Ovulation Induction

Making an appointment with a fertility doctor to have a thorough talk about potential causes of infertility is the first step to take if ovulation induction is being explored. A sperm test result should be available to confirm that induction and timed intercourse is the optimum choice when discussed with the doctor.

Since all facets of fertility treatment are covered in this session and questions can be addressed, it is highly advised that both partners attend. It is possible to perform blood tests and write medicine prescriptions. You might also talk to the lab staff and the fertility sister regarding the procedure.

Since sperm production can change over time and a healthy sperm population is required for the process to be successful, a sperm test should be performed at the unit, especially if a prior test was performed more than a year ago or at a different lab that is not an accredited South African fertility unit.

The accounts department should be contacted with any questions you may have before the treatment begins so they can explain the fees and processes involved.

The first month must be a monitored cycle, which entails coming in for a number of scans and undergoing a number of blood tests during this month. As soon as the patient’s period begins, she should get in touch with the fertility sister. She can get in touch with the sister early on Monday morning if this occurs over the weekend. Day 1 will be the first day of menstruation, and Day 3 or Day 4 of the cycle is often when the stimulation medicine is started. The sister will then help the patient schedule a visit with the doctor for the initial sonar scan and have another conversation about the treatment strategy and stimulant medicine.

It is crucial to get in touch with the sister at the beginning of her cycle since in some circumstances blood tests and/or a sonar scan may be required before medication is started. Please take note that Day 1 of your menstruation is defined as the first day of bright red blood flow.

There are several different medications with different strengths and actions.  They will be prescribed based on each patient’s diagnosis and the response of the ovaries and eggs.   The medication is in the form of tablets, e.g. Clomid, Fertomid, Femara, Laradex, and injections, e.g. Menopur, Gonal-F. These medications include some that contain FSH (follicle stimulation hormone) to stimulate the eggs to grow. To initiate the egg growth, the stimulation medicine is often used from Day 3 to Day 7.

Around  Day 2 or Day 3 of your menstrual cycle, you will have a scan to ensure that there are no polyps or cysts and that the endometrium, the lining of your uterus, is thin and regular. The number of follicles that might respond to the medicine will also be counted by the doctor.

The sonar scan on Days 10 or 11 enables the physician to track the development of your endometrial lining as well as the growth of the follicles (which hold the eggs). Following that, one or more scans to track the development of the follicles may be performed, along with some blood tests.

Blood LH testing will start when the leading follicle is about 18mm in size. When the follicle (the sac where the egg ripens) is mature and prepared for ovulation, a rise in LH levels in the blood can indicate this. A single blood test may not always detect the LH surge since LH is delivered in pulses or brief bursts. Consequently, it could be essential to carry out two or more of these tests on back-to-back days.

Even though figuring out whether and when ovulation is happening may seem difficult and time-consuming, getting pregnant frequently requires this step.

If your period is a few days late, you can perform a less accurate home pregnancy test. A blood test should be used to verify the results of the urine test. If you have any questions regarding the tests or how to interpret the data, you can contact the nursing sister at any time.

You might be needed to return for scans in the following month if the medicine and/or dose need to be adjusted.

Once we have identified your specific treatment plan, in terms of the correct type of medication and dose, as well as your LH peak, you will then be given your ‘fertile days’ and timed intercourse can then happen accordingly for the next 4 – 6 months.

After three months, a planning meeting with your treating doctor will often be conducted to discuss the next step, especially in the case of  patients over the age of 38 or couples with a known male component.