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Anovulation (not ovulating) is one of the common reasons of infertility. This can be treated by inducing ovulation. What forms of treatments are available for inducing ovulation? The most commonly prescribed medicines for induction of ovulation include:
- Clomiphene citrate
- Human menopausal gonadotrophin (HMG)
- Follicle stimulating hormone (FSH)
- HCG (human chorionic gonadotropin)
- GnRH (gonadotropin releasing hormone)
- GnRH analogue
- For women with hypogonadotropic hypogonadism (low FSH and LH levels), the treatment of first choice is HMG. This is effective replacement therapy; and excellent pregnancy rates can be achieved in these women.
- For women affected by hyperprolactinemia, the drug of first choice is bromocriptine.
- For most other women, the drug of first choice is clomiphene - the "workhorse" of ovulation induction. If this does not work, then HMG is resorted to.
- Poor responders to HMG can be treated with GnRH analogues in conjunction with the HMG; or by adding a hormone called the human growth hormone.(HGH).
- HCG (human chorionic gonadotropin) is given to trigger off the release of the egg.
- In patients with high androgen levels (high blood levels of male hormones), dexamethasone can be used as an adjunct, since this suppresses androgen production.
Often ovulation induction requires an investment of time, money, energy and emotion before a satisfactory response is achieved. After all, every woman is different and there can be no standard "formulae". Careful monitoring of the response to ovulation induction is the key to therapy - and this usually involves daily ultrasound scans and/or blood tests.
It is often a tedious process - which may involve "trial and error" to tailor the therapy to the individual patient's ovulatory response. With the treatments available today, however, correcting ovulatory dysfunction is one of the most rewarding and successful of infertility treatments.
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