Overview:For women who are not ovulating regularly, the goal of treatment is to mature and ovulate a single egg—this is known as ovulation induction. In some cases, where ovulation of multiple eggs is desirable this can also easily be achieved.
Why is it done?This technique is most often used in women with (polycystic ovarian syndrome), but can be used for many others including male factor infertility, endometriosis, advanced maternal age.
OVULATION INDUCTIONIf you’re trying to develop just one to three eggs, the two main agents that we use are letrozole(Femara) or clomiphene citrate (Clomid, Serophene). Both of these are pills that are taken for five days from menstrual cycle day 3-7, in the hopes of producing at least one, and often 2-3 eggs per cycle. For women with PCOS, letrozole has been proven to have a higher success rate compared to Clomid (Legro et al. N Engl J Med 2014; 371:119-129). Letrozole reduces estrogen levels making the pituitary gland secrete more FSH, stimulating the ovaries to produce at least one and often several eggs. Clomiphene citrate works by inhibiting feedback of estrogen levels on the hypothalamus, causing increased FSH and LH release, again stimulating the production of eggs.