For a pregnancy to occur, the egg must mature and be released—this is ovulation. If ovulation does not happen naturally, the process can be stimulated with medication. This is called ovulation induction.
The treatment aims to help the egg mature so that fertilisation can take place naturally—either through intercourse or insemination.
Ovulation induction may be recommended if the menstrual cycle is irregular or absent. In some cases, hormone treatment is also used even when the cycle is regular, to support follicle development and increase the chances of ovulation.
Before treatment begins, it is important to understand why ovulation is not functioning as it should—and whether there are factors that can be improved naturally.
The most common cause is polycystic ovary syndrome (PCOS), but thyroid disorders (such as hypothyroidism or hyperthyroidism) can also affect ovulation. In some cases, disturbances in pituitary gland function may be involved.
Changes in weight—both overweight and underweight—as well as excessive exercise in relation to energy intake, can disrupt hormonal balance. Age also affects fertility: after the age of 35, both the number and quality of eggs decline, making pregnancy more difficult.
If the ovarian reserve is very low, hormonal treatment may unfortunately have limited effect.
During ovulation induction, the ovaries are stimulated with hormones to trigger ovulation. The goal is usually to have one or two follicles mature during the same cycle.
Treatment can be combined with timed intercourse or insemination, depending on your situation.
Medications are given either as tablets or as injections under the skin. For most patients, tablet treatment is sufficient.
Tablet treatment is a simple and well-established method. The most commonly used medication in Sweden contains the active substance letrozole, an aromatase inhibitor. It temporarily lowers estrogen levels in the body, which signals the ovaries to produce more estrogen and stimulates follicle maturation. At the same time, the egg prepares to be released.
Tablets are taken at the beginning of the cycle for five days. Side effects are uncommon.
Treatment is monitored with ultrasound, usually one visit per cycle, where the physician checks the number of follicles, their growth, and the thickness of the uterine lining. If needed, treatment can be supplemented with gonadotropin injections.
If the treatment works as expected (a follicle releases and the uterine lining looks good), you can continue according to your doctor’s instructions without additional ultrasounds. However, during the first cycle it is important to confirm that the medication is effective.
If tablets do not provide sufficient effect, ovulation can be stimulated with injections containing gonadotropins.
Treatment usually starts on cycle day 2–5. A small dose of hormone is given daily as a subcutaneous injection. During treatment, ultrasounds are performed a few times per cycle to monitor follicle growth and uterine lining development.
Blood tests may also be taken if needed to check hormone levels, but ultrasound monitoring is often sufficient.
The injection pens are easy to use and the needle is very thin—our staff always provide careful instruction.
Careful monitoring improves the chances of pregnancy and reduces the risk of complications, such as multiple pregnancy.
To increase the chance of fertilisation, it is important to time intercourse or insemination correctly within the cycle. This timing is often determined using ovulation tests (LH tests).
If ovulation disorders are the only cause of infertility, the chances of pregnancy are very good.
If ovulation is not achieved, or if pregnancy does not occur after 4–6 treatment cycles, other types of fertility treatments may be considered.
In Ovumia, we are always ready to help you!
