Induction of ovulation
If there is no oocyte maturation – ovulation, the state is called anovulation. Often, this is manifested by irregular, usually prolonged menstrual cycle.
In many cases, ovulation can be induced by antiestrogenic compound of clomiphene citrate (e.g. Clostilbegyt tbl.) which is administered in the first half of the cycle. The use of progestogens (progesterone) themselves in the second half of the menstrual cycle induces menstruation, but not ovulation, and thus it does not make sense to use them in this way. About 80% of women react well on clomiphene citrate and similar substances, but only about 60% of them become pregnant. It is reported that if a woman does not become pregnant after three or six cycles at maximum, there is no sense in further use of clomiphene citrate.
Another group of drugs that induce - stimulate ovulation are gonatrophic hormones. They are in the form of subcutaneous injections which are applied in the first half of the cycle and such stimulation must be monitored by ultrasound - folliculometry. Since the treatment with gonadotrophic hormones is more expensive, we try to maximize the chance, and therefore we always combine stimulation of ovulation through GTH with intrauterine insemination.