Ovulation monitoring and induction
What is ovulation monitoring?
Ovulation monitoring involves having ultrasounds and/or blood tests to track the growth of a follicle in the ovary to help determine the time of ovulation and the fertile window. An injection may be used to stimulate ovulation and to help get the timing of intercourse right.
What is ovulation induction?
Ovulation induction is a relatively non-invasive fertility treatment that involves taking oral or injectable medication to induce the development of an egg for ovulation. The medication is commenced at the beginning of the menstrual cycle and the body’s response is monitored with ultrasound and/or bloods tests. This helps to detect when you are due to ovulate and therefore the best time for intercourse. Your clinician will advise if you need medications to stimulate the ovaries and will recommend a program of monitoring.
What is the process?
Contact the nurse on the first day your cycle (and make payment - click here for information about fees)
Book in ultrasounds (usually around day 11 or 12 of cycle)
Take ovulation induction medication if advised
Attend ultrasound either in our clinic or at an external provider - the nurse will then provide you with the next steps
Take 'trigger' injection (if advised)
Have timed intercourse
Blood test to check ovulation (7 days after trigger)
If no period arrives 17 days after you trigger injection, do home pregnancy bloods test. If your period does arrive, contact the nurse to discuss the next steps.
FREQUENTLY ASKED QUESTIONS
When is 'day 1' of my cycle?
Day one refers to the first day of full-flow, fresh bleeding (not just brown spotting). If the "full-flow" comes after 6pm, the following day is day 1.
What is ovulation?
When an egg is released from one of the ovaries, this is known as ‘ovulation’. In women with regular menstrual cycles, this happens approximately once a month. In some women, the follicles that hold the eggs don’t develop regularly and so the woman ovulates irregularly, rarely or not at all.
I don't get regular period, when do I start my cycle?
If you don't get regular periods, you may be instructed to take a medication to induce a withdrawal period.
How do I contact my nurse?
What are the ovulation induction medications?
The drugs that you may need to take to induce ovulation include:
Letrozole tablets - an oral tablet taken for 5 days from day 2 or 3 of the cycle. Letrozole tricks the pituitary gland into producing more follicle stimulating hormone (FSH) to help follicles develop
FSH injections - stimulate the growth of follicles. Taken from day 2 until advised to stop.
Ovidrel (Choriogonadotropin alfa) injection - used once the follicles are mature to stimulate ovulation. This is a once off medication. It is injected into the fat tissue of the abdomen and comes in pen form. It is often referred to as a 'trigger' injection. Click here for demonstration
Where do I have my ultrasound?
We offer some scan appointments in our clinic with our practice nuse on Monday, Wednesday and Thursdays. You can also book the ultrasound at your local medical imaging provider. When booking your scan, please ask for a "follicle tracking ultrasound". Ultrasound providers are usually accommodating due to the time sensitivity of these scans. Please try to book the scan for early in the day so we have time to receive and review results. Our nurse will provide you with referrals when you make contact at the beginning of your cycle.
What is the cost?
When do I have intercourse?
It is important to have regular intercourse once ovulation has been triggered. Ovulation occurs approximately 24-48 hrs after the trigger injection. Sperm survives for 72 hrs and egg for 12-24 hrs. We generally recommend intercourse on the day of the trigger plus the three days following.
When do I have the trigger?
The trigger shot is generally advised if one or two follicles are present > 17-20mm in size. If more than two mature follicles are seen, the cycle is abandoned and you are advised to avoid unprotected intercourse for the next 10 days to prevent a multiple pregnancy. If there is no follicle development, the cycle is cancelled and the medication dose may be altered the following month
Does ovulation induction have any risks?
For most women, ovulation induction is a straight forward process however, like all medical treatments it has some risks.
The main risks are:
Multiple Pregnancy – When the ovaries are stimulated, it is possible for more than one follicle to mature and release an egg at the same time. This could result in a multiple pregnancy. Our ultrasound monitoring checks for this and we adjust or stop medication and/or recommend abstinence from intercourse if we see too many follicles developing however the risk cannot be completely ruled out.
Hyper-stimulation Syndrome (OHSS) – This is a rare problem where the ovaries over-respond to the ovarian stimulation and can experience symptoms including pain, bloating, nausea and vomiting. Symptoms range from mild to severe and, in worst cases, need urgent hospital treatment. We minimise the risk of OHSS by monitoring your treatment cycle with ultrasound scans, and sometimes blood tests. If we see potential for OHSS to develop, we adjust or discontinue the medication.