Infertility Treatment: Ovarian Hyperstimulation

A first step for many couples dealing with fertility problems is to increase egg production. It is typically done in conjunction with intra-uterine insemination, which increases success rates.

This treatment doesn’t correct a specific cause of infertility. Instead, it is an often effective approach to get multiple eggs and sperm together at the time of ovulation. This type of treatment has been shown to increase the monthly chances for a pregnancy, as compared to timed intercourse alone, in patients with unexplained infertility.

Ovarian stimulation with insemination should not be used with very low sperm concentration or very poor sperm motility, blocked fallopian tubes, or if the age of the female partner is over 41.

Controlled ovarian hyperstimulation is also used to develop multiple mature follicles for in vitro fertilization cycles.

Ovarian Hyperstimulation Process

• The ovarian stimulating drug (Clomid, GnRH injections) is given early in the menstrual cycle.
• A baseline blood and ultrasound is usually done on day 2-4 of the menstrual cycle.
• The medication is started soon after that.
• Ultrasound and blood testing is done to monitor the response to the meds and follicle sizes.
• An HCG trigger shot is given when the follicles are mature.
• Sex or insemination are timed for about 36 hours after the trigger shot.

Pregnancy Success Rates for Controlled Ovarian Hyperstimulation

Success rates for controlled ovarian hyperstimulation with intrauterine insemination vary considerably and depend on the age of the woman, the total motile sperm count, the quality of the sperm, how long the couple has been trying to get pregnant, what the infertility factors are in the couple, etc. It is used most often in couples with unexplained infertility and in those with slight reductions in sperm counts (“mild” male factor).

For women 40 and older, success rates with this form of infertility treatment are very low, and IVF should be considered relatively soon.

We have found that this type of treatment is considered reasonable for about 3 cycles (in women under about age 38), after which IVF is usually considered as the next step.