About 35%t of women are found to be anovulatory upon assessment, that is, not ovulating enough to conceive without assistance. These women may sometimes ovulate, but not regularly enough to be able to predict fertility and plan conception. Women in this situation will be introduced to the concept of what is called ovulation stimulation or induction.  Ovulation stimulation, in its simplest form means, to induce ovulation to help women ovulate monthly

Ovulation stimulation may also be recommended for those patients who are ovulating regularly, but who are coping with some forms of male factor infertility or unexplained causes of infertility. For these women, Dr. Torbati can do what we call 'superovulation', which gives them medications for the sole intention of creating more than one egg per cycle and to increase their chances of getting pregnant.

When considering the miracle of conception, which is one egg meeting one sperm to create an embryo, superovulation via fertility medications is simply a way to boost the odds: more eggs, more chances to conceive.

Whenever fertility medication is used in conjunction with in vitro fertilization (IVF), the goal is to help the woman's body create 10 or more eggs. Again, it's a way to maximize chances for success. This allows us to generate a higher number of embryos. Then, we can evaluate and only transfer back the embryos that will give the woman a good chance at pregnancy.

Generally speaking, out of 10 eggs, five to seven will fertilize to embryo stage, and then of those, about half will have the best qualities for pregnancy.

Comparing the options

Ovulation stimulation is done through administering of special medications, often referred to as fertility drugs, to the woman. Medications range from relatively inexpensive orals (tablets of the drug clomiphene citrate) to more costly injectables. Some of the most widely used injectable medications are follitropin alfa or beta, and urofollitropin.

Clomiphene is often the first line of treatment for many women, but it is not generally used in IVF, and can sometimes actually lower chances at conception through its antiestrogen action. Statistics point out that most women who respond well to clomiphene by ovulating do so within the first cycle of treatment.

A typical IVF cycle and some artificial insemination cycles use medications that are injected subcutaneously (with a small needle just under the skin) at home by the patient (or her partner), accompanied by stringent monitoring by the clinic staff. Monitoring includes ultrasound and checking of hormone levels by blood draw approximately every three days. Such monitoring is important because there are some risks involved for the woman, notably ovarian hyperstimulation, a situation that can result in nausea and abdominal distention and which can be remedied quickly upon observation.

Another risk of ovulation stimulating medication use is multiple pregnancy (30% chance depending on the drug used and the number of eggs produced.)  Because it stimulates the ovaries, a woman may produce more than one egg in each cycle, which can result in a pregnancy of twins (or, rarely, more). While a multiple pregnancy occurs for only about one in 15 women, it is something to consider before beginning treatment.