Ovarian stimulation—where medications are used to increase your fertility—is often one of the first steps in treating infertility. SRM offers a range of ovarian stimulation protocols.
Clomid and Letrozole
Clomid and Letrozole are oral medications (pills) that can be used to cause ovulation or increase the number of eggs being ovulated. They cause an increase in the production of FSH, or follicle stimulating hormone, which is the signal to cause egg/follicle development.
You will typically start Clomid or Letrozole on Day 3 of your cycle (the third day of your period) and continue taking the medication for 5 days. Side effects of these medications can include mood changes, fatigue, and hot flashes. Sometimes an ultrasound is performed mid-cycle to assess your response to this medication, and to determine the number of eggs that are going to be ovulated that month.
Your physician may recommend an injectable medication called Human Chorionic Gonadotropin (hCG, Novarel or Ovidrel) to induce the release of the egg(s). hCG acts in the same way a woman’s natural LH (luteinizing hormone) rise would act in order to cause the eggs to release (ovulation predictor tests check for LH rise).
If Intrauterine Insemination (IUI) is part of your treatment plan, it will typically be performed 18–38 hours after the hCG shot.
Injectable gonadotropins are another common infertility medication. They are given via subcutaneous injections and contain FSH (follicle stimulating hormone), LH (luteinizing hormone) or both. These medications help stimulate egg development and are stronger, and more costly, than Clomid and Letrozole. You are at higher risk of a multiple pregnancy when using these medications.
Gonadotropins are typically given after a 5-day course of Clomid or Letrozole, or administered at the start of your cycle (started on the second or third day of your period). Higher doses of gonadotropins are given during an In Vitro Fertilization (IVF) cycle.
When eggs/follicles are mature (determined by ultrasound and estrogen levels), a medication called Human Chorionic Gonadotropin (hCG, Novarel or Ovidrel) is injected to induce release of the eggs.
If Intrauterine Insemination (IUI) is recommended for you, it will be performed 18–38 hours after the hCG shot.
If your physician has recommended progesterone support, it will begin 2–4 days after ovulation. You will be given clear instructions on the type, dosage, and schedule of when to administer the progesterone. You should continue to take the progesterone until your pregnancy test, which is done two weeks after ovulation. Progesterone can delay your period, so a pregnancy test must be performed. If pregnancy occurs, the medications will continue until around the 10th week of pregnancy. If the pregnancy test is negative, the medication is stopped, and a period will occur in 2–7 days.