Medications to stimulate ovulation are often offered in cases of difficulty conceiving. Clomid®, hormonal injections… They allow you to trigger or regulate ovulation depending on the case. Indications, effectiveness, risks and procedure: here is what you need to know before starting.
There are medications capable of stimulating female ovulation. They are used to trigger or regulate ovulation in women who are having difficulty conceiving. They are part of the first-line treatments in cases of infertility linked to an ovulation disorder. They can be prescribed alone or as part of medically assisted procreation (intrauterine insemination or in vitro fertilization). Their use requires strict medical monitoring in order to optimize the chances of pregnancy and limit adverse effects. Regular ultrasounds monitor the response of the ovaries, count follicles and assess endometrial thickness. Details with Dr Odile Bagot, gynecologist.
In what cases is a medication prescribed to stimulate ovulation?
Treatment is considered in the event of ovulation disorders (absence or irregularity), particularly in the following situations:
- polycystic ovary syndrome (PCOS)
- hormonal disorders
- endometriosis
- unexplained infertility
Before starting treatment, a complete assessment is essential. It includes a pelvic ultrasound, hormonal measurements, a check of the permeability of the tubes (hysterosalpingography) and a spermogram. The aim is to adapt the treatment to the cause of infertility and to avoid unnecessary or ineffective stimulation.
Name: what drugs stimulate ovulation?
1. Clomiphene citrate : Clomid® is the most prescribed first-line oral treatment.
Other names/equivalents: generic clomiphene (without specific brand)
It stimulates the production of FSH, the hormone which allows the maturation of oocytes.
- taken for 5 days at the start of the cycle
- start between the 2nd and 5th day of menstruation
- treatment limited to 6 cycles in general
2. Gonadotropins (hormonal injections)
Gonadotropins are injectable hormones used when oral treatment fails or in certain specific situations. Most used medications:
- Gonal-f
- Puregon
- Bemfola
- Ovaleap
- Rekovelle
- Menopur
- Fostimon
- Pergoveris
“They are prescribed in the event of failure of Clomid, when the assessment has revealed an insufficiency of the pituitary gland or when dysovulation is linked to hyperprolactinemia”explains Dr Odile Bagot, gynecologist.
- daily subcutaneous injections
- start at start of cycle
- self-injection possible with pens
Ovulation is then triggered by an injection of hCG (like Ovitrelle).
In both cases, “these treatments are always accompanied by monitoring of ovulation in particular to avoid hyper stimulation and, where applicable for gonadotropins, not to trigger ovulation if too many follicles are ready to ovulate at the same time.“, adds our expert.
What about egg freezing?
The same medications are used for fertility preservation, with a different goal. We use in particular:
- Gonal-f
- Puregon
- Menopur
- Ovitrelle
Sometimes combined with: GnRH antagonists (e.g. Orgalutran, Cetrotide) to block spontaneous ovulation
The objective is to stimulate the ovaries to obtain several oocytes (often between 5 and 15), which will then be collected and frozen.
What follow-up during treatment?
Monitoring is based on regular ultrasounds and blood tests. It allows you to:
- check follicle growth
- determine the time of ovulation
- avoid the risks of hyperstimulation
For how long?
- Clomid: up to 6 cycles (sometimes 9 maximum)
- Gonadotropins: duration varies depending on response to treatment
What are the side effects?
With Clomid:
- hot flashes
- headache
- visual disturbances
- nausea
With gonadotropins:
- abdominal pain
- feeling of swelling
- temporary weight gain
- Common risks
- multiple pregnancy
- ovarian hyperstimulation syndrome (rare but serious)
- fatigue, stress, sleep problems
What are the contraindications?
These treatments are not indicated in cases of:
- history of hormone-dependent cancer
- pituitary tumor
- severe bleeding disorders
- history of thrombosis or stroke
Treatments to stimulate ovulation are based on two main options: tablets like Clomid® and hormonal injections like Gonal-f® or Puregon®. The choice depends on the medical situation and the objective, whether to trigger ovulation or to preserve fertility.
