What is Ovulation?
Ovulation is when an egg is released from the ovary. The process of ovulation begins each month with a menstrual cycle. As the egg grows and matures, it makes estrogen and when the estrogen levels reach a certain point, it causes a surge of a hormone from the brain called luteinizing hormone (LH). Once this LH surge happens, women will ovulate approximately 36 hours later.
During fertility treatments, there are a couple of fertility drugs that doctors can use to force, or trigger, ovulation. They include HCG and GnRH agonists. Because they make you ovulate at a known point in time, doctors use these medications to time intercourse, Intrauterine Insemination (IUI), or In-Vitro Fertilization (IVF).
Human Chorionic Gonadotropin (hCG)
hCG is similar in structure and function to LH. An injection of hCG mimics the natural LH surge and causes ovulation to occur about 36 hours later. Ovidrel, Pregnyl, and Novarel and are all hCG’s. It is important to remember that a pregnancy test works by detecting hCG, a hormone that is produced by the implanting embryo and developing placenta. Pregnancy tests (either blood or urine) may be falsely positive if done less than 10 days after an hCG is given to trigger ovulation since the residual hCG is still present.
GnRH agonists are synthetic hormones similar to natural GnRH. Leuprolide acetate, nafarelin acetate, and goserelin acetate are GnRH agonists. GnRH is released from the hypothalamus and it stimulates the pituitary gland to secrete FSH and LH. When a woman takes a GnRH agonist, this causes an initial rise in FSH and LH production which triggers ovulation.
Some women may have difficulty getting pregnant because they do not ovulate. Fertility specialists may also use additional medications in combination with hCG or GnRH agonists to help these women get pregnant. These medications include pills like clomiphe citrate (Clomid) and aromatase inhibitors (Letrozole) as well injectables called gonadotropins. There are two common ways these medicines are used: 1) to cause ovulation in a woman who does not ovulate regularly, and 2) to cause multiple eggs to develop and be released.
Ovulation Treatments in Orange County
Reproductive Health and Wellness Center offers treatments for women having trouble ovulating. Click here to watch a video on ovulation stimulation, explained by our founder, fertility specialist, Dr. Marcus Rosencrantz, FACOG.