What is Ovulation Induction?
Ovulation induction stimulates the ovaries with medication to produce and release eggs. It is mainly used when ovulation is irregular or absent — most often in women with PCOS — but can also be used with intrauterine insemination (IUI) for unexplained or mild male-factor infertility. Treatment is monitored with ultrasound to track follicle development and minimise the risk of multiple pregnancies.
Medications Used
Letrozole: now first-line for PCOS, taken as 5 daily tablets early in the cycle
Clomiphene citrate (Clomid): an alternative oral option, also 5 days early in the cycle
Gonadotropins (FSH/LH injections): used when oral medications fail or for IVF
Metformin: not strictly an ovulation drug, but improves ovulation in PCOS
Ovulation trigger (hCG injection): times the release of mature eggs precisely
Success Rates and What to Expect
Letrozole induces ovulation in 70-85% of women with PCOS
Pregnancy rates of 20-25% per cycle, with 60-70% over 6 cycles
Higher chance of twins (5-10%) than natural conception
Ultrasound monitoring is essential to reduce multiple pregnancy risk
Most clinics try 3-6 cycles before moving to IVF if unsuccessful
Risks and When to Move On
Mild side effects: hot flushes, mood changes, bloating
Risk of multiple pregnancy (twins or more)
Rare risk of ovarian hyperstimulation, mainly with injectables
If 3-6 monitored cycles fail, consider IVF or further investigation
Always done under specialist supervision with cycle monitoring