What is ovulation induction and who is it for?

Ovulation induction is a medical treatment pathway for women who do not ovulate or have irregular ovulation. This can make it more difficult to conceive, as the maturation and release of an egg do not occur, or do not occur predictably. Hormonal medication is used to stimulate or regulate ovulation, with the aim of improving the cycle and increasing the chance of spontaneous conception. This does not involve artificial techniques such as insemination or IVF.

The treatment takes place within a broad diagnostic framework, with the individual cycle at its centre. Through systematic cycle observations and additional diagnostics, insight is gained into hormonal patterns, the timing of ovulation, and possible underlying causes. Based on this data, the treatment is tailored to the individual situation.

During treatment, the body's response to medication is evaluated per cycle. If necessary, dosage or medication will be adjusted, with the aim of achieving the best possible alignment with the natural cycle and safe, effective ovulation induction.

Ovulation induction is used for women with disturbed ovulatory function, such as with polycystic ovary syndrome (PCOS), hypothalamic dysfunction, or other hormonal imbalances. This treatment can also be considered for unexplained subfertility or when the timing of ovulation is not optimal.

The choice of medication depends on the underlying cause, cycle characteristics, and individual response:

Letrozole
Letrozole is often used as a first step, particularly in women with PCOS. It lowers the oestrogen level, which in turn increases the production of follicle-stimulating hormone (FSH) and stimulates the maturation of a follicle.

Clomiphene citrate (Clomid)
Clomifene citrate stimulates the production of FSH and luteinising hormone (LH) via the hypothalamus, which leads to follicle maturation and ovulation.

Gonadotropins (injections)
When oral medication has insufficient effect, gonadotropins can be used. These hormones act directly on the ovaries and provide a more potent stimulation of follicle growth. Due to the more intensive nature, more intensive monitoring takes place.

Metformin
Metformin can be used in women with PCOS and insulin resistance. By improving insulin sensitivity, hormonal balance can be supported, which can have a positive effect on ovulation.

The aim of ovulation induction is to support a regular and predictable cycle, where ovulation occurs at a well-timed moment. By combining treatment with an understanding of the cycle's progression, the chances of a natural pregnancy can be increased in a targeted and careful manner.