Abnormal levels of hormones can cause irregular ovulation or lack of ovulation. For example, polycystic ovary syndrome is a condition in which the levels of certain hormones are abnormal and menstrual periods are irregular or absent. It is a common cause of infertility. The drug most commonly used for ovulation induction is clomiphene citrate. About 40% of women achieve pregnancy with the use of this drug within six menstrual cycles. If this medication is not successful, stronger medication called gonadotropins may be used.Twins occur in about 10% of women treated with clomiphene citrate. Triplets or more are rare. The risk of multiple pregnancy is higher when gonadotropins are used.
In intrauterine insemination, a large amount of healthy sperm is placed in the uterus as close to the time of ovulation as possible. It often is used with ovulation induction. The woman’s partner or a donor may provide the sperm. Sperm that has been retrieved earlier and frozen also can be used. The likelihood of twins and higher multi-fetal gestations are higher when this is done.
In IVF, sperm is combined with the egg in a lab, and the embryo is transferred to the uterus. IVF is done for the following causes of infertility: Damaged or blocked fallopian tubes that cannot be treated with surgery, some male infertility factors, severe endometriosis, premature ovarian failure, unexplained infertility. In vitro fertilization is done in cycles. It can take more than one cycle to succeed. The sperm may come from your partner or from a donor. Sperm can be retrieved and then frozen for later use in IVF. Ovulation usually is induced with gonadotropins so that many eggs are produced. The egg also may come from a donor. Eggs that have been previously frozen can be used.
Eggs are removed from the ovaries when they are mature. Healthy sperm then are added to the eggs in the lab. The eggs are checked the following day to see if they have been fertilized. A few days later, one or more embryos are placed in your uterus. The embryo may come from a donor. Healthy embryos that are not transferred can be frozen and stored for later us.