Approximately one-third of infertile patients have abnormalities with the ability to produce mature eggs or release the eggs (ovulation). Ovulation medications "fertility drugs" can stimulate the ovaries to release eggs (ovulation induction). Ovulation induction may be recommended to correct ovulation disorders or produce several eggs (superovulation) especially in patients with unexplained infertility, advanced age, or when other more treatments have not resulted in pregnancy. The most commonly prescribed ovulation drugs are clomiphene citrate and follicle stimulating hormone (FSH) or human menopausal gonadotropin (hMG).

Clomiphene Citrate
Clomiphene citrate is an oral medication used to stimulate ovulation in women with irregular cycles and often as a first line treatment for couples with unexplained infertility. The medication is generally given for 5 days each menstrual cycle (days 3-7) and ovulation usually occurs about a week after the last tablet. Ovulation may be monitored by ultrasound and blood testing (progesterone levels). Either intercourse or intrauterine sperm insemination may be recommended at the time of ovulation. The lowest dose of clomiphene citrate that induces ovulation is generally recommended as increasing the dosage generally increases side effects without improving ovulation. The most frequent side effects include hot flashes, nausea, breast tenderness and headaches. Fertility medications increase the risk of multiple pregnancies. The chance for twins with clomiphene citrate is approximiately 8 percent and rarely do more than twins occur. Generally, clomiphene citrate is used for four to six cycles and if pregnancy has not occurred, other options are considered including superovulation treatment.

Superovulation Treatment
Superovulation treatment will stimulate the growth of several follicles in the ovaries to induce the formation of more than 1 or 2 eggs per cycle in order to enhance the chance for pregnancy. The medications are given as daily injections of FSH and/or hMG and start around the 3rd day of your cycle continuing for approximately 6-10 days. Patients are monitored closely by ultrasound and bloodwork to assure an appropriate response to the medication. This typically involves 4 or 5 visits before ovulation, although additional monitoring may be required. The most common side effects of the medication include abdominal bloating, breast tenderness, and mood swings. In 80 percent of pregnancies that occur following superovulation treatment a single intrauterine pregnancy will result, however, there is an increased risk of multiple pregnancies. Closely monitoring the response to the medication can decrease this risk.

Intrauterine Insemination (IUI)
Intrauterine sperm insemination is a specialized procedure in which washed sperm are deposited within the uterine cavity by a catheter passed through the cervical canal. We hope to provide motile sperm with an increased number of eggs to enhance the chance of pregnancy. Intrauterine insemination may be recommended in conjunction with clomiphene citrate or superovulation treatment and will often be recommended for couples with male factor infertility.