Making Ovulation Possible
Ovulation Induction with Clomid® and Other Fertility Drugs in Chicago, Illinois
Medication plays an important role in the treatment of infertility. While many fertility problems can be addressed through medication alone, even advanced treatment procedures like IVF rely on fertility drugs to stimulate the ovaries and control the menstrual cycle. Fertility drugs like Clomid® and Gonadotropins (FSH injections) make ovulation induction at our Chicago, Illinois-area practice possible.
- Clomiphene Citrate
- Gonadotropins (Injectables)
- Human Chorionic Gonadotropin (hCG)
Clomiphene Citrate (CC)
Clomiphene citrate, or Clomid®, is chemically similar to estrogen and works (as an anti-estrogen) by triggering the pituitary to increase the production of follicle stimulating hormone (FSH). FSH is responsible for the stimulation and maturation of oocytes (eggs).
Due to its effectiveness and relatively low risks, Clomid® is among the most frequently prescribed fertility drugs, especially for women who do not ovulate regularly. Patients must have a functioning pituitary gland and an adequate ovarian reserve for successful results. On average, 40 percent of women who take Clomid® will conceive within the first four cycles. If the first few cycles are unsuccessful, IUI may be added to the treatment plan. The risk of ovarian hyperstimulation syndrome (OHSS) is minimal and the risk of having twins is also relatively low.
During treatment with Clomid®, the patient will be monitored regularly to assess the effectiveness of treatment, watch for adverse reactions, and help pinpoint the time of ovulation. Once the eggs are released, insemination or intercourse should take place within 24 to 38 hours for the best chance of conceiving.
Learn more about treatment with Clomid® and IUI by visiting our Other Treatments page.
Read Dr. Jacobs' article about Clomid® and IUI (PDF)
Gonadotropin preparations, such as Gonal-f® , Follistim®, Bravelle®, Repronex® and Menopur® are designed to directly mimic the effects of FSH and LH on the ovaries, rather than triggering the release of these hormones by the pituitary. Gonadotropins are most commonly used during ovarian stimulation for IVF, although these fertility drugs can also be administered to patients who do not adequately ovulate in response to treatment with Clomid®. Gonadotropins may also be used in combination with Clomid® in order to improve the ovarian response.
Patients undergoing gonadotropin therapy (non IVF) will be closely monitored to ensure that follicular development is progressing properly. Because gonadotropins act directly on the ovaries, there is an increased risk of ovarian hyperstimulation syndrome (OHSS) as compared to Clomid®. If signs of OHSS are observed, administration of fertility drugs will be ceased. Gonadotropins with IUI or intercourse may increase pregnancy rates compared to Clomid®, but unfortunately the risks of multiples are considerably higher, as are the costs.
To learn more, read Dr. Jacobs' article "Couples' Guide to Fertility Treatments" (PDF 291KB)
View training videos from Freedom Fertility Pharmacy to learn how to administer injections of fertility medications.
Human Chorionic Gonadotropin (hCG)
Human Chorionic Gonadotropin (hCG) is used during ovulation induction to trigger the final maturation and release of the eggs. Because the use of fertility drugs often interrupts the body's natural hormonal processes, a patient taking gonadotropins will not have the increase in lutenizing hormone (LH) that would normally trigger ovulation. HCG, a pregnancy hormone produced by the placenta, mimics the effects of LH and prepares the eggs for release or retrieval.
It should be noted that hCG is the hormone that is detected by both urinary and blood tests for pregnancy. The administration of hCG during infertility treatment can result in a false positive on a home pregnancy test. Patients undergoing ovulation induction or receiving fertility drugs will need to have a laboratory pregnancy test, which measures the quantity of hCG and can differentiate between the small amount of residual hCG from treatment and the increased levels that indicate pregnancy.
Under normal circumstances, a woman's body produces progesterone after ovulation, which causes the uterine lining to thicken and provides support for the early embryo, should conception occur. When a woman undergoes ovarian stimulation and egg retrieval for IVF, however, she does not generally produce enough progesterone to achieve these effects. This is because the cells within the follicles that produce progesterone are removed along with the eggs during the IVF follicle aspiration. Therefore, supplemental natural progesterone is given to ensure that the uterus is ready to receive and support the embryo when the transfer procedure is performed.
Natural progesterone may also be administered during ovulation induction treatments, as well as in cases of recurrent pregnancy loss due to inadequate progesterone production.
To learn more, read Dr. Jacobs' article about progesterone supplements (PDF)
Commonly known as Lupron®, this medication is sometimes administered at the end of a prep cycle preceding an ovarian stimulation cycle for IVF. By suppressing the body's natural hormone functions, Lupron® prevents spontaneous, early ovulation and improves our ability to control the ovarian stimulation process.
Contact Laurence Jacobs, M.D.
To learn more about Clomid® and other fertility drugs used during ovulation induction, contact our Chicago, Illinois-area practice.