Ovulation Induction: Method, Cost, Risks, Success Rates, and More

By Abeera Maham
Edited by Taj Schlebusch

Published October 22, 2021.

Woman tracking ovulation cycle

Ovulation occurs when luteinizing hormone (detectable by properly using an ovulation test) causes an egg to be released from one of the ovaries and happens around once a month in women who have a regular menstrual cycle. However, in some women, the follicles that house the eggs do not mature regularly and so, they either ovulate irregularly, seldom, or not at all (anovulation).

Ovulation induction is a type of hormone therapy used to stimulate egg growth and release (ovulation). The goal is to release a single, mature healthy egg (ovum).

The purpose of ovulation induction is to increase the chances of conceiving a child by women, either through sexual intercourse or through intrauterine insemination (IUI) or other fertility treatments.

How Can You Induce Ovulation?

Before treating ovulation difficulties or treatment of fertility issues, various tests must be performed to determine the cause. An ultrasound scan of the ovaries and womb, as well as blood tests to evaluate hormones such as thyroid, prolactin, follicle-stimulating hormone (FSH), luteal hormone (LH), testosterone, and other androgens, are among the procedures used (male hormones).

It is also critical to ensure that the ovary can respond to medical therapy. Ovarian failure, often known as menopause, is one possible cause of unsuccessful ovulation.

If ovulation does not occur, medicines to increase egg production may be given at the start of menstruation. If tablets do not work, more potent fertility injections may be required to induce an increase in egg production in the ovaries.

Medication Regimens Used to Induce Ovulation:

  • Clomiphene or Clomid Tablets These stimulate the pituitary gland's production of follicle-stimulating hormone (FSH), promoting follicles and thereby egg development. This pill is typically administered in a starting dose of 50 mg (1 tablet) from the second to the sixth day of the period. If your periods are highly irregular, you may need to stimulate them using a different medication called Norethisterone. Alternatives to Clomiphene or Clomid include Tamoxifen and Letrozole tablets.
  • Gonadotrophins Administered Through Injection The active element in Gonadotrophins is the follicle-stimulating hormone. Menopur, Gonal F, and Bemfola are examples of injections that are administered daily and begin at a dose of 75 IU each day.
  • Aromatase Inhibitors With indications similar to clomiphene citrate, Aromatase inhibitors are particularly beneficial in PCOS patients. Most people are familiar with this medicine as Letrozole or the brand name Femara.
  • Insulin-Sensitizing Medications These medications are utilized in some PCOS patients who have diabetes or prediabetes. Metformin is the most common name for this medicine among patients.

Using Letrozole for Successful Ovulation

Women who use Letrozole can produce more natural stimulation, causing their ovaries to induce ovulation naturally. A Letrozole dose for ovulation induction works by inhibiting estrogen production, causing the body to produce more follicle-stimulating hormone(FSH) than usual.

According to an extensive study from a research network financed by the National Institutes of Health, the medicine Letrozole appears to be more helpful than the usual prescription Clomiphene in assisting women with polycystic ovarian syndrome (PCOS) to achieve pregnancy.

  • How to Take Letrozole for Fertility Letrozole is usually administered orally at a dose of 2.5mg. It should be taken five days a month, from day two to day six of your menstrual cycle. The first day of your period is day one (the day you start to bleed). For the best effects, take this pill at the same time every day.
  • Possible Side Effects of Letrozole Fatigue, dizziness, headache, bloating/abdominal discomfort, hot flashes, blurred vision (far less common than with Clomid), and difficulty sleeping are all possible side effects of taking Letrozole for fertility.

Monitoring Ovulation Induction

Ultrasound scans are used to monitor the reaction to any medications that have been administered. When the follicles reach an adequate size, intercourse is advised. Or, an HCG injection is administered to help with the timing of intercourse or IUI.

How Long Does Ovulation Induction Take?

The timeline of ovulation induction varies. The individual reactions to therapy can be unpredictable, and if the response is insufficient or too strong during monitoring, the cycle may need to be interrupted and resumed as needed. If the reaction to the medications is adequate, treatment is normally continued for six cycles; these treatments can be completed without interruption.

How Successful Are Ovulation Induction Treatments?

According to the Yale University Medical Department, ovulation induction has a 20 to 25% success rate of conception per cycle. The basic rule is to try this for no more than six cycles. Ovulation induction success rates for the first three cycles are the highest, which subsequently begin to decline in the following cycles.

Can Ovulation Induction Cause Twins or Triplets?

When the ovaries are stimulated, many follicles might grow and release an egg at the same time. This could lead to multiple pregnancies.

According to University Hospitals Coventry and Warwickshire, twins can occur in up to 10% of Clomiphene-treated cases and 20% of gonadotrophin-treated cases. In roughly 1% of cases, triplets are also conceivable.

What Is the Cost of Ovulation Induction?

The cost of ovulation induction drugs varies greatly:

  • Oral medication (which can be provided by an OB-GYN or REI (Reproductive Endocrinologist): $30-$130
  • Injectable medication (administered only by REIs ): $3000-$5500

What Are the Risks of Ovulation Induction?

Potential side effects of ovulation induction include:

  • OHSS (Ovarian Hyperstimulation Syndrome) This is a rare condition in which a woman reacts adversely to ovulation induction and experiences symptoms such as discomfort, bloating, nausea, and vomiting. The symptoms range from moderate to severe, and in the worst cases, hospitalization is required immediately.
  • Multiple Pregnancies Ovulation induction procedures can result in multiple pregnancies. The likelihood of multiple pregnancies is decreased but not eliminated, with careful monitoring.

Who Should Consider Ovulation Induction?

Women who did not ovulate on their own but want to have a child, women with irregular menstrual cycles, and women going through anovulation (absent ovulation) problems can also benefit from the ovulation induction method.

For motivation and support through this period, we recommend finding success stories about ovulation induction.