Ovulation induction

Dr Richard Murphy

Ovulation induction

Ovulation induction is a ‘fertility treatment’ which aims to produce optimal conditions for pregnancy when an egg is released. Your fertility specialist will prescribe medication that helps one of your eggs mature. Any type of fertility treatment will always start with an accurate diagnosis allowing the most appropriate further investigations and treatments to be chosen. As your fertility doctor, I will help you understand your options so you can make a well-informed decision.
Obstetrics and gynaecology consultations at my private practice in Subiaco.

Fertility consultations at Genea Hollywood

Delivering at the Labour Ward of SJOG Subiaco Hospital

Perth fertility doctor

What is normal ovulation?

Ovulation is the release of an egg (ovum) from your ovary, into your fallopian tube. On average, ovulation occurs 14 days before the start of your next period. As part of your normal menstrual cycle, there is a carefully choreographed balance of hormonal, ovarian and endometrial activity all acting together.

"The aim of every menstrual cycle is the production of an egg at ovulation that is ready to be fertilised. The fertilised egg can then be supported as an embryo and grow into a healthy foetus and eventually a newborn baby."

Dr Richard MurphyFertility Specialist and Perth obstetrician

Pregnancy & ovulation

Ovulatory dysfunction and fertility

When you want to fall pregnant, it is important that you release an egg from your ovary every month. Along with normal sperm and patent fallopian tubes, ovulation is one of the 3 fundamental requirements for pregnancy to occur naturally.
There are a broad range of problems which can occur with ovulation from irregular cycles to failure of the egg being released from the ovary, low levels of progesterone after ovulation to complete absence of ovulation, known as amenorrhoea.

“If you are trying to conceive, it is important that you ovulate and that you know when it happens. In a normal cycle, it would happen about 14 days before your next period but when you have ovulatory dysfunction it is hard to track your ovulation. That’s because your period is irregular or infrequent or you don’t have a period at all.”

What causes ovulatory dysfunction?

Abnormality at any level of the hypothalamic-pituitary-ovarian-uterine axis can cause menstrual problems.
Prior to any Ovulation Induction treatment a complete investigation looking for the cause of any menstrual problems will be done. Common conditions include Polycystic Ovarian Syndrome (PCOS), hypothalamic-hypogonadism, thyroid and prolactin problems. If a correctable, reversible cause is found then treating this directly may be all that is needed.

Ovulatory dysfunction investigation

You will need blood tests and an ultrasound to investigate the cause of your ovulatory abnormalities. In addition to this, prior to Ovulation Induction treatment we will need to make sure your tubes are not blocked and your partner’s sperm is normal. Testing your tubes can be done in any one for 3 ways. Usually a hysteroscopic contrast sonogram (HyCoSy) or a hysterosalpingogram (HSG) is done. These are simple outpatient procedures. If there is another indication on history or ultrasound then laparoscopy and dye insufflation of the tubes can be done, though this required a general anaesthetic in theatre.

Ovulation induction treatment Perth

What is ovulation induction?

Ovulation induction involves using one or more medications allowing an egg to mature and to be released from the ovary into the fallopian tube. There are quite a number of medications which can be used including Clomiphene citrate, Letrozole, recombinant FSH (Gonal-F or Puregon) and Metformin. Laparoscopic ovarian drilling is another option. Each of these has its merits which we can discuss.

“The aim is to achieve robust, normal, physiological hormone levels in the first half of the cycle, the follicular phase. By doing so all the building blocks necessary for the ovaries to develop and sustain a healthy egg will be present. Medications may be used such as Clomid, Recombinant FSH and Letrozole.”

Before you start Ovulation Induction treatment an accurate diagnosis is needed. Any treatable cause for ovulatory dysfunction such as thyroid problems should be corrected. The health of your fallopian tubes should be checked as well as the quality of your partner’s sperm, as these are both crucial factors in the success of your treatment.
That is why, before you commence ovulation induction treatment, you and your partner will undergo fertility tests to rule out any other issues that prevent you from falling pregnant.

"Any artificial stimulation of the ovaries will increase the risk of multiple pregnancy and ovulation induction should only be performed under the supervision of an experienced fertility specialist."

Dr Richard MurphyFertility Specialist

IVF or ovulation induction?

Sometimes people believe that IVF will be a better treatment for women with ovulatory difficulties. If there are no other barriers to a successful pregnancy except ovulatory problems then ovulation induction is the treatment of choice. We should remember that when transferring an IVF embryo, to give it the best chance of success we need to have a normal, healthy endometrium and hormonal environment. If your fertility issues are just abnormal ovulation then results are almost always better with this simple, affordable and much more enjoyable procedure.

Fertility success rates Perth

Success rates of ovulation induction

When used appropriately and after the correct investigations have been done Ovulation Induction has a very high success rate.

"In those situations, you can expect a 25% pregnancy rate per cycle with Ovulation Induction. That is the same ‘success rate’ as for fertile couples. Remember, human reproduction is complicated, even for couples that don’t have fertility issues."

There is never a 100% guarantee with any fertility treatment and often a few cycles are needed to achieve success. By aiming for the release of a single egg, these results can be achieved with a very low rate of multiple pregnancy. That ‘single egg’ is important, because multiple pregnancies (twins, triplets and higher) have significantly higher risks for mothers and babies compared to having one baby at a time.

Perth fertility doctor for ovulation induction

Why Dr Richard Murphy for ovulation induction?

Polycystic ovarian syndrome (PCOS) is a very common condition and the most common cause for ovulatory dysfunction. Hypothalamic-hypogonadism is less common and less appreciated but not rare. I love the way something as simple as Ovulation Induction, when done right, can produce such good results. If you have concerns about your cycle then I can assess and treat any problems safely and relatively easily, helping you to complete your family.