Your doctor may recommend superovulation if Clomiphene and/or Letrozole have been ineffective or when the ovaries need stronger stimulation. This treatment may be used for patients with unexplained infertility. Superovulation involves injecting fertility hormones (gonadotropins) to stimulate the growth of multiple eggs in order to increase the chance of conception.
Medications used in ovarian stimulation:
Gonadotropins are the hormones that signal or stimulate the ovaries to produce eggs. There are two gonadotropin hormones: Follicle Stimulating Hormone (FSH), which stimulates the development of eggs, and Luteinizing Hormone (LH), which is important in egg maturation.
Human Chorionic Gonadotropin (hCG)
hCG is a hormone that is naturally produced in pregnancy. It is used in fertility treatment because it is known to bring about the final maturation and release (or “ovulation”) of mature egg(s).
What is the process?
Your treatment usually starts on day two or three of your menstrual cycle and lasts approximately eight to ten days. A nurse will teach you and your partner how to give the injections at home. You will likely have two to four clinic appointments for blood tests and/or vaginal ultrasounds to monitor your response and adjust your gonadotropin dose.
When the blood tests and ultrasounds indicate that you have one to four mature follicles, your doctor will administer a second medication (hCG) to trigger ovulation. You will usually ovulate 36 to 48 hours after this final injection.
Approximately 24 to 36 hours after the hCG injection, you will have an intrauterine insemination (IUI). This is accomplished by inserting a specially prepared sample of your partner’s sperm (or donor sperm if applicable) through the cervix and placing it near the top of your uterus where it has the best chance of reaching an egg. The procedure takes only a few minutes and should be relatively painless.
What are the side effects?
You may experience bloating, breast tenderness, cramping, pelvic twinges or heaviness, fatigue, and headaches.
Your doctor will talk to you about the risks.
They can include
- Overstimulation (too many follicles)
- Multiple pregnancies
- Ovarian Hyperstimulation Syndrome (OHSS)
- Cycle cancellation