One in six Australian couples will have a fertility issue at some point in their lives and one in 10 couples will have trouble conceiving their second child. You are not alone.
Don’t panic, your fertility journey doesn’t have to be an express service straight to IVF. Some simple changes can improve your chance of conceiving naturally.
It's important to remember the emotions, worries and thoughts you are currently trying to deal with are valid and common. You are not alone. Read on
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Ovulation induction (OI) with controlled ovarian stimulation is a lighter form of treatment we might recommend for women who have normal tubes, and whose partners have a normal semen analysis, but who rarely or never ovulate.
For women who do ovulate regularly, stimulation can also be used to increase the chance of pregnancy by increasing the number of follicles that develop fully and, therefore, increasing the number of eggs that are ovulated during a cycle.
Two types of hormones may be used to stimulate ovulation: tablets of clomiphene citrate (Clomid® or Serophene®) and injections of follicle stimulating hormone, or FSH (Gonal-F® or Puregon®).
After more than 30 years helping people get pregnant, we understand how hard it can be to sort through your fertility options.
That is why we introduced our Fertility Advisor service. You can speak with one of our advisors, helping you to move towards gaining control of your fertility, without taking what we understand can be a daunting step of seeing a specialist.
Clomiphene (Clomid® or Serophene®) is often the first choice for stimulating ovulation because of its low cost and ease of use.
A synthetic hormone, clomiphene acts as an anti-oestrogen, tricking the brain into producing higher levels of FSH than in an untreated cycle. That in turn stimulates ovarian follicular development. A course of tablets is given for five days - usually days two to six or five to nine of the cycle.
Side effects can include thickening of the cervical mucus, vaginal dryness and hot flushes, while some women also complain of mood changes and irritability. Uncommonly there can be abdominal bloating, breast discomfort, nausea, a skin rash or dizziness. These symptoms usually pass after the five days of tablets finish.
Because it is an anti-oestrogen, clomiphene can have a negative effect on cervical mucus and on the lining of the uterus, impairing conception and implantation.
Follicle stimulating hormone (FSH) is the hormone necessary for the multiple follicular development required in IVF. FSH may also be used in smaller doses for ovulation induction or ovarian stimulation. The FSH is made in the laboratory and is identical to human FSH. FSH is given by injection under the skin, with a fine needle. This is because it is a protein that, if taken orally, would be digested in the stomach. There are two brands of FSH available in Australia - Gonal-F® and Puregon®. Both are self-administered with pen-like devices (similar to those used for insulin by diabetics).
Using FSH to induce ovulation for getting pregnant naturally, as opposed to through IVF, can be tricky because of the risk of stimulating too many follicles and having a multiple pregnancy. This is why we closely monitor the body’s response with blood tests and ultrasounds.
When the lead follicle or follicles are the right size on ultrasound, ovulation is triggered with an injection of human chorionic gonadotrophin (hCG), which mimics the LH surge.
Even with the most careful monitoring, more follicles can reach maturity than desired. Intercourse should be avoided because of the high risk of twins, triplets or an even higher-order multiple pregnancy. If this looks too likely, either the ovulation cycle that has been induced will need to be cancelled or a suggestion might be made to carry out an IVF procedure.
Multiple pregnancy is the single greatest complication in using FSH injections for ovulation induction. If pregnancy occurs, there is a 20 per cent chance of twins. Triplets or higher occur in about five per cent of pregnancies. These multiple pregnancy rates are far higher than those experienced using IVF with single embryo transfer, as such, many of our Fertility Specialists have a natural reluctance to use ovulation induction with FSH injections.
Infertile couples might think twins are a blessing, but complications are much more common in twin than singleton pregnancies.
As it is identical to a hormone that a woman’s body makes naturally, the side effects a woman experiences with FSH are really the expected effects of the injections. These include bloating as the ovaries are stimulated and mood changes as oestrogen levels rise.
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A small fluid-filled cyst on the ovary in which the eggs grow until released and which produce...
The hormone produced by the pituitary gland which controls growth of ovarian follicles and...
One of the drugs used to stimulate the development of follicles. Recombinant FSH...
A hormone that tells the corpus luteum to continue progesterone...
A hormone (gondatrophin) produced by the pituitary gland that triggers ovulation of a mature...
The use of drugs to stimulate the development of follicles in the ovaries to undergo...
Recombinant follicle stimulating hormone made by pharmaceutical company...