Regular ovulation is associated with regular menstrual cycles. If there are irregular periods, long intervals between periods, or no menstrual periods, it can be said that an ovulation problem exists. In such a case, treatment may be required to ensure normal ovulation order and to make pregnancy possible. If pregnancy does not occur despite regular periods, medications may also be recommended for ovulation induction in order to increase the chances of pregnancy.

What is ovulation induction?

Ovulation induction is the process of taking medication to stimulate ovulation in irregular or non-ovulating women. According to scientific studies, 25 to 30 percent of women with infertility problems are known to have ovulation problems.

Normal ovulation occurs when a mature egg in the ovaries is released for fertilization. This biological routine occurs during a woman’s menstrual cycle, generally every 28 days. 21 to 35-day intervals also indicate acceptable and normal ovulation. If fertilization does not occur in the egg cell, mature eggs, and additional tissues are broken down and excreted from the uterus with menstrual bleeding.

Irregularity exists when ovulation occurs less than once every 35 days or in an unpredictable period. When the ovulation period is completely unpredictable, it is called oligoovulation, and if it does not occur at all, it is called anovulation. Ovulation problems affect fertility by eliminating the predictability of ovulation and the suitability of a potentially fertilized egg.

The purpose of ovulation induction is to increase a woman’s chances of having a baby by using sexual intercourse, intrauterine insemination method, or another fertility treatment such as IVF. However, the treatment of the underlying problem may also restore normal ovulation and fertility since the absence of ovulation is a symptom of a fertility problem.

Who is suitable for ovulation induction?

Ovulation induction is a common treatment method for women with frequent or infrequent ovulation. Women with disorders that interrupt ovulation, such as polycystic ovarian syndrome, may also benefit from ovulation induction.

Ovulation induction is also used in IVF treatment to stimulate multiple mature eggs. This is called controlled ovarian hyperstimulation.

Ovulation induction is performed for;

• Disorders that can directly prevent normal ovulation, such as polycystic ovarian syndrome,
• Imbalances in a woman’s hormone levels,
• Excessive exercise by the woman,
• Problems that may indirectly affect ovulation such as thyroid disorders, eating disorders, and obesity.

What medications are used in ovulation induction protocols?

In ovulation induction, various hormone-based medications to regulate a woman’s reproductive hormones and increase her chances of ovulating are used. Some of the commonly used medications are:

• Clomiphene citrate: It is used to stimulate ovulation in women who have normal pituitary hormones, which, however, do not undergo monthly normal changes.
• Aromatase inhibitors: In addition to similar indications such as clomiphene citrate, such medications are also very effective in polycystic ovary patients.
• Factors with insulin sensitivity: Such medications are used in some polycystic ovary patients diagnosed with diabetes or prediabetes.
• Gonadotropins: These contain luteinizing hormone (LH) and follicle-stimulating hormone (FSH), two injectable hormones that promote egg growth and are normally produced by the pituitary gland. Gonadotropins require more frequent observation than clomiphene citrate and letrozole as they strongly stimulate egg growth. If not used carefully, it may cause multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) where the ovaries are over-stimulated.

In some cases, the treatment of another disease, such as obesity or hypothyroidism, may naturally make ovulation regular.

What are the benefits of ovulation induction?

Ovulation induction is one of the first treatments usually used for infertility. In addition, ovulation induction is relatively low-cost compared to other fertility treatments. IVF is more effective in combination with intrauterine insemination or other fertility treatments if there are more serious causes of anovulation or infertility.