Ovulation Induction

Common Cause

Some 5% of all women are affected by an endocrine disorder known as polycystic ovarian syndrome, or PCOS. PCOS comes with symptoms such as the absence of menstruation, obesity, hirsutism (excessive hair growth), and insulin resistance. Cases of female infertility are most often traced to this syndrome.

Downright Impossible

The best way to control the unpleasant and even dangerous symptoms of PCOS is with birth control pills, since these regulate the menses by suppressing ovulation. But that means that conception becomes not just difficult, but downright impossible.

A drug known as Clomiphene (Clomid) was created for women who suffer from PCOS. This drug increases the female sex hormones which lead to ovulation. Some 80% of women with PCOS respond to treatment with Clomid and half of them will become pregnant.

But what about the other 20% of women with PCOS who fail to respond to Clomid? And fail, they do, even when the maximum dose is prescribed and after the maximum number of trials is administered. They just don't ovulate.

Such women are then classed as being ready for ovulation induction with gonadotropins. This type of treatment may be given alone, or in combination with GnRH (gonadotropin-releasing hormone agonist). Two popular gonadotropin therapies are Pergonal and Humegon and these are combination drugs consisting of luteinizing hormone (LH) and female sex hormone (FSH).

Drugs that consist of only FSH include Metrodin, Fertinex, Follistim, and Gonal-F. There's not much difference in the ways these various preparations work. When the pituitary gland fails to produce LH and FSH, the ovaries don't do what nature intended. Gonadotropins come to the rescue and can stimulate your ovaries to ovulate when nature lets you down.

The main problem is in the administration of the treatment since women with PCOS can respond by producing too many eggs when given gonadotropin therapy. That means that ovarian hyperstimulation becomes a life-threatening risk. The best way to solve this problem is to have the doctor take out all the eggs and put back the number of eggs you are likely to carry to term.

One of the benefits of Clomid is its inexpensive price tag. Pergonal prices go in the other direction, with one cycle costing $1000.00 or perhaps even more. The other downside of this medication is the way in which it is administered. Pergonal, Humegon, and Metrodin are given as intramuscular injections in the hip. Sometimes, the male partner learns how to give the injections. Other drugs, such as Fertinex, Follistim, and Gonal-F are given by subcutaneous (under the skin) injection and most women have no problem learning to self-inject these drugs.

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