Conception is not just an event, it takes time, patience, and often multiple attempts to be able to conceive a child. And many times, it is the lack of awareness that is the undoing for several couples. Ovulation induction is a stage in the conception procedure wherein the egg is released from the ovaries and is ready for fertilisation.
It all begins with the first day of the periods, in case of those who have had challenges with their cycles a dose of progesterone can be helpful. Once the period commences, the doctor can examine the vaginal cavity to ascertain the stage of the ovaries and understand if there are underlying conditions such as endometriosis or PCOD that is hampering conception. The patient, based on this assessment may be placed on medication to boost hormone production, aid maturity of the eggs and trigger ovulation.
The doctor will also conduct a transvaginal ultrasound examination of the ovaries for their assessment. If any large cysts are present, the cycle may be cancelled. However, if tiny cysts are present, similar to those seen in women in Polycystic Ovary Syndrome (PCOS), then the cycle will not be cancelled.
Medication is given to boost hormone production and stimulate the ovaries so that it can promote the development of a mature egg or mature eggs which will be released during ovulation. Two types of medication can be prescribed: Pills, such as Clomid, (or) in an Injectable Form. Oral medication is usually taken for 5 days and injectable medication is typically taken for 8-12 days based on how the ovaries respond. Your doctor will create a custom medication schedule tailored to you. Some women take oral medication at night to sleep through some of the side effects, while others prefer taking it in the morning.
Monitoring the Ovaries
To ensure accurate timing of each step, ultrasounds and blood tests will be done every 2-3 days to monitor the growth of the follicle and ensure that things are progressing safely and in the right required direction. This will help the doctor evaluate how many eggs are developing and the cycle may be cancelled if an excessive number is likely to ovulate to avoid multiple high-risk pregnancies and enable singleton pregnancy. Based on how the eggs are developing, the doctor is monitoring to select the best time to administer the trigger shot which will induce ovulation.
Once the egg has reached optimal development, a trigger shot is administered, causing ovulation within 36-42 hours. The trigger shot has human chorionic gonadotropin (hCG), a hormone that signals the follicles to rupture and release an egg.
Following the trigger shot, the couple are advised to have intercourse daily or every alternate day to maximise the chances of fertilization.
Testing for Pregnancy
A pregnancy test is taken 2 weeks after ovulation. If the pregnancy test is taken earlier than the 2 weeks wait might result in a false positive due to the hormone given via the trigger shot. If the cycle is unsuccessful and does not result in pregnancy, another cycle may be pursued and the medication levels will be adjusted accordingly. If more than 3 timed intercourse cycles do not result in pregnancy, we would advise the patients to move on to other advanced treatment options. During this process, the doctor will take great care to discuss your options and chances for success with each. We listen to your needs and guide you towards the treatment option that is best for you and support you in your journey to parenthood.