Referral & Treatments

Ovulation Induction

Ovulation induction involves the controlled administration of fertility drugs that stimulate the ovary to produce mature eggs. This is usually reserved for women who have very irregular menstrual cycles and in whom investigations have shown that they do not ovulate on a regular basis. Ultrasound scans and blood tests are undertaken to ensure that the treatment is effective and that you do produce a mature follicle so that intercourse can be timed at the optimum time to achieve a pregnancy.

There are two fertility drugs that are commonly used. The first of these is a tablet known as Clomiphene citrate. Clomiphene is an anti-oestrogen and works by stimulating your pituitary gland to release more follicle stimulating hormone, which is the hormone required in the latter stages of egg development. Normally this is given in a short course at the beginning of the menstrual cycle for 5 days. Under normal circumstances women ovulate naturally in response to Clomiphene. Occasionally an added hormone injection - human chorionic gonadotrophin (hCG) is given when the follicle is mature to ensure that it is released from the follicle.

The second type of fertility drug that is used is the hormone injection known as a gonadotrophin. There are a variety of gonadotrophins available, and some common proprietary names include Gonal-F, Puregon, Menogon and Menopur. Gonadotrophin injections are given on a daily basis usually in a low dose to try and stimulate the development of a single mature follicle, which is then primed to release the egg using an hCG injection when the follicle has reached an appropriate size.

Your fertility specialist will advise which of these medications is appropriate. Under normal circumstances women may need a few months of ovulation induction treatment to conceive.

Intrauterine Insemination

Intrauterine insemination is used in couples with poorly explained fertility. It is normally combined with a process known as superovulation. Superovulation involves taking fertility drugs at the beginning of the menstrual cycle either in tablet form or by hormonal injections to stimulate the production of 2-3 eggs. The response is monitored by ultrasound scans to make sure that treatment is effective and that you do not produce too many follicles. When the lead follicle reaches a certain size (usually 17 mm) ovulation is induced using and hCG injection.

Just prior to the time where you would ovulate, your partner's sperm needs to be placed inside the cavity of the uterus so that it is in the right place at the time the egg is released. Insemination technique involves placing a speculum (the same instrument that is used when you have a cervical smear test) which inserted into the vagina to expose the cervix. A sample of your partner's sperm, which has been appropriately prepared in the laboratory, is then inserted into the uterus. This should not cause any undue discomfort.