In some women injectable medications are used to directly inject FSH or LH into the adipose tissue on the body, which produces a stronger response from the ovaries. To optimize success rates, this is frequently combined with intrauterine insemination.


Controlled ovarian hyperstimulation can be used when patients have failed attempts at conception using oral medications, do not respond to oral medications, or where a greater egg number is desired because of age, egg quality or sperm quality. It is also the best treatment outside of IVF for all patients with normal fallopian tubes, including those with unexplained infertility.


Patients will need to undergo teaching. The medications have been designed to be extremely user friendly and are capable of being injected in a near painless, easy, self-administered method. Most patients will need to use the medications anywhere from 8-12 days to optimize follicle growth. In order to avoid any risks of excessive egg production, patients are always carefully monitored with ultrasounds and blood work every few days.


There are risks of bruising and inflammation or even infection at the injection site, though these are extremely rare. Some patients who are ovulating multiple eggs will experience mild to moderate cramping at the time of ovulation. In rare instances, patients can develop ovarian hyperstimulation syndrome, and require further medication and/or treatment(s) to mitigate the symptoms. Multiple pregnancy rates are higher than with natural conception or oral medications, usually occurring in up to 10-20% of cycles.