|
What is controlled ovarian hyperstimulation?
It involves the use of some of the same medications used for induction of ovulation in
women that have anovulation. These medications are used to stimulate development of
multiple mature follicles and eggs in order to increase pregnancy rates with various
infertility treatments.
Ultrasound of multiple follicles (black circles) in a stimulated ovary
Who should be treated with controlled ovarian hyperstimulation?
This therapy is often used as infertility treatment for infertile couples. It is usually
done in conjunction with intrauterine insemination.
This treatment does not really correct any specific cause of infertility. Instead it is
a "shotgun" approach to get multiple eggs and sperm together at the time of ovulation.
This type of treatment has been shown to increase the monthly chances for a pregnancy
as compared to timed intercourse alone.
Ovarian stimulation with insemination should not be used with very low sperm concentration
or very poor sperm motility, blocked fallopian tubes, or age of the female partner
over 43. This treatment is very unlikely to be effective in these situations.
Controlled ovarian hyperstimulation is also used to develop multiple mature follicles
for in vitro fertilization cycles.
Details about ovarian stimulation protocols for IVF
How is controlled ovarian hyperstimulation performed?
The medication is given early in the menstrual cycle in the same manner as described for
induction of ovulation. The way the medications are given are described on the pages
that discuss subcutaneous FSH injections and intramuscular FSH injections.
An approximate schedule and calendar for an injectable FSH cycle
Pregnancy rates for controlled ovarian hyperstimulation
Success rates for controlled ovarian hyperstimulation with intrauterine insemination
vary considerably and depend on the age of the woman, the total motile sperm count, the
quality of the sperm, how long the couple has been trying to get pregnant, what the
infertility factors are in the couple, etc.
Ovarian stimulation with gonadotropins (injectable FSH products like Pergonal or Follistim)
plus intrauterine insemination gives pregnancy rates of about 5-12% per cycle (women
36 and younger) for unexplained infertility, as demonstrated in several published studies.
Success rates are lower if the woman is over age 36 or if there is a sperm problem -
male factor infertility. For women 40 and older, success rates with this form of
infertility treatment are very low, and IVF should be considered as an option relatively
soon.
In general, this type of treatment is considered reasonable for about 3-6 cycles (in
women under 37), after which IVF is usually considered as the next step.
Cost:
The costs associated with controlled ovarian hyperstimulation depend on the type and
dose of medication required and the number of ultrasound and blood tests required to
adequately monitor the cycle. Intrauterine insemination increases the chances for a
pregnancy, as well as the cost of the cycle.
|
