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OVULATION SUPPORT
Egg growth and development leading to ovulation of one or multiple eggs is the basis for fertility treatments -- it all starts with the egg! In order to enhance this process, medications may be prescribed to assist in providing a more efficient process or possibly to allow for multiple eggs to develop in order to increase chances of conception. Cycles utilizing oral or injectable medications often require ultrasound monitoring to determine appropriateness of dosing and response as well as determining timing of ovulation. Medications can be utilized in cycles where couples elect to time intercourse appropriately at home or in conjunction with intrauterine inseminations (IUIs) in the clinic.
OVULATION SUPPORT
Oral medications alter the body's perception of estrogen, through one of several mechanisms, which in turn signals the pituitary gland in the brain to produce FSH, thus helping a follicle to grow and release an egg. Sometimes, this process allows for multiple follicles to grow and thus release multiple eggs. In general, pregnancies resulting from cycles utilizing oral medications carry a 10% chance of multiples (i.e. twins).
- Clomid is an oral medication that can be utilized to assist egg development in advance of ovulation. It can cause common side effects of headaches and hot flashes; severe, but rare, side effect includes visual disturbances -- should this occur, this should be reported immediately to our clinical staff.
- Letrozole is another oral medication that can aide egg growth and development in advance of ovulation. It is officially FDA-approved for use in breast cancer patients to decrease risk of recurrence. It has been well-researched for over a decade in the reproductive health arena, and though utilized in an off-label manner is a commonly-prescribed alternative to Clomid. Common side effects are headaches, hot flashes, and achy joints. Rare but serious side effect is a potentially increased incidence of birth defects in offspring if taken in early pregnancy (and therefore warrants consideration for blood testing for pregnancy prior to prescribing).
- Gonadotropins are hormone injections that directly stimulate the ovaries to grow follicles and release eggs. Because of direct stimulation of ovaries rather than altering indirect pathways peripherally and in the brain, gonadotropin injections often provide a more robust response by way of mature follicles at the time of ovulation. Injections are started very early in a patient's menstrual cycle and continue, daily, for as long as a couple of weeks with close monitoring by way of ultrasound and labwork.
