Ovulation Induction/Intrauterine Insemination
Ovulation Induction
Ovulation is the process by which a mature egg is produced and released from the ovary to be fertilised by a sperm. In response, the uterus (womb) lining thickens and prepares for the implantation of the fertilised egg. Ovulation is controlled by hormones. However, low hormonal levels may lead to problems with conception. Ovulation induction is hormone therapy that stimulates your ovaries to release eggs.
Indications
Ovulation induction is used to stimulate egg development and release in women who cannot ovulate. The goal is to produce multiple eggs in a single cycle to increase the chance of conception. It is usually ordered in conjunction with other assisted reproductive techniques like intrauterine inseminations (IUI, injection of high quality sperm directly into the womb for fertilisation).
Preparing for the procedure
Prior to ovulation induction, your ovulation cycle is confirmed by measuring your blood hormone levels. A vaginal ultrasound scan (imaging technique using sound waves) is performed to view the development of follicles in the ovary, and appearance and thickness of the lining of the womb.
Procedure
Ovulation is induced by fertility drugs. The ovulation induction cycle includes the following steps:
- On day 1 of the menstrual cycle, you will visit the clinic for a blood test.
- On day 4, you will inject medication subcutaneously for ovulation induction.
- On day 10 or 11 of the menstrual cycle, you will be having another blood test to check your hormonal levels.
- On day 14 of the menstrual cycle, an ultrasound scan will be ordered to ascertain if you are about to ovulate. However, if your menstrual cycle is irregular, you may not ovulate on day 14, and would need to continue with the medication until you do so.
Risks and complications
The most common complications associated with ovulation induction are the development of ovarian cysts and multiple births. The procedure may sometimes lead to the over stimulation of the ovaries (ovarian hyperstimulation syndrome), which may cause severe pain in the chest, abdomen and pelvis, weight gain, nausea and difficulty in breathing.
Ovulation induction controls the time of egg release so you can accurately schedule sexual intercourse and other assisted procedures such as IUI and IVF (fusion of egg and sperm in the lab) to increase your chances of pregnancy.
Intrauterine Insemination
Intrauterine insemination (IUI) is a treatment for fertility, performed in couples unable to conceive despite trying for at least a year. IUI involves placing sperm in a women’s uterus to facilitate fertilization (fusion of egg and sperm). IUI gives the sperm a head start in entering the womb, but will still have to reach and fertilize the egg on its own.
Indications
IUI is a fertility treatment indicated for couples with conditions such as unexplained infertility, abnormal sperm count or mobility, cervical problems and ejaculation dysfunction.
Preparing for the procedure
Semen is collected from your partner at the clinic. The sperm sample is washed to select only the best sperm that look normal and highly active, from the low-quality sperm. There are higher chances of conceiving if a highly-concentrated sample of healthy sperm is used. You will be monitored for signs of ovulation (release of an egg). Physicians may also ask you to take medication to stimulate the ovaries and improve egg production and chances of pregnancy. IUIs are usually performed a day or two after ovulation is identified.
Procedure
During the procedure, you will lie on an exam table. A hormone called human gonadotropin hormone is injected to release the eggs. Your doctor injects the sample of semen directly into the uterus through a catheter (long tube). After the procedure, you will be asked to remain lying on your back for a few minutes. This entire procedure may cause minimal discomfort and is completed in a short time.
Risks and complications
IUI is relatively safe and is not associated with serious complications; however, certain risks may occur such as infection and vaginal bleeding due to the placement of the catheter inside the uterus. IUI by itself may not be associated with a risk of multiple pregnancies. However, when coupled with ovulation inducing medication, you are at a higher risk of multiple pregnancies.
