Treatment for failure of ovulation (anovulation) is usually quite straight forward. It usually involves drugs but can also involve surgical treatment.
1. Clomiphene (Clomid), Tamoxifen and Letrozole
These drugs form the most common ‘first line’ of treatment for ovulatory failure.
Both these drugs work in basically the same way and have the same effect. They stimulate the pituitary gland to produce more of the hormone FSH which increases stimulation of the ovary and the chances of an egg being produced.
These drugs are relatively mild. Side effects include hot flushes (usually whilst the tablets are being taken), occasional mood swings and nausea.
There is an increased risk of twins when a patient is taking these drugs. Ultrasound scanning is carried out in the first cycle to assess the response and reduce the likelihood of multiple pregnancy.
If blurred vision or severe headaches occur the drug should be stopped and the symptoms reported to the Centre and your GP.
There are a lot of these drugs in use. They include Metrodin high purity, Puregon, Menopur and Gonal-F and all contain the hormone FSH which powerfully stimulates the ovaries to produce many eggs. These drugs are taken as an injection.
It is important that whilst a woman is taking these drugs she is carefully monitored through ultrasound scans and blood tests to prevent a condition known as ovarian hyperstimulation syndrome and also to prevent the production of too many eggs.
3. GnRH Agonists/Antagonist + Gonadotrophins
This is the most common second stage of drug treatment used at the unit. GnRH agonists/antagonists block the production of FSH and LH from the pituitary gland (the body’s own gonadotrophins). This prevents the body interfering with the injected gonadotrophins which makes the stimulation of the ovaries more controlled. This allows for better quality stimulation. GnRH-agonists are usually taken as an injection.
4. Surgical Treatment
Occasionally patients who don’t respond well to treatment with Clomiphene, particularly if they have polycystic ovaries (PCO), are treated by making holes in the ovary using a hot needle (diathermy). This is done via laparoscopy where a small cut is made at the belly button and a laparoscope (small telescope) is inserted to guide the surgeon.
Fertility success rates
Drug treatment of ovulation failure has a high success rate. Patients should, however, bear in mind that it may take several months to achieve a pregnancy and there is no guarantee of success. Additionally the risk of a miscarriage may be increased.
The Centre’s success rates can be found on the Success Rates page.