Non-IVF Treatment Options
Sometimes we recommend using oral pills (like clomiphene citrate) or injectable medications (called gonadotropins) to stimulate the ovaries to produce single or multiple mature eggs. Injection medications are sometimes recommended when an infertile woman/couple has not had success using oral medications (usually clomiphene citrate) to induce ovulation or cause pregnancy. Gonadotropins are also used as a primary treatment for in-vitro fertilization (IVF) treatment cycles and certain circumstances where other medications would not be expected to be effective.
Here is more information about the injections medications:
- The medications are natural or recombinant forms of one or both of the hormones “Follicle Stimulating Hormone” or “Luteinizing hormone”.
- The goal of COH depends on each woman's unique situation but may be to stimulate the growth of one ovarian follicle (with egg inside) or multiple follicles.
- The dose of the gonadotropins is highly variable but relates to the underlying cause of infertility, age, previous response to medications, and how many follicles your doctor is attempting to stimulate.
- Every woman responds differently to the gonadotropins so the first treatment cycle of COH often becomes a learning experience as the doctor evaluates how a woman responds.
- Gonadotropin doses are commonly altered during a treatment cycle.
Practical information about using injection medications:
- Patients generally use daily injections of gonadotropins for about 7 to 10 days.
- During the treatment, a patient will usually come in 5 days after starting the medications for an ultrasound and an estrogen measurement (blood draw).
- One to three subsequent visits to the IVF clinic for an ultrasound and estrogen are usually necessary during the treatment cycle.
- Once the follicles reach a mature size (as seen by ultrasound) this indicates that the eggs are ready for ovulation and gondotropin medications are discontinued.
- An injection of human chorionic gonadotropin (hCG) is given that evening and ovulation predictably occurs about 36 hours later.
- Timed intercourse or intrauterine insemination then occurs about 36 hours after the hCG injection.
- The use of gonadotropins is discussed in detail during a “COH Teaching Class” offered on a regular basis by the UNC Fertility nurses.