WHAT IS OVARIAN SUPEROVULATION WITH HUMAN MENOPAUSAL GONADOTROPINS?

Generally, one egg is released in a normal female menstrual cycle once each month, when a woman is having regular periods. Human menopausal gonadotropins (HMG) are used in “superovulation”  (also called ovarian stimulation) to increase the number of eggs to be released/ made during a given cycle.  By creating more eggs each month, the chance for pregnancy increases, Superovulation is used to help infertile women conceive with intercourse or inseminations therapy

MEDICINES USED

1. Bravelle, Follistim, or Gonal F – These drugs are given by subcutaneous injections with short needles and contain follicle-stimulating hormone (FSH) only. The drug Bravelle contains highly purified FSH. Gonal F and Follistim are recombinant DNA products.

2. Menopur – This drug contains hormones which are usually released by the pituitary gland to help control ovulation and the menstrual cycle. They contain FSH in a concentrated form and (LH) luteinizing hormone or hCG.

3. Novarel, Profasi, Ovidrel or Pregnyl – These drugs contain human chorionic gonadotropin (hCG). These are given at the end of the superovulation cycle to assist in ovulation.

HOW THESE MEDICINES ARE GIVEN

The medication for superovulation is usually given for seven to twelve days. Usually, the patient, or the partner will give the medications. These medications are given by intramuscular (IM) or subcutaneous (SC) injections.

The amount of medicine used is adjusted based on the level of blood estrogen along with the growth of ovarian follicles. While on the medications to make the eggs grow, there will be ultrasound measurements to determine ovarian follicle growth and blood tests to assess estrogen levels.

THERAPY EFFECTIVENESS

Usually, if the ovarian stimulation therapy with intercourse or insemination is going to work, it will do so within the first three cycles. If pregnancy hasn’t occurred by this time, the patient may have to go to the next level of treatment. Not all patients are candidates for  HMG therapy. For those with an Ovulation disorder there is a 20 to 22 percent chance for pregnancy, however some patients that do not ovulate are not good candidates for HMG due to the risk of over stimulation or multiple pregnancy. 

Ovarian Hyperstimulation Syndrome (OHSS) is when the ovaries become very sensitive to the fertility medication and become enlarged. Sometimes patients have to be hospitalized. There is a very low chance that an ovary has to be removed due to this, but on rare occasions, it has happened.