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Induction of ovulation (IOO) is suitable for couples with ovulatory disorders, whilst stimulated intra-uterine insemination (S-IUI) is suitable for couples with unexplained infertility, endometriosis and mild sperm abnormalities.
What are IOO and S-IUI?
IOO is an ovulation induction treatment, which involves stimulating the ovaries to produce one or two follicles, which will hopefully contain an egg each. The release of the eggs is timed to coincide either with regular intercourse or with an injection of prepared sperm into the woman’s uterus in an IUI procedure.
The chance of achieving a pregnancy with induced ovulation is around 10-14% per cycle. We recommend up to 6 cycles of IOO or 4 cycles of S-IUI before potentially moving on to an IVF cycle if you are not pregnant.
What is involved in the treatment?
For both methods, ovulation induction protocols are the same:
You’ll need to ring the Fertility Nurse on 01625 569 448 or 07500 806 319 on the first day of your period to request treatment. You will be asked to visit the clinic for a blood test and/or scan on day 2 of your cycle.
Based on the results of these tests, you will be asked to start daily injections of Gonadotrophins to stimulate the ovaries. Don’t worry, our nurse will teach you how to self-administer and give you a supply to keep at home. All your drugs will be delivered to you by our pharmacist.
Ovulation induction protocols dictate you will then come back to the clinic on day 8 of your cycle for another blood test and scan, so the development of the follicles can be monitored. Injections will continue, and you’ll be asked to visit the clinic until mature follicles are confirmed on the scan. This means having one or two follicles measuring around 16mm or above. The nurse will ask you to take an injection of hCG (Pregnyl or Ovitrelle) to stimulate ovulation.
If you’re having IOO, we recommend you have intercourse every other day from then onwards.
If you’re having IUI, you will need to attend our designated unit with your partner on the day we advise. Your partner will need to provide a semen sample, which is prepared in the laboratory for insemination. The prepared sperm will be injected (inseminated) into your womb through a simple procedure that is similar to having a smear test. The procedure is relatively painless and takes around 15 minutes. You can carry on with your usual activities afterwards.
What are the risks?
The drugs used in induced ovulation are given in low doses and are generally safe. There is, however, a small risk of over responding and developing ovarian hyperstimulation syndrome (OHSS). You will be regularly monitored through blood tests and scans to prevent this complication. If you develop significant nausea, vomiting, shortness of breath or severe abdominal pain, you must contact the Fertility Nurse as soon as possible.
If more than three dominant follicles develop during treatment, the cycle may be cancelled due to risk of multiple pregnancies. If that is the case, we would not give you Ovitrelle/Pregnyl and request that you only have protected intercourse (using condoms). If more than six follicles develop and you are eligible for IVF, we would discuss the possibility of converting the cycle to IVF. This will be at a considerably greater expense.