Controlled Ovarian Hyperstimulation
Controlled Ovarian Hyperstimulation is the use of fertility drugs to stimulate the ovaries to release one or more eggs. This is usually the first treatment for women who do not ovulate or ovulate irregularly with the goal of growing 1 healthy egg to ovulate. Pregnancy is also achieved by inducing ovulation to perform a procedure called intrauterine insemination (IUI), which involves washing and concentrating sperm and then inserting it directly into the woman's uterus through a small catheter.
What to expect
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A transvaginal ultrasound within the first 2~3 days of the menstrual cycle.
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Take fertility drugs.
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Be monitored by transvaginal ultrasound and blood tests for the development of the follicle(s) to decide when to trigger ovulation for natural intercourse or IUI.
Who needs this?
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Polycystic Ovarian Syndrome
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Irregular or absent ovulation (Menstrual cycle)
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IUI
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IVF
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Egg Bank
Advantages
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Noninvasive and relatively low cost.
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Can be an effective treatment in conjunction with timed intercourse, IUI and IVF.
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IUI's success rate is about 10%. Any couple trying to get pregnant at any given age or any given month their chance of success is 20%. However, after a couple has been trying for 1 year and still not pregnant, it drops to 2%, and 1% after 2 years.
More info
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The medications most commonly used in fertility treatment are Clomiphene (Clomid), Letrozole (Femara), Gonadotropins, HCG, Lupron.
Q&A
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What is ovarian reserve?Ovarian reserve is the number of eggs left in the female. A woman makes all the eggs she will ever have before she is born, about 6 million eggs. Then at birth only 1 million is left because the eggs have already died. By puberty only 500,000 eggs are left. The egg count is constantly decreasing until menopause around age 52 when there are no more eggs left.
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What are fallopian tubes?Fallopian tubes are where the sperm and the egg meet. If the tubes are blocked, the eggs are on one side and the sperm on the other side. They cannot meet and pregnancy cannot occur.
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What is third party reproduction?Third party reproduction is when an outside person is involved to help build your family by either donating sperm, egg, or uterus to carry the pregnancy.
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How long does fertility testing take?Basic fertility testing for the woman will take 2 visits over 7-10 days at the beginning of the menstrual cycle.
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Is fertility testing covered by insurance?Some, but not all insurance cover fertility testing.
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Is it a painful process?Egg count testing is a vaginal ultrasound and blood draw. Patient’s experience minimal discomfort with both procedures. Uterine testing requires insertion of a catheter into the uterine cavity and the uterine cavity is distended with fluid. Insertion of the catheter and uterine distension can cause some cramping equivalent to menstrual cramping. Fallopian tube testing requires insertion of the catheter into the uterine cavity, distension of the uterus with fluid, then the filling and spilling of the fluid from the fallopian tubes. This procedure is usually quick with minimal pain if the fallopian tubes are open, but can also cause significant cramping and discomfort if the tubes are blocked.
