Ovulation stimulating drugs for conception. What and how can you stimulate ovulation?

Stimulation of ovulation is considered the most common and popular way to achieve a long-awaited pregnancy. But it has its pros and cons.

We will tell you in this material how artificial stimulation of natural processes for a woman takes place, what drugs are used and what results can be achieved.

What is it?

Every or almost every month, ovulation occurs in the body of a healthy woman who is capable of conceiving. After menstruation, during the first half of the cycle, which lasts approximately 14 days, follicles mature in the ovaries. One of them, the dominant one, bursts in the middle of the cycle and releases an egg ready for fertilization.

Ovulation and subsequent periods are usually separated by 14 days. If the cycle lasts 28 days, then ovulation should be expected on the 14th day of the cycle, If individual characteristics are such that the cycle lasts 30 days, then ovulation occurs on the 16th day; with a cycle lasting 32 days, ovulation usually occurs on the 18th day.

Ovulation calculator

Cycle duration

Duration of menstruation

• Menstruation
• Ovulation
• High probability of conception

Enter the first day of your last menstrual period

Ovulation occurs 14 days before the start of the menstrual cycle (with a 28-day cycle - on the 14th day). Deviation from the average value occurs frequently, so the calculation is approximate.

Also, together with the calendar method, you can measure basal temperature, examine cervical mucus, use special tests or mini-microscopes, take tests for FSH, LH, estrogens and progesterone.

You can definitely determine the day of ovulation using folliculometry (ultrasound).

Sources:

1. Losos, Jonathan B.; Raven, Peter H.; Johnson, George B.; Singer, Susan R. Biology. New York: McGraw-Hill. pp. 1207-1209.
2. Campbell N. A., Reece J. B., Urry L. A. e. a. Biology. 9th ed. - Benjamin Cummings, 2011. - p. 1263
3. Tkachenko B. I., Brin V. B., Zakharov Yu. M., Nedospasov V. O., Pyatin V. F. Human physiology. Compendium / Ed. B. I. Tkachenko. - M.: GEOTAR-Media, 2009. - 496 p.
4. https://ru.wikipedia.org/wiki/Ovulation

But this is ideal, but in practice small deviations from the rules are acceptable.

The egg is released within one hour, then for another day it retains the ability to fertilize and waits for the sperm in the fallopian tube. Conception is possible only during ovulation, because the process of egg release is regulated by the pituitary gland, which begins to produce luteinizing and follicle-stimulating hormones.

Under the influence of FGS (a hormone that stimulates the growth of follicles), in the first half of the cycle the follicle enlarges; under the influence of luteinizing hormone (LH), the egg itself within it manages to mature in a fairly short time.

After release, the egg slowly moves through the tube towards the uterine cavity. If fertilization occurs, then the embryo descends into the uterus, and if conception does not occur, then the egg also descends into the uterus and dies there within 24 hours.

As a result of hormonal imbalance, ovarian dysfunction and for a number of other reasons, the cycle provided by nature may be disrupted, and therefore a woman may experience anovulatory cycles, that is, cycles without ovulation.

These may be cycles when the egg does not mature, or matures but does not leave the follicle. In this case, it is impossible for a woman to become pregnant naturally.

Doctors come to the rescue and can perform ovarian stimulation to plan pregnancy. Most often this is done using hormonal therapy.

Stimulation of ovulation gives a real chance of conception to couples who have been unable to conceive on their own for a long time. The procedure falls under the category of assisted reproductive technologies.

Indications - for whom is it performed?

This method annually helps tens of thousands of women find the joy of motherhood. First of all, stimulation is indicated for women with polycystic ovary syndrome, with various manifestations of their dysfunction, including age-related ones. Medical artificial stimulation of ovulation is usually not performed on women over 40 years of age.

With complaints about the inability to get pregnant, a woman turns to a gynecologist. The doctor studies not only the condition of her reproductive organs, but also the characteristics of the menstrual cycle. Such diagnostics include mandatory monitoring of follicle maturation using ultrasound diagnostics.

If this examination shows that ovulation is not occurring, preparations for stimulation begin.

The main indication for drug stimulation of the ovaries is the absence of pregnancy for a year, provided that the spouses do not use protection and have regular sex life. If the spouses (especially the woman) are already 35 years old or more, then the period of waiting for conception naturally is reduced to six months.

The procedure is contraindicated in women suffering from obstruction fallopian tubes : otherwise may happen ectopic pregnancy. Also stimulation is not performed on patients with inflammatory processes in the ovaries and other pelvic organs.

Another indication for stimulation is the absence of menstruation due to hypothalamic-pituitary insufficiency.

The reason for the procedure may be preparation for IVF or intrauterine artificial fertilization - insemination. Doctors are usually quite successful in stimulating the work of multifollicular ovaries; there are also stimulation schemes for endometriosis.

In case of hormonal imbalances, when ovulation is often “late,” stimulation of late ovulation is carried out.

Also The procedure is indicated for women with significant metabolic disorders, which manifests itself as obesity or, conversely, underweight, because in these conditions a couple often fails to get pregnant on their own.

Artificial stimulation methods

There are many methods by which you can support ovarian function and help ovulation occur.

In addition to medications, pills and injections as part of hormonal therapy, which is used to restore the ovaries and provoke the release of an egg from a mature follicle, folk remedies that women practice at home are widespread. These include herbs, mud therapy, vitamin therapy and some physiotherapeutic procedures, such as acupuncture.

Some even practice yoga for conception. Some asanas (postures), according to women's reviews, complement complex treatment well and contribute to the healing of the entire body in general and the reproductive system in particular.

Despite the huge number of recommendations and ways to achieve what you want, the main method with proven effectiveness, in which the effect is to a lesser extent explained by the usual successful coincidence of circumstances, is considered to be medicinal hormonal stimulation.

How does drug stimulation and preparation work?

After a woman contacts a doctor, she and her partner are recommended to undergo a detailed examination designed to establish the true cause of family infertility. A woman is prescribed a full range of laboratory tests, from general and detailed blood and urine tests to blood tests for infections, including sexually transmitted infections.

You definitely need to do a blood test for hormones.(lutenizing, follicle-stimulating, progesterone, prolactin and a number of others, if the doctor considers it necessary).

To a woman Ultrasound of the pelvic organs and mammary glands is mandatory. Sometimes a laparoscopic diagnosis may be necessary to ensure that the fallopian tubes are patent.

A woman’s sexual partner takes blood tests for infectious diseases, sexually transmitted infections, and also undergoes a spermogram to determine the quality of his reproductive cells, since in case of male infertility, all ovulation stimulation schemes without exception will not give any result.

If pathology is suspected inside the uterus, hysteroscopy is performed.

Once the first stage, diagnostic, is left behind, the second stage begins - treatment of existing inflammatory diseases and hormonal imbalances. Sometimes a woman manages to get pregnant already at this stage, since the pathologies that caused her ovulatory cycle disruptions can in most cases be treated.

Women who are overweight or underweight (weight less than 45 kilograms) are prescribed a course of body weight correction. According to the observations of specialists, sometimes it is enough for a patient to reduce her weight by just 10% in order for ovulation to begin to occur on its own.

The third stage is the stimulation itself. Schemes of protocols for stimulating ovulation can be different. The doctor determines the specific drug, its dosage, duration and frequency of administration on an individual basis, taking into account the patient’s age, weight and gynecological history.

Sometimes it’s not the hormones’ turn. Pregnancy occurs before the third stage if a woman manages to completely reconsider her attitude towards unsuccessful attempts to become pregnant. Fear, anxiety, worries, grief, disappointment at the psycho-physical level trigger blocking of estrogen production, so ovulation does not occur.

If a woman learns to treat failures correctly, to perceive them as temporary and extremely harmful to her health, the ovulatory cycle is often restored without medications at all.

At the initial stage, doctors try to prepare the endometrium of the uterus. With a thin endometrium, conception, even if it occurs, may not lead to pregnancy, because it will be difficult for the embryo to gain a foothold in the uterine cavity. To prepare, a course of treatment with female sex hormones is carried out.– “Proginova”, external preparation “Divigel” and other drugs that contain the hormones estrogen and progesterone are used.

As a rule, from the 5th day of the cycle, special medications are prescribed, while at the same time doctors monitor the maturation of the follicle using ultrasound.

Activities should be started immediately after the end of menstruation.

It is possible that a woman will have to visit the ultrasound diagnostic room every day from the 10th day of her menstrual cycle. As soon as one of the follicles reaches a size of 17-18 mm, stimulation can be carried out and after 24-36 hours expect the arrival of the cherished moment - ovulation itself.

Still in preparation a woman must donate blood for a hormonal test to determine the level of AMH- anti-Mullerian hormone, which is “produced” by the growing structures of the follicles.

If a woman's own AMH level is low, the ovarian response to stimulation will be weak and the effectiveness of the protocol will be significantly reduced. The level of this hormone when examined over time will also allow doctors to see the effectiveness of stimulation and prevent excessive hyperstimulation.

You can stimulate the ovaries up to three times in a row, that is, for three cycles. If conception does not occur, a break is required so that the ovaries can rest from the “hormonal attack” and recover. During this time, the man and woman again visit the doctor, who can make adjustments to the treatment regimen.

A total of 5-6 cycles with stimulation are considered acceptable. If they do not bring results, the method is considered ineffective for this couple, they are recommended other assisted reproductive techniques, including surrogacy, removal of mature healthy eggs from the ovaries followed by in vitro fertilization, fertilization of a donor egg with the husband’s sperm, etc. It all depends on the true causes of infertility and whether the woman produces her own healthy reproductive cells.

There is no point in insisting on continuing to stimulate ovulation; after 5-6 courses, there is a high probability of irreversible ovarian depletion and premature aging.

To stimulate ovulation, you do not need to go to the gynecological hospital. A woman can be at home, in her usual conditions. She must strictly adhere to the prescribed schedule of visits to the doctor for ultrasound monitoring, and also take all prescribed medications in full accordance with the specified individual dosage.

Drugs - list

All drugs that are included in ovulation stimulation protocols are divided into two large groups:

• follicle growth stimulators;
• ovulation triggers.

The first ones are prescribed from the 5th day of the cycle (immediately after menstruation), and the triggers are introduced one-time - when an ultrasound shows the follicle is completely ready to release an egg. They imitate the release of luteinizing hormone, under the influence of which the egg quickly matures and leaves the follicle.

After ovulation has taken place, medications are prescribed that help the ovaries maintain the functions of the corpus luteum so that pregnancy, if it occurs, can develop normally. Let's look at the drugs of all these groups in more detail.

"Clostilbegit ("Clomiphene citrate", "Clomid")

This drug is widely known to women planning pregnancy, as it has proven itself as a means of stimulating the ovulatory process. The medicine is a stimulator of the formation and growth of follicles in the ovaries.

In certain doses, it helps the production of follicle-stimulating hormone FSH, luteinizing hormone (LH) and gonadotropins. The product is available in tablet form.

There are no general recommendations on the dosage regimen of the drug, because the dose depends on how the ovaries react to taking this medicine - it can be reduced or increased at the discretion of the attending physician.

If a woman’s menstruation occurs fairly regularly and there are no long-term disruptions, then treatment with Clomid begins on the 5th day of the cycle (counted from the first day of menstruation). According to one of the common schemes, the drug is taken every day for five days, in this case ovulation is expected to occur from the 11th to the 15th day of the cycle.

If there is no ovulation, then in the next cycle another regimen is introduced, in which the drug must be taken from the 5th day of the cycle for 5 days, but in double the dosage.

If both regimens do not show results, treatment is interrupted for three months, after which the course can be repeated.

For each course, a woman should not take more than 750 mg of the drug. After the second course, if it does not bring the long-awaited result, Clomid treatment is considered completely ineffective and other methods of assisted reproduction are chosen.

Side effects of the drug can cause discomfort to the woman. These include nausea, vomiting, flatulence, headache, increased drowsiness, inhibition of movements and mental reactions, therefore, for the duration of treatment, the woman is recommended to refrain from driving and work related to high risks for life.

Many women notice that they feel sick while taking Clomid. depressed mood, their sleep and appetite are disturbed. There may be pain in the lower abdomen, minor pain in the chest area, white liquid discharge from the genitals.

Clostilbegit, like other drugs that stimulate follicular growth, increases the risk of subsequent multiple pregnancies. Many women note that during treatment they become somewhat plump.

Analogues of this product are Clomiphene, Serofen, Serpafar.

"Letrozole"

This non-steroidal drug is also enhances FSH production and promotes ovulation, however, experts consider it more effective than Clomiphene, although Clomiphene remains the first choice.

Letrozole has significantly fewer side effects, making it more pleasant to take. In addition to regulating hormones, the drug improves the condition of the endometrium. There are also several schemes according to which this medicine can be taken in tablets.

In the first case, 2.5 mg is prescribed from the third day of the cycle for five days; in the second regimen, the woman is recommended to take the drug from the fifth day of the cycle at a dose of 5 mg.

The best results are shown by the use of this drug as part of complex therapy: on the second to sixth day of the cycle, Letrozole is prescribed at a dosage of 2.5 or 5 mg per day, then from the 7th to 10th day of the cycle, the woman is given FSH injections, and then given an injection of hCG at a dosage of 10,000 units, as soon as the dominant follicle reaches the required size according to ultrasound (from 18 mm).

Analogues of the drug are “Letrosan”, “Femara”.

"Gonal-F"

This drug also belongs to the group of drugs stimulating the growth and development of follicles in the ovaries in the first half of the menstrual cycle. It contains a recombinant hormone, which, thanks to the efforts of genetic engineers, was obtained from the ovarian cells of female Chinese hamsters.

The drug is administered subcutaneously and is sold in special, easy-to-use syringe pens. “Gonal-F” is prescribed if stimulation with the first drug prescribed, Clostilbegit, turns out to be ineffective.

Similar effects of this drug are typical for many hormonal drugs - headaches, dizziness, drowsiness and lethargy, lack of tone, vaginal dryness, changes in appetite, insomnia. Sometimes women report diarrhea, temporary blurred vision, acne, and weight gain.

The drug is administered subcutaneously. The doctor will give the first injection, and the woman will be able to inject subsequent ones herself. yourself at home.

The course of stimulation begins in the first days of the cycle and lasts up to 11-14 days. The dose of administration is determined by the doctor, usually starting with 75-10 IU and gradually increasing the dosage.

With each subsequent injection, the woman needs to choose a new injection site; she should not inject in one area.

Analogues of the drug are “Choragon”, “Ovitrel”.

"Puregon"

This drug can also be used for the initial preparation of follicles in the first half of the cycle. It is available in the form of a powder for the preparation of a solution for injection, as a ready-to-use solution and a solution in cartridges. The liquid is administered intramuscularly and subcutaneously. The drug in the “pen” is administered in only one way - subcutaneously.

The drug contains recombinant FSH from the same Chinese hamster, which in many respects is superior to FSH obtained from human urine. It is safer and easier to tolerate.

Under its influence, several follicles begin to actively grow in a woman’s ovaries, which can then be used in any of the assisted reproductive methods.

The dose depends on how the patient’s ovaries “respond” to the effect. Daily ultrasound monitoring and determination of estrogen in the blood will help the doctor have a good idea of ​​what exactly is happening in the woman’s gonads and not miss the moment of ovulation.

The initial dose is 50 IU, then, if there is no ovarian response, the dosage is increased daily and monitored when the response appears. Treatment begins on the second day of the menstrual cycle, it lasts about 7-14 days (it all depends on when it is possible to achieve follicle growth and an increase in the concentration of estadiol in the blood). The stimulation is completed by an injection of hCG in a dose suitable for inducing ovulation (usually 10,000 IU).

"Chorionic gonadotropin" (hCG)

This drug is obtained from the urine of pregnant women because this hormone is produced in large quantities in the initial period of bearing a baby - most intensely until the 12th week. An injection of this drug in a dosage of 5,000 to 10,000 IU is used to ensure that the very fact of ovulation occurs, so that the egg can leave the follicle stimulated in the first stage.

Then the drug can be administered every two days until the expected menstruation to support the functions of the corpus luteum, which produces sex hormones necessary to maintain pregnancy.

If pregnancy is confirmed, hCG can subsequently also be used up to 10-11 weeks, if there is a threat of miscarriage due to low intrinsic hCG levels.

If a woman’s ultrasound reveals a threat or fact of ovarian hyperstimulation, then they refrain from using hCG. It is also not recommended to use human chorionic gonadotropin for women with kidney and liver pathologies.

Side effects of the drug include irritability and mood swings, headaches, and drowsiness. HCG also increases the chance of conceiving twins or triplets, and this fact cannot be ignored when planning a pregnancy.

An analogue of the drug is “Pregnil”.

Dydrogesterone (Duphaston)

This is a popular hormonal drug, the main active ingredient of which is an analogue of progesterone. The product can be indispensable in the second half of the menstrual cycle, as it helps maintain pregnancy, promotes proper implantation, regulates many processes, adjusting the woman’s body to a new state.

Duphaston has no effect on ovulation, but after it it becomes very important, since it strengthens the possible positive result stimulation. The drug does not affect the growing embryo, and therefore its use in the first weeks and months of pregnancy is not prohibited, and sometimes recommended.

The dosage is prescribed individually depending on the result of a blood test for progesterone, as well as the purpose of taking it - tablets can be prescribed not only to control the level of the hormone, but also to prevent the threat of miscarriage, to prevent a frozen pregnancy, if such facts have previously occurred.

Women do not gain weight from Duphaston, do not lose concentration, and therefore can continue to drive without restrictions while taking this medication.

Vitamins to stimulate ovulation

Vitamin preparations are included in standard treatment regimens for female and male infertility. When ovulation is stimulated, taking vitamins is indicated 1-2 months before the cycle selected for stimulation, as well as throughout the entire period of stimulation, and then until pregnancy is confirmed.

Sometimes, in order to establish regular ovulation, it is enough to adjust a woman’s lifestyle, her diet and prescribe her vitamins, so vitamin support at the pregnancy planning stage is of great importance.

Vitamins D, A, B12, B9, E, C are especially important for normalizing ovulatory cycles:

• Vitamins D and D 3 participate in the process of producing sex hormones in women.
• Without vitamin A The development of the follicle is not avoided; in addition, retinol is involved in normalizing the composition of cervical mucus.
• Vitamin E participates in cellular processes, helps the maturation of the egg, promotes its release beyond the follicle.
• Ascorbic acid (vitamin C) improves blood circulation, which helps enrich the ovaries with useful substances.
• B vitamins, especially folic acid, regulate the duration of the luteal phase of the cycle, and also increase the viability of the egg.

• From the beginning of menstruation until ovulation - vitamin E, vitamin A and folic acid.
• From the moment of ovulation throughout the second phase of the cycle - vitamin C, vitamins B, vitamin E.

Specific vitamin preparations should be prescribed by a doctor, taking into account a biochemical blood test, which shows which substances are needed and which are sufficient without synthetic drugs.

An example of a successful vitamin therapy regimen could be like this:

• From 1 to 14 days of the cycle- cocarboxylase + riboflavin (in injections) daily, as well as lipoic acid and vitamin E in tablets and capsules.

• From 15 to 24 days of the cycle- Riboxin, pyridoxine, folic acid and potassium orate in tablets, as well as vitamin E three times a day.

Treatment with folk remedies

Our ancestors knew something about women’s health long before such concepts as “ovulation stimulation” appeared. However, experts tend to believe that the theory of probability plays a big role in alternative medicine - There is always a chance to conceive, and therefore drinking weed in principle won’t hurt.

Modern doctors respect folk remedies for improving women's health, but warn against self-prescribing them.

Any traditional treatment you need to discuss it with your doctor so as not to cause harm.

For folk ways increases in ovulatory ability also exist certain rules. For example, You should not take herbs at the same time as hormonal therapy with medications., this can lead to ovarian hyperstimulation.

Herbs and roots for female fertility should not be taken during menstruation, and treatment with them for more than 3 months in a row, as well as with hormonal medications, is not recommended.

The principle of treatment in alternative medicine is exactly the same as in traditional medicine. In the first half of the cycle they take herbal remedies, which help the growth and development of the follicle. This is sage - decoctions and essential oils, a decoction of rose petals, an infusion of plantain seeds.

In the second half of the menstrual cycle, after ovulation, traditional healers recommend taking boron uterus- This plant contains plant progesterone. Decoctions and infusions are made from it, according to the instructions for use, which are included in the pharmacy packaging with this herbal collection.

To achieve ovulation, a woman is advised to stop drinking alcohol, not abuse nicotine, and diversify her diet with foods that best affect the functioning of the ovaries. This is liver, lean red meat, sea ​​fish, dairy products.

Efficiency

In the first cycle, when ovulation is stimulated in a woman, approximately 15% of couples manage to become pregnant.

During the second and third cycles, the number of positive outcomes, when ovulation can be restored, reaches 70-75%. In general, the effectiveness of drug ovulation induction is estimated at 70-80%. This is the number of couples that are ultimately able to be helped to get pregnant naturally.

The rest come to the aid of IVF, ICSI and other assisted reproductive techniques and techniques.

Possible consequences and complications

Stimulation is carried out with hormonal drugs, the effect of which on the female body would be wrong to underestimate. The induction itself during the cycle often causes painful and unpleasant sensations in women. Many people complain that the lower abdomen is tight and even that the ovaries hurt after stimulation. Almost everyone notices “hot flashes” – bouts of heat that occur in waves.

One of the most dangerous consequences of stimulation is overstimulation., in which follicle growth occurs so rapidly that hyperstimulation syndrome develops. Most often it can make itself felt for the first time 3-4 days after the start of induction.

If signs of such a pathology appear in more late dates- after 7-10 days of the menstrual cycle, the syndrome becomes quite severe, with vomiting, diarrhea, swelling of the limbs and face, a drop in blood pressure, and a sharp deterioration in well-being.

A woman may require qualified assistance in a hospital setting. Therefore, stimulation should be carried out by a doctor with extensive experience in reproductive programs, who can promptly monitor the processes occurring in a woman’s body under the influence of hormones and make correct and informed decisions.

Indications and contraindications

Before medical procedures in
it is mandatory to check the fallopian tubes and analyze the quality of the seminal
man's fluids. If infertility is male
or tubal factor, stimulation will be inappropriate.

The procedure is used when the process of releasing eggs from the follicles is irregular or completely absent. It is also indicated for patients with polycystic ovary syndrome and hormonal dysfunction. In addition, specialists perform ovulation stimulation in cases of high or low body mass index (BMI).

The procedure cannot be performed if there is pathology of the fallopian tubes, which is accompanied by their obstruction. IN in this case you need to contact a reproductive specialist. Obstruction of the fallopian tubes is one of the indications for in vitro fertilization. In the IVF process, stimulation is performed to obtain eggs, which are then aspirated for artificial insemination.

Quite often there are situations when the cause of a woman’s fertility problems are diseases of her genital organs, which make the process of embryo implantation impossible. Against the background of such a pathology, it is not advisable to stimulate ovulation. It is necessary to undergo a course of treatment to eliminate the cause of the pathology. In the future, pregnancy can occur in a normal cycle.

It should not be performed on women with a low ovarian reserve and a high chance of maturing low-quality oocytes. The procedure should not be performed if the patient’s sexual partner has a spermatogenesis disorder. Poor quality of seminal fluid significantly reduces the chance of fertilization.

It is first necessary to treat the man to stabilize his reproductive function.

Prices for ovulation stimulation are significantly lower than the cost of traditional assisted reproductive technologies (IVF, ICSI, etc.). This makes it a fairly popular method of overcoming infertility. However, before starting treatment, you should always consult a doctor to determine the possibility of carrying out the appropriate procedure.

Doctors prescribe treatment if the natural cycle is pathologically disrupted, and pregnancy does not occur for more than 1 year with futile attempts married couple conceive a child. More often, the problem is caused by the hormone progesterone, or rather its insufficient production in certain female diseases. It is important to timely identify provoking factors clinically and laboratory and eliminate them from a woman’s life during pregnancy planning. These may be the following diagnoses and circumstances:

• polycystic ovary syndrome;
• long-term use of birth control pills;
• hyperandrogenism;
• excessive thinness of a woman (lack of adipose tissue);
• reduced resistance to stress;
• chronic fatigue, insomnia;
• primary ovarian failure;
• syndrome of resistant, exhausted ovaries;
• hypothalamic-pituitary dysfunction;
• numerous ovarian cysts;
• obstruction of the fallopian tubes;
• pathologies of the genitourinary area.

Stimulation drugs

Stimulation of ovulation before
IVF begins on the 5th day of the menstrual cycle. Dosage of drugs
are selected individually based on age and reproductive health. For
Each period of the menstrual cycle has certain groups
medicines. Gonadotropic drugs are administered by injection.
Antiestrogenic tablets are taken orally. To the most often
The medications used include:

• Orgalutran;
• Puregon;
• Cetrotide;
• Gonal;
• Clostilbegit;
• Divigel;
• Proginova;
• Menopur;
• Chorionic gonadotropin.

First they take estrogens,
stimulating egg growth. These include Puregon, Elonvoy and Gonal-F. At
stimulation in the natural cycle, take Clostilbegit. In 3-4 days
drugs are added to control premature rupture
follicle membranes. Among them are Cetrotide and Orgalutran.

The traditional means for starting the process of rupture of the follicle wall with the release of the egg remains human chorionic gonadotropin. Its injection leads to the completion of oocyte maturation. It blocks the transformation of the follicle into a cyst.

The release of the egg most often occurs 35-40 hours after the introduction of hCG into the body. When using IVF, the follicles are pierced with a special needle a little earlier, after 34-36 hours. This is necessary to collect the oocyte and prevent its loss.

In some situations, the use of hCG leads to ovarian hyperstimulation with the simultaneous maturation of a large number of oocytes. But patients who have undergone ovulation stimulation leave mostly positive reviews and claim that hyperstimulation syndrome develops extremely rarely. To prevent such developments, GnRH agonists are introduced into the treatment regimen.

Typical symptoms of ovarian hyperstimulation syndrome (OHSS) are:

• abdominal pain;
• nausea;
• bloating;
• hot flashes;
• sleep disorders;
• headaches.

Severe pathology leads to the formation of cysts in the ovaries. Sometimes free fluid is found in abdominal cavity. The disease requires medical attention. In order to get pregnant, more than 1 stimulation is usually required, since the chance of conception in one cycle does not exceed 30%. Doctors do not recommend performing more than 6 procedures in a row. Each subsequent procedure increases the chance of developing OHSS.

Stimulation of ovarian ovulation with drugs is carried out after eliminating contraindications. The procedure is considered risky, so it is important to familiarize yourself with possible complications before performing it. Throughout the entire cycle, a woman needs to take medications. The response of the ovaries to the therapy is monitored by ultrasound. Drugs that stimulate follicle growth include:

• Clostilbegit (clomiphene citrate)
• Letrozole Femara
• Menopur

Drugs for stimulating ovulation also include Divigel and Proginova. They influence the enlargement of the endometrium. The quality of implantation depends on the thickness and looseness of the uterine layers. There is an opinion that Proginova and ovulation are mutually exclusive concepts. But estradiol, which is part of the tablets, does not have a suppressive effect on the endometrium. Divigel has a similar effect. It is distinguished by its transdermal method of application.

Stimulation with Gonal or any other drug containing hCG is carried out after the dominant follicle reaches a size of 18 mm. The injection is administered once in a dosage of 5,000 to 10,000 units. The injection causes the follicle to rupture. Thanks to this, the egg is released and directed towards the uterus. This occurs within 24-48 hours after the injection. It is during this period that a woman’s fertility increases.

The drug is a non-steroidal anti-estrogenic drug. In moderate doses, it is able to stimulate the body's production of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. Stimulation with clostilbegit is carried out for women preparing for IVF or intrauterine insemination.

General indications of the drug:

• Anovulation (Lack of ovulation);
• Amenorrhea (Dysgonadotropic form);
• Androgen deficiency;
• Secondary amenorrhea;
• Galactorrhea;
• Oligomenorrhea;
• Stein-Leventhal syndrome;
• Chiari-Frommel syndrome (prolonged postpartum amenorrhea-galactorrhea syndrome);
• For men: Oligospermia.

Stimulation with clostilbegit is contraindicated in women with fallopian tube obstruction. Pregnancy in this case may occur, but it will turn out to be ectopic and cause serious complications for the health and morale of the woman dreaming of a child. Stimulation is also not done for inflammatory diseases of the pelvic organs.

Initially, during diagnosis, these ailments are identified and attempts are made to treat them.

Since 2001, it has been prescribed to combat infertility in women. The main component of the drug is an aromatase inhibitor. The medicine has a slight antiestrogenic effect. The advantage of the product is the short period of elimination from the body. Its components are not present in the body at the time of implantation of the fertilized egg. In addition, the product has a beneficial effect on the endometrium of the uterus, preparing it for the attachment of the embryo.

Among the disadvantages of the stimulant, the risks of developing complications after taking it are possible:

• Nausea;
• Abnormal bowel movements (diarrhea or constipation);
• Abdominal pain;
• Feeling of dry mouth;
• Leukopenia;
• Headaches;
• Feeling of anxiety;
• Increased fatigue;
• Sudden change of mood;
• Depression;
• Drowsiness;
• Memory impairment;
• Tachycardia, increased heart rate.
• During treatment, it is possible to increase blood pressure and develop thrombophlebitis with damage to the deep veins;
• Development of heart failure;
• Allergic rashes (Erythema, Papules, Vesicles);
• Loss of scalp hair;
• Increased sweating;
• Swelling of the respiratory system;
• Pain and aching in bones;
• Development of osteoporosis and arthrosis;
• Problems in the genitourinary system (frequent urination after taking it, the sensitivity of the organs of the urinary system to the introduction of pathogenic flora also increases);
• Violation of the vaginal microflora (vaginal dryness, uterine bleeding)
• Unpleasant sensations in the chest.

To prescribe a drug, you need to undergo an examination and undergo tests as in the case of taking other drugs, namely:

• Analysis for sexually transmitted infections;
• Ultrasound of the reproductive system;
• Ultrasound of the mammary glands.

The doctor assesses the patency of the woman's fallopian tubes. In case of positive tests, the doctor individually prescribes letrozole to stimulate ovulation and a regimen.

Examination before stimulation

To determine the female hormone level, it is necessary to undergo diagnostics, which includes tests hormonal levels and ultrasound monitoring. Among the mandatory examinations, a biochemical blood test predominates to determine chemical composition biological fluid concentration of testosterone, progesterone.

Injections to stimulate ovulation during IVF

Additionally, medications containing human chorionic gonadotropin are prescribed. They are administered subcutaneously and intramuscularly. Injections promote the proper functioning of the corpus luteum, which subsequently has a positive effect on the course of pregnancy. They can be done either in the treatment room or independently. The most common drugs with human chorionic gonadotropin include Horagon, Pregnil and the domestic version of the same name.

Some drugs are presented in the form of a pen, which is injected into the fold of the abdomen. The injection is completely painless, so it can be done without outside intervention.

The procedure includes the following steps:

1. The injection site is wiped with alcohol;
2. The syringe is filled with solution;
3. A fold is formed from the skin on the abdomen;
4. A syringe at an angle of 45° is inserted into the desired area;
5. The contents of the syringe are carefully squeezed out;
6. After the procedure, the needle insertion site is treated with an antiseptic.

Injections that involve
intramuscular injection is done in the same way, but in the buttocks. They
are considered more painful. Therefore, it is advisable to entrust them to specialists.

How to stimulate ovulation at home

Achieving successful conception and becoming pregnant in the presence of the above-mentioned health problems is problematic, treatment female body sometimes it drags on for 6-12 months or longer. Productive ovulation induction is designed for 6 menstrual cycles. After the specified period, according to WHO indicators, it is necessary to take a temporary break and undergo a more extensive examination to identify the etiology of the pathological process.

Artificial stimulation of the uterus and ovaries for the purpose of growth and maturation of follicles can be carried out in a comfortable home environment. The appropriate technique is determined only by the attending physician; the main goal is to establish hormonal levels, increase the low concentration of sex hormones progesterone, and successfully become pregnant.

Products

Before you get involved with artificial insemination and decide to prepare for the IVF procedure, you can stimulate ovulation using home methods. Compared to drug treatment, it is safer for the body. To begin with, it is advisable to review the daily diet, make certain adjustments to the menu, and the presence of natural vitamins. For intensive production of estrogen hormones, it is recommended to consume the following foods over a long period of time:

• hard cheeses;
• tomatoes and cucumbers;
• sprouted wheat;
• homemade cow's milk;
• beans and soybeans;
• quail eggs;
• apples and carrots;
• pumpkin seeds;
• pomegranate and dates;
• linseed oil.

Folk remedies

Alternative medicine methods in a given direction also differ high efficiency, if the main cause of the pathology is eliminated in a timely manner. In addition, during puberty it is also better to be treated (as a woman) with folk remedies, so as not to disturb the already unstable hormonal levels.

• Tribulus terrestris extract;
• decoction of boron uterus;
• a mixture of aloe pulp with ghee and honey;
• decoctions and infusions of sage;
• decoctions of rose petals, Adam's root, plantain seeds;
• Radiola quadruple leaf extract;
• infusion of knotweed herb.

A woman’s body should receive large amounts of vitamins C and E, which are found in certain essential oils. Thus, artificial stimulation is provided by oil compositions of sage, tea rose, cypress, basil, lavender, anise, and sandalwood. To carry out this procedure, it is necessary to know the proportions of each medicinal ingredient, to eliminate the risk of developing allergic reactions and potential complications when ovulation is restored.

How is ovulation stimulated during IVF?

And so, after visiting a doctor and undergoing a detailed examination designed to establish the true cause of family infertility, a woman is prescribed a full range of laboratory tests, from general and detailed blood and urine tests to blood tests for infections, including sexually transmitted infections.

A man also undergoes blood tests for sexually transmitted infections, and also undergoes a spermogram, because if the quality of sperm is poor, then in case of male infertility, all ovulation stimulation schemes without exception will not give any result.

Next, if any diseases are identified, existing inflammatory diseases and hormonal imbalances are treated. Already at this stage, it is possible to induce ovulation in a natural way, since the pathologies that caused the ovulatory cycle to fail can, in most cases, be treated.

Stimulation of ovulation during IVF
occurs in several stages. First, they take drugs responsible for growth
eggs. Every 2 days the woman attends an ultrasound examination. It
allows you to timely diagnose hyperstimulation, which can cause harm
her health. After approximately day 10 of the cycle, medications begin to be taken
for the endometrium.

There are several variations
protocol – optimal, short and long. Short protocol does not imply
use of drugs that block the pituitary gland. Stimulant medications begin
Take not from day 5, but from day 2 of the cycle. In this case, there is a risk that
ovulation will be early. With the optimal protocol, the initial stage is the same as
short.

Stimulation schemes

Having determined what can cause diagnosed infertility, the doctor individually recommends conservative treatment and makes adjustments to the usual diet and lifestyle. One of the two proposed schemes, specially developed and tested in practice in similar clinical situations, effectively stimulates the maturation and growth of follicles.

If after all these steps ovulation does not occur, the doctor will prescribe a specific drug, dosage, duration and frequency of administration.

How is ovulation stimulated to get pregnant? At the initial stage of the procedure, doctors try to prepare the endometrium of the uterus. With a thin endometrium, conception may not lead to pregnancy, because it will be difficult for the embryo to gain a foothold in the uterine cavity. To prepare, a course of treatment with female sex hormones is carried out - Proginova, Divigel and other drugs are used (containing the hormones estrogen and progesterone).

Already from the 5th day of the cycle, special medications are prescribed, as well as tracking the maturation of the follicle using ultrasound. When one of the follicles reaches the desired size (17-18 mm), stimulation can be carried out and ovulation can be expected after 24 (sometimes up to 36) hours.

During the procedures, the level of AMH in the body is monitored. If a woman's own AMH level is low, the effectiveness of the protocol will be significantly reduced. The level of this hormone when examined over time will also allow doctors to see the result of stimulation and prevent hyperstimulation.

Stimulation can be carried out up to three times in a row, that is, within three cycles. If conception does not occur during this time, a break is required so that the ovaries can rest and recover.

The success of the measures taken is indicated by the formation of the corpus luteum at the site of the ovulated follicle. To increase the chances of successful implantation of the embryo, the hormone progesterone is needed. To ensure its entry into the body, take Duphaston (dydrogesterone) or Utrozhestan. Progesterone drugs are taken until the arrival of menstruation. Before canceling them, you need to make sure there is no pregnancy.

Drug stimulation

Treatment is carried out using conservative methods, and is very successful after 3-5 months. Only the attending physician can select and prescribe medications to stimulate ovulation; he also adjusts daily dosages and determines drug interactions. Correctly selected and effective scheme You can cure infertility and get pregnant. List of which pills are the most effective for stimulating ovulation, their brief characteristics are presented below.

Reception medicines may cause side effects, so self-medication is excluded. If doctors prescribe Clostilbegit, this therapeutic approach ensures forced activation of luteinizing and follicle-stimulating hormones. Prescribe medications for days 5-9 of the menstrual cycle, 1 tablet per day.

Letrozole

This non-steroidal aromatase inhibitor has anti-estrogenic properties, increases the production of FSH hormones for successful fertilization of the egg and stimulates the ovulation process. The course of intensive therapy is 5 days, 2.5 mg per day, starting from the 3rd day of the menstrual cycle. The medicine is especially effective if female infertility is preceded by the woman’s advanced age and polycystic ovary syndrome. Do not violate the recommended doses of medications, otherwise you will not be able to successfully become pregnant, and the clinical picture will only become more complicated.

Dydrogesterone

This is another name for the hormonal drug Duphaston. If there is no ovulation, the patient is prescribed these pills more often than others, since the risk of side effects is minimal. The recommended course of progesterone preparations is at least 18 days in the second half of the menstrual cycle, 1-2 pills per day. After 3 weeks of treatment, it is indicated to perform an ultrasound before successful fertilization occurs.

If problems arise with natural conception, hormonal drugs contribute to successful conception over a long course. Representatives of the pituitary follicle-stimulating hormone Gonal-F or Puregon, administered subcutaneously or intramuscularly, have a targeted effect. Taking into account the dosage of the drug, induction is carried out in 7-day cycles of no more than 6 courses.

It is important to understand that tablets are less effective, injections are targeted. Injections are prescribed in complicated clinical situations in order to correct hormonal imbalances in a shorter period of time and ensure sustainable positive dynamics of the underlying disease. The hCG drug, as an option - Pregnil, is administered intramuscularly at a dosage of 5,000-10,000 IU once or take 1,500 IU every 3 days for 10 days. Extending hormonal therapy is indicated individually.

After ovulation stimulation, pregnancy did not occur

The frequency of pregnancy after stimulation of ovulation in one cycle is about 15% (Data not scientifically confirmed, approximate figure from practice). Pregnancy does not necessarily occur in the first cycle; it occurs after stimulation of ovulation in subsequent cycles. Do not be upset, because natural ovulation after stimulation is possible in subsequent cycles.

Doctors cannot prescribe stimulation for more than three cycles in a row. It must be taken into account that stimulation with various drugs is not recommended no more than six times in a lifetime. The drugs can cause hyperstimulation, which is dangerous by depleting the ovaries.

It is difficult to speed up the process of successful fertilization in case of impaired ovulation; the woman must regularly undergo a single course of hormonal therapy (depending on the phase of the cycle). In the first cycle after stimulation, you cannot count on pregnancy; you need to wait another 2-3 cycles. Fertilization occurs during subsequent natural cycles, since medicinal methods have been able to improve a woman’s reproductive activity.

IVF is used as a radical method of solving the problem of impaired ovulation, subject to medical indications. First, special preparation is carried out, a number of tests and laboratory studies are prescribed, which are subsequently reflected in IVF protocols. This way you can significantly increase the chances of future motherhood and successful ovulation, but the possibility of carrying out the procedure is no more than 3 times.

If ovulation is prevented by pathogenic factors, after they are eliminated and treated, the health problem may remain. Moreover, serious health complications cannot be ruled out. Alternatively, the ovaries are pathologically enlarged, the patient complains of bloating, migraine attacks, nervousness, and hot flashes. However, there are more dangerous conditions for women that prevent ovulation:

• multiple and ectopic pregnancy;
• pathological childbirth;
• ovarian rupture;
• intrauterine embryonic death;
• spontaneous miscarriage early;
• ovarian hyperstimulation;
• tubal pregnancy.

Drugs that help you get pregnant are divided into three main types: follicle-stimulating hormone (FSH) and luteinizing hormone (LH) drugs, hCG drugs and progesterone drugs.

9 rules to get pregnant, you need to fulfill three basic conditions:

1) the woman has ovulated;
2) the sperm has fertilized the egg;
3) the embryo is securely fixed in the uterus.

Respectively:

1) drugs that enhance the production of FSH and LH, helping to get pregnant, stimulate ovulation - the growth of follicles on the ovaries;

2) HCG helps the largest follicle to remain large enough to release an egg, which must be fertilized by a sperm;

3) progesterone prepares the inner layer of the uterus for the implantation of the embryo and helps to bear the fetus.

A little theory: the mechanism of ovulation

Ovulation is the release of a mature egg from the ovary. The egg is then sent through the fallopian tubes into the uterine cavity. This usually happens in the middle of the cycle, that is, on the 14–15th day after the start of menstrual bleeding. Women with regular cycles are likely not asking the question, “Will I be able to get pregnant?” With a regular cycle, ovulation usually occurs regularly.

If you came to the doctor with the question “Why can’t I get pregnant” or the complaint “I haven’t been able to get pregnant for a year,” then most likely you are not ovulating. They can't get pregnant without it.

If you are wondering, “Why can’t I get pregnant?”, you can do an ovulation test. It can be bought at a pharmacy. Contact your doctor if you do not ovulate for several cycles in a row.

Ovulation may not occur for various reasons: due to hormonal imbalances, inflammation of the pelvic organs, and so on. If you have not been able to get pregnant for a year because ovulation has not occurred, your doctor may prescribe injections and pills to help you get pregnant - stimulating it.

Who is ovulation stimulation indicated for?

If the question “Why can’t I get pregnant?” is relevant to you, then you need to undergo an examination. It would be good if your spouse did the same - this would help establish the cause of infertility.

The doctor prescribes drugs to stimulate ovulation in cases where:

The couple has been trying to get pregnant for over a year to no avail;
Spouses over 35–40 years of age do not become pregnant within 6 months.

If you are going to take pills to help you get pregnant, be sure to get a tubal patency test. This will help avoid ectopic pregnancy.

FSH and LH drugs. The goal is ovulation

Under the influence of FSH, follicles begin to grow on the ovary - “sacs” on the surface of the ovary, in which one egg matures. To stimulate the growth of follicles, the following drugs are most often prescribed to help get pregnant:

"Klostilbegit";
"Puregon";
"Menogon";
and others.

Drugs that help you get pregnant are selected individually, depending on the results of tests and ultrasound examinations. In this material we describe the most famous, but not all existing drugs.

"Klostilbegit"

“Pills that help you get pregnant” is what Clostilbegit is called by women for whom this drug helped realize their dream of conceiving a child. It stimulates the production of pituitary hormones: FSH - to stimulate follicle growth; LH (luteinizing hormone) - to stimulate ovulation, that is, the release of an egg from the follicle; prolactin - for milk production in the mammary glands.

According to the instructions, these pills that help you get pregnant should not be taken more than 5-6 times in your life. Otherwise, early ovarian depletion is possible, as a result of which pregnancy will be impossible, since all the eggs will be used up. Stimulation of egg maturation with the drug "Clostilbegit" is usually carried out from the 5th to the 9th day after the start of menstruation. These pills help you get pregnant, take 1 piece once a day.

This drug negatively affects the growth of the endometrium. If an ultrasound shows that the endometrium is thinner than 8 mm, then another drug must be used to stimulate ovulation. With a thin endometrium, it will be difficult for the embryo to gain a foothold in the uterus - and the answer to the question “will I be able to get pregnant” will be negative, despite the fact that conception occurs.

"Puregon"

"Puregon" is included in the list of gonadotropic drugs, as it stimulates the pituitary gland's production of sex hormones - FSH and LH. “Puregon” helps the ovaries “grow” several follicles, which makes it possible for ovulation to occur in the middle of the menstrual cycle. Suitable for stimulating ovulation both during natural conception and during artificial insemination in the IVF program.

"Menogon"

Replenishes the lack of sex hormones FSH and LH, which in turn increases the concentration of estrogens - female hormones. As a result, follicles on the ovaries begin to grow, and the inner layer of the uterus (endometrium) grows and prepares for a possible pregnancy.

"Puregon", "Menogon" and other gonadotropins (which activate the pituitary gland) begin to be taken on the second day of menstrual bleeding. The duration is 10 days, but it needs to be adjusted with a doctor, and also monitor the reaction of the ovaries using ultrasound.

HCG preparations

After the ultrasound shows that the follicles have grown to the desired size (20–25 mm), injections of human chorionic gonadotropin (hCG) are prescribed. These are also hormonal drugs that help you get pregnant. HCG is administered one day after the last dose of Menogon, Puregon and other drugs. The hCG hormone is contained in the drugs Pregnil, Horagon, Profasi, Gonakor and others. HCG hormone preparations are prescribed as a one-time dose of 5,000–10,000 IU. A day after the injection, ovulation occurs. For the therapy to help, you need to have sex a day before the injection of hCG drugs and for another 24 hours after.

Progesterone preparations

If the effect of the above drugs is positive, then progesterone drugs are prescribed. They help “consolidate” the pregnancy. Duphaston and other progestin tablets that help you get pregnant are prescribed individually.

In many cases, hormonal therapy, the regimen described above, helps women cope with the problem of “I can’t give birth and carry a child.” With the development of medicine, more and more more women they get the opportunity to feel the happiness of motherhood and forget about the times when they started topics on forums with the heading “I can’t give birth.”
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Reading time: 4 minutes. Views 175 Published 11/26/2019

Stimulation of ovulation is one of the methods of treating infertility in women. It is carried out both in the natural cycle and as part of in vitro fertilization. Therapeutic treatment involves taking hormonal drugs that have a stimulating effect on ovarian function.

Stimulation of ovulation during IVF

In vitro fertilization is the process of artificially implanting an embryo into the uterine cavity. Conception in this case occurs in a laboratory setting, in a test tube. The procedure involves a series preparatory activities. It is carried out solely according to indications.

Stimulating ovulation before IVF allows you to get as many healthy eggs as possible. During the cycle, a woman takes hormonal medications that promote the development of oocytes. During this period, diagnostic studies are carried out to control the situation. The more eggs that can grow, the greater the chance of successful fertilization. All manipulations are carried out according to a special algorithm, under the supervision of medical personnel.

Drugs to stimulate ovulation during IVF

Stimulation of ovulation before IVF begins on the 5th day of the menstrual cycle. The dosage of drugs is selected individually, based on age and reproductive health. For each period of the menstrual cycle, certain groups of medications are prescribed. Gonadotropic drugs are administered by injection. Antiestrogenic tablets are taken orally. The most commonly used medications include:

• Orgalutran;
• Puregon;
• Cetrotide;
• Gonal;
• Clostilbegit;
• Divigel;
• Proginova;
• Menopur;
• Chorionic gonadotropin.

First, estrogen is taken to stimulate egg growth. These include Puregon, Elonvoy and Gonal-F. When stimulated in the natural cycle, take Clostilbegit. After 3-4 days, medications are added to control the premature rupture of the follicle membrane. Among them are Cetrotide and Orgalutran. To improve the structure of the endometrium, Proginov tablets are used or Divigel is rubbed locally. In some cases, additional medications are selected individually.

Injections to stimulate ovulation during IVF

Additionally, medications containing human chorionic gonadotropin are prescribed. They are administered subcutaneously and intramuscularly. Injections promote the proper functioning of the corpus luteum, which subsequently has a positive effect on the course of pregnancy. They can be done either in the treatment room or independently. The most common drugs with human chorionic gonadotropin include Horagon, Pregnil and the domestic version of the same name.

Some drugs are presented in the form of a pen, which is injected into the fold of the abdomen. The injection is completely painless, so it can be done without outside intervention.

Attention! Stimulation should not be performed without medical supervision. The procedure is used only after a doctor’s prescription!

The procedure includes the following steps:

1. The injection site is wiped with alcohol;
2. The syringe is filled with solution;
3. A fold is formed from the skin on the abdomen;
4. A syringe at an angle of 45° is inserted into the desired area;
5. The contents of the syringe are carefully squeezed out;
6. After the procedure, the needle insertion site is treated with an antiseptic.

Injections involving intramuscular injection are done in the same way, but in the buttocks. They are considered more painful. Therefore, it is advisable to entrust them to specialists.

How is ovulation stimulated during IVF?

Stimulation of ovulation during IVF occurs in several stages. First, drugs are taken that are responsible for the growth of eggs. Every 2 days the woman attends an ultrasound examination. It allows you to timely diagnose hyperstimulation, which can harm her health. After about 10 days of the cycle, medications for the endometrium begin. HCG injections are administered after embryo transfer. They have a positive effect on the functioning of the corpus luteum. Dosages of medications may vary depending on the results of the ultrasound examination.

Ovulation stimulation IVF scheme

There are several variations of the protocol - optimal, short and long. The short protocol does not involve the use of drugs that block the pituitary gland. Stimulant medications begin to be taken not from day 5, but from day 2 of the cycle. In this case, there is a risk that ovulation will be early. With the optimal protocol, the initial stage is the same as for the short one. The difference lies in the use of antagonist drugs. In the long protocol, medications are started on day 21 of the cycle. Antagonists must be used within 5 days.

Increasingly, women are turning to a gynecologist with problems conceiving. But medicine does not stand still, it is constantly evolving, so a desired pregnancy can occur after treatment with special drugs that stimulate ovulation.

Most often, the inability to get pregnant is associated with the absence of ovulation as such or with its abnormal course. There may be several reasons for this:

1. Diseases of the pelvic organs of an infectious-inflammatory nature (salpingoophoritis, ovarianitis, etc.).
2. A woman’s weight is too low, usually less than 48 kg, which causes insufficient production of sex hormones, which leads to lack of ovulation and amenorrhea.
3. Hormonal changes in the body due to stress, with excessive weight (when the body mass index is more than 25), with certain diseases of the thyroid gland (hypo- or hyperthyroidism), etc.
4. Long-term use of oral contraceptives. In this case, the body stops producing hormones on its own, and it sometimes takes several months to fully restore this ability.
5. Excessive exercise can also negatively affect ovulation, especially if it is associated with the use of synthetic sports nutrition supplements. These drugs have a very negative effect on the female reproductive system.

In what cases is stimulation needed and when is it not carried out?

Possible when a couple cannot conceive a child for a year. If a woman is 35+, then this period can be reduced to six months. In any case, a thorough diagnosis (preferably of both partners) is necessary to identify the true causes of infertility and make a decision on stimulation.
In particular, the following diagnostic studies are carried out:

1. Collecting the patient’s medical history, which takes into account her age, the presence/absence of abortions and pregnancies, miscarriages, chronic diseases, wearing an intrauterine device, etc.
2. The patency of the fallopian tubes is checked. For this purpose, non-operative and operative techniques are used. The first include metrosalpingography (X-ray examination). A variation is ultrasound metrosalpingography, when the patency of the tubes is monitored using a contrast agent and ultrasound equipment. These methods are not universal; they have their drawbacks, such as the harmfulness of radiation and possible errors in the results. For a more accurate diagnosis, an operational study is used, but it gives the most reliable results.
3. A routine ultrasound examination, which can show possible inflammatory diseases, polycystic disease, various neoplasms and other pathologies of the female reproductive system.
4. In some cases, ovulatory failures can occur due to hormonal disorders, so donating blood to determine the amount of female sex hormones is prerequisite. At the same time, it is recommended to conduct studies of the activity of the thyroid gland, since this organ has a direct impact on female fertility.
5. A spermogram of the partner should also be carried out, since sometimes the reason for the lack of pregnancy may be insufficient motility and viability of sperm.
6. Partner compatibility test. If the results are unfavorable, the doctor may suggest artificial insemination.

It should be noted that contraindications to stimulation are inflammatory diseases of the uterus and (or) ovaries, tubes, adjacent organs and systems (urinary, gastrointestinal tract), hormonal fluctuations, the onset of menopause or the premenopausal period.

Methods to stimulate ovulation

Stimulation of ovulation is possible with the help of drug therapy (pharmacy drugs), as well as using folk recipes and alternative methods of treatment.

Pharmaceutical preparations to stimulate ovulation

Vitamins and microelements

Stimulation of ovulation is impossible without taking vitamin complexes and useful microelements. Truly “female” vitamins include E, A, B (folic acid is required), C. Additionally, vitamin D is recommended, especially for women living in areas where sunny days are rare.

Stimulation of follicle maturation with vitamin E

Vitamin A helps follicles and regulates the amount of cervical fluid.
B vitamins are recommended to be taken both at the planning stage of pregnancy and during it, since they not only prolong the luteal phase of the cycle, promote endometrial growth and egg maturation, but also eliminate toxicosis during pregnancy, prevent miscarriages and help the healthy development of the fetus.
Vitamin E stimulates maturation, “supports” ovulation itself and increases the production of progesterone, which is especially useful if this hormone is deficient.
Vitamin C helps normalize hormonal levels and also serves as a means to prevent the development of DNA abnormalities in the unborn fetus.
Also, when preparing for pregnancy, it is advisable to ensure a sufficient intake of Omega-3 polyunsaturated fatty acids into the body. They are found in the highest concentrations in fatty fish, synthetic fish oil, as well as in linseed and olive oils.
Means for stimulating ovulation also include preparations containing selenium, zinc and iron.

Specialized pills that stimulate ovulation.

Clostilbegit is a drug intended for enhanced maturation of follicles. This effect can cause multiple pregnancies. An interesting fact is that the pharmacological effect of the drug has not been fully studied, since it was originally developed as a contraceptive. But the effect turned out to be the opposite, so at present Clostilbegit is successfully used to treat infertility, for both partners.
The drug can be taken not independently, but with auxiliary means. The classic scheme is:

• Days 5-9 of the cycle, 1 tablet of Clostilbegit per day (subject to taking only one product);
• if Puregon is prescribed in parallel, then Clostilbegit begins on the 3rd day of the cycle and ends on the 7th. From the 8th day of the cycle they start drinking Puregon. In this case, constant ultrasound monitoring is necessary. As soon as the follicle reaches 18 mm in diameter, these drugs are discontinued and Pregnil is prescribed, which supports the maturation of eggs. After this, the favorable time for conception comes.

Drugs for stimulating the ovaries can be taken no more than 5 times during a lifetime to avoid atrophy of the reproductive system.

Stimulation of ovulation using folk remedies

Methods can be used simultaneously with drug therapy or as independent treatment traditional medicine. The most common of them is herbal medicine (herbal treatment).

1. Sage - used when the lack of ovulation is due to a lack of estrogen.
2. Borovaya uterus - used for progesterone deficiency. Prevents miscarriages.
3. Red brush – can be used simultaneously with sage or hogweed.
4. Plantain, rose petals, and aloe are also widely used.

The advantages of herbal medicine are relative safety and low cost, the disadvantages are the duration of treatment. It should be remembered that herbal medicine is still a treatment, and herbs are medicines, so consultation with a doctor is required.
More about ovulation stimulation traditional methods read .

Alternative therapy

1. Therapeutic mud also stimulates ovulation; they are recommended in cases where character diseases are present. Therapeutic mud relieves inflammation (they are especially effective for chronic diseases) and restores impaired reproductive functions.

You can buy this product at the pharmacy; you just need to warm it up a little and apply it to the stomach at the level of the ovaries. If possible, you can go to a sanatorium that specializes in mud therapy, or a suitable resort (for example, Saki).

1. Stimulating ovulation with acupuncture is a rather controversial area of ​​medicine, but there are many cases where exposure to acupuncture points has had a positive effect in the treatment of infertility. The difficulty with this method is that it will take a lot of time to find a professional who specializes in treating female infertility with acupuncture.

All of these methods of restoring ovulatory function are effective. However, they should not be used at random. A consultation with a doctor is necessary, as is an extensive and comprehensive diagnosis of both partners.