necessary step to help prevent the occurrence of a multiple pregnancy.

Egg Fertilization

A patient may choose to fertilize the released egg naturally with timed intercourse or use Intrauterine Insemination (IUI). The latter is appropriate if there are issues with low sperm count, low sperm motility, or unexplained infertility. 

Testing

A blood test will be drawn two weeks after fertilization to see if a pregnancy has resulted. If not, this cycle may be repeated each month to increase a couple’s chances of becoming pregnant.

We want to help you start your family

If you’ve been having a difficult time conceiving, we are here for you. Our team of specialists is here to listen to your concerns, look to determine the root cause of any difficulties, and help you form a fertility plan that is right for you.
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FAQs

What percentage of infertility is caused by ovulation problems?
Approximately 25% of known infertility cases are caused by ovulation issues.
What medications are used in ovulation induction?

There is no single medication that works best for all cases. Your doctor will work with you to determine the best course of action for you. Typically, the medications used in ovulation induction cycles include:

  • Letrozole
  • Clomiphene citrate
  • Follicle-stimulating hormones (FSH)
  • Gonadotropin-releasing hormone (GnRH) agonist
  • Gonadotropin-releasing hormone (GnRH) antagonist
  • Human menopausal gonadotropin (hMG)
  • Luteinizing hormone (LH)
  • Human chorionic gonadotropin (hCG)
  • Progesterone
What are the success rates of ovulation induction treatment?
The success rates for this procedure vary depending on the cause of infertility, risk factors, and more. On average, this procedure increases the chance of pregnancy to 10-20% each month.
How do doctors monitor this form of treatment for effectiveness?
Through a series of ultrasounds and bloodwork. When needed, it may be recommended that this form of treatment be combined with IUI or IVF treatment, depending on the causes of infertility.
Who is a good candidate for ovulation induction treatment?
In order to be considered as a candidate for ovulation induction treatment, your uterine cavity must not have any abnormalities, at least one patent fallopian tube and the sperm count of your partner (or donor sperm) must be healthy.
What are the benefits of ovulation induction?

Ovulation induction is an affordable option for patients experiencing difficulty with conceiving. It is also a non-intrusive process, making it an ideal first option, if appropriate. 

Are there any risks associated with ovulation induction?

Other than possible short-term side effects, there is a potential risk for more than one egg to be released—resulting in a multiple birth pregnancy (for example twins).That said, the risk of twins is low, and triplets, in our hands, is extremely low.

Is ovulation induction ever combined with another fertility treatment?

Depending on the causes of infertility, it would be typically be a component of an IUI or IVF cycle.

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