Stages of ovulation stimulation. The purpose of ovarian stimulation when planning pregnancy. Conditions for stimulation

Every woman sooner or later begins to dream about how she will bear a small miracle under her heart and then love him with all her heart. But, unfortunately, it is not always possible for a woman to become pregnant. Infertility... Previously, the diagnosis sounded like a death sentence, but now we can overcome it if we have the strength and desire. But when you want a child, they cannot but exist.

Stimulation of pregnancy or, more correctly, stimulation of ovulation is one of the modern methods of reproductive medicine. The probability of getting pregnant using this method is 70%. However, it is not suitable for everyone. It is ideal for women whose ovaries produce healthy eggs that for some reason do not mature. The method is also good for those who have irregular ovulation or who suffer from.

And for women whose ovaries produce defective eggs, this method is contraindicated. They do not stimulate pregnancy in this way even if there is inflammation of the ovaries or pelvic organs, or if there is a hormonal imbalance - at least until these diseases are completely cured. The reason for refusing the method of stimulating ovulation may be age restrictions and some diseases that are accompanied by taking certain medications. In any case, the main person who can say “yes” to stimulation by the ovulation method is a doctor and only a doctor!

First - and most importantly - before starting a method of inducing pregnancy, the attending doctor must make an accurate diagnosis and determine the causes of infertility. Based only on basal temperature charts or even on several observation cycles, an accurate diagnosis cannot be made: you need to go through a serious one. To exclude the factor of male infertility, your partner also needs to be examined.

The minimum is tests for HIV, hepatitis, syphilis, sexually transmitted infections in both spouses, a smear to determine the degree of cleanliness of the vagina for a woman, a smear for oncocytology from the cervix. Most likely, you will also have to do an ultrasound of the mammary glands and a study of antibodies to rubella. But: further - more. There will be examinations regarding the patency of the fallopian tubes, because it is in them that fertilization occurs, and regarding intrauterine problems, this is very important for women who have previously had abortions, curettage due to bleeding, inflammatory processes, or if she previously had an IUD inserted. Immediately before the stimulation itself, a hormonal status examination will be carried out and, most likely, more than once. If problems arise, they will be corrected.

The ultrasound room will become almost the most frequently visited place for a woman if she has decided on a method of inducing pregnancy. Doctors will examine the pelvis. Ultrasounds will begin to be done on days 8-10 - this is if the cycle is 28 days - and every 2-3 days until the fact of ovulation is detected. The man must undergo a spermogram and the procedure will begin only if it is satisfactory.

The main goal of stimulating ovulation is to “grow” follicles measuring 20-25 mm. After this, hCG is prescribed, which will trigger ovulation and prevent the reverse development of the follicle and the formation of a cyst. As a rule, ovulation occurs within a day or 36 hours after injecting the drug. Next, the ovaries are supported by hormones of the second phase - progesterone or duphaston.

Drugs to stimulate ovulation

Most often, ovulation stimulation is done with drugs based on gonadotropins (these are special hormones that are responsible for the functioning of the genital organs) and drugs analogues of clostelbegite. The most used among them are Menopur (contains the hormones FSH and LH) and Gonal-F (contains the hormone FSH). As a rule, these are injections that are given into the muscle or subcutaneously and only in strictly defined concentrations on strictly established days of the cycle.

How long to take the drugs is determined by the doctor.

Stimulation with clostilbegite begins with a minimum dose from the third to seventh or from the fifth to ninth days of the cycle. It happens that hCG is also injected additionally. During the stimulation process, the patient must constantly monitor basal temperature and monitor hormone levels, the doctor must conduct ultrasound monitoring of the ovarian reaction and egg maturation.

As for sexual activity during the procedure, the doctor will most likely recommend active sexual intercourse, either daily or every other day.

As a rule, courses of stimulation with clostilbegit are done no more than 3-5 times in a lifetime, because the doses are constantly increasing, and kolstilbegit can, in turn, lead to early depletion of the ovaries or the onset of early menopause.

If the method does not work, the cause of infertility most likely lies elsewhere. However, besides this, there are still many successful medical methods for achieving the main dream of life.

Stimulation of ovulation using folk remedies

For example, methods known to traditional medicine, offering decoctions and infusions of medicinal herbs that, according to the recommendations of healers, can accelerate the onset of pregnancy. These herbs include, first of all, sage, hogweed and red brush grass.

As popular rumor goes, sage promotes the maturation of the egg and the formation of the endometrium, which is so important in the first half of the cycle. The boron uterus, as stated in folk medicine, contains substances similar in nature to the female hormone progesterone, which is necessary in the second half of the cycle for pregnancy. In this regard, stimulation of ovulation with folk remedies, which involves the use of these herbs, is carried out according to the following scheme: in the first half of the cycle, a decoction of sage is taken 3-4 times a day (1 tablespoon of herb per 200 ml of boiling water), in the second half of the cycle - a decoction boron uterus in the same proportions and in the same quantity. For better results, in parallel with taking a decoction of boron uterus in the second half of the cycle, combine it with taking a decoction of red brush (prepared in a similar way).

Another way to stimulate ovulation using folk methods can be called not only “romantic”, but also quite “tasty”, and it involves taking a decoction of rose petals. Drinking a decoction of rose petals if you want to become pregnant is useful for both women and men: it is believed that rose petals contain vitamin E, which has a beneficial effect on the ability to conceive. The “female” decoction is prepared from white and pink petals, the “male” one from dark pink and red ones. The preparation method is quite simple: 1 tbsp. A spoonful of petals is poured with 200 ml of boiling water, kept in a water bath for 15 minutes, after which the decoction is taken 1 teaspoon every night before bed.

Shilajit has long been used in the treatment of infertility; preparations with mumiyo are used both in the treatment of women and in the treatment of men. The greatest effect is achieved when mumiyo is taken simultaneously with carrot, quince or sea buckthorn juice. Thus, to stimulate ovulation using traditional methods, mummy is mixed, for example, with carrot juice in a ratio of 1:20 and taken 2 times a day, morning and evening, on an empty stomach.

In an effort to conceive a child without the fate of pharmaceuticals, you can try to stimulate ovulation using aromatherapy. “Suitable” essential oils in this case would be sage, basil, cypress, and anise oils, which, when inhaled, stimulate the production of estrogen by the ovaries. In addition, rose geranium and lavender oils are useful for normalizing hormonal levels - they can be added to the bath when bathing (3-5 drops each).

Traditional medicine has always been and is the subject of controversy among many scientists, and in the case of stimulating ovulation using such methods, it is better to first consult a doctor. The fact is that the consequences of the practice of using traditional methods can have negative consequences.

And, in addition, in order to achieve positive results by carrying out stimulation with folk remedies, it is necessary to initially calculate ovulation. Why today a variety of methods are successfully used: charting basal temperature, ovulation tests, ultrasound monitoring.

Consequences of ovulation stimulation

It was already mentioned above that ovulation stimulation should always be carried out exclusively for medical reasons and under the supervision of a doctor. Unfortunately, the consequences of stimulating ovulation under some conditions can be very complex. An illiterately selected dose of drugs, stimulation of ovulation without a preliminary thorough examination, negligence towards the patient - even one of these factors can significantly “damage” the female body.

Thus, simulating ovulation does not always have a beneficial effect on the ovaries and, if carried out incorrectly, can lead to ovarian rupture or early depletion. If ovulation is stimulated, there is a high probability of multiple pregnancies. Stimulation of ovulation with large doses of gonadotropic drugs affects the function of the thyroid gland, adrenal glands, and affects the mammary glands.

But perhaps the most difficult consequences of ovulation, which can manifest themselves as a result of an incorrect treatment regimen (in addition to ovarian rupture), is hyperstimulation. Excessive stimulation is the result of an incorrectly calculated dosage and ignoring a timely ultrasound examination. Already stage 2-3 of hyperstimulation is accompanied by very severe pain, and stage 3-4 requires treatment in a hospital, usually for quite a long time, even several months. Hyperstimulation is accompanied by flatulence, nausea, and stool upset. In severe cases, the accumulation of a large amount of fluid in the pelvis, often in the lungs; the fluid must be removed surgically. Against this background, the ovaries can increase to unnatural sizes, and cysts can form on them. Severe degrees of hyperstimulation are accompanied by very severe pain and require constant medical supervision.

That is why ovulation stimulation must be carried out strictly according to indications and only if all the necessary examinations have been completed, tests have been taken and pregnancy can occur only with stimulation.

Especially for- Maria Dulina

From Guest

There were problems, I couldn’t get pregnant, they couldn’t find the reason, and the doctors shrugged until I got to a good specialist. I was advised to contact gynecologist-reproductologist Natalya Anatolyevna Kalinina at the SM Clinic. She is a wonderful specialist, we passed all the necessary tests, found a problem with ovulation, they gave me stimulation for the onset of ovulation, and everything worked out. Not always. self-medication can help. I advise you to contact Natalya Anatolyevna, maybe she will help you too.

The happiness of every woman is known in motherhood, but it does not always come so easily. Many women are unable to get pregnant for many reasons, so they are forced to seek help from specialists. Today there are a huge number of clinics in which doctors are ready to help women find out what real motherhood is.

One of the modern effective ways to speed up fertilization is ovarian stimulation to plan pregnancy. It is performed by taking hormonal medications, strictly selected for each specific case. Very often, this method of increasing the chances of conception is used with artificial insemination or in vitro fertilization, but with similar success it can be used in the absence of ovulation due to age or hormonal imbalance in a woman. In any case, the procedure has a positive effect.

Possible problems

The natural process of egg formation is when it is fully formed, after which the follicle enters the fallopian tube and bursts, releasing the egg. Violation of this process leads to problems with conception.

The reasons may be:

• serious gynecological diseases;
• hormonal imbalances;
• excess weight;
• infectious diseases and much more.

Most often, ovulation is absent due to hormonal imbalances in a woman’s body.

Operating principle

Stimulation of the ovaries for planning conception is carried out by taking hormonal medications to normalize the natural menstrual cycle, during which it will be possible to fertilize a mature egg. It can be done naturally or artificially.

Almost half of the cases of using this stimulation method have a successful outcome, but this method is suitable only for women whose reproductive organs are absolutely healthy, and problems arise due to disruptions in the body’s hormonal system. But even in this case, many do not dare to use this method, since taking hormonal drugs has a number of side effects that may occur. Among the negative consequences of ovarian stimulation for pregnancy planning (reviews from real patients confirm this) include pain in the ovarian area. The procedure can also lead to depletion of the egg reserve, which has certain consequences that affect the general condition of the woman’s body.

Drug dosage regimen

Only a qualified doctor can prescribe the medications necessary for each specific case, since even for this he needs to familiarize himself with a number of results of examinations and tests of the woman. The dosage of the drugs is also selected individually; all treatment processes are united only in that they begin their effect on the body only after the third or fifth day from the beginning of the menstrual cycle.

Most often, ovarian stimulation for pregnancy planning is carried out through intramuscular injection of the drug. This choice is explained by the rapid effect of gonadotropic medications on the body, but other methods can be used to speed up conception:

• pills;
• antiestrogenic substances;
• recombinant drugs.

To evaluate the effectiveness of the chosen method, the entire process of egg maturation is strictly monitored by specialists using regular ultrasound examinations. As soon as the egg is fully mature and the follicle bursts, the woman is given an injection of human chorionic gonadotropin, which contributes to a further favorable course of pregnancy. In the case of natural fertilization, conception occurs immediately after this. If you plan to carry out in vitro fertilization, then the next day it is necessary to collect the egg.

Other options

Stimulation of the ovaries for planning conception using the described method is the most commonly used by doctors, but there are also cases when it does not have the desired effect on the body. In such cases, women increase the dose of prescribed medications or are recommended to take other medications. In any case, the scheme will be identical:

• started taking gonadotropins;
• after them - follicle-stimulating hormone in recombinant form;
• third step - antiestrogenic drugs;
• the final one is human chorionic gonadotropin.

Each stage has multiple options for possible prescribed drugs. If there are no results after applying each, it will be necessary to re-take tests and undergo examinations for a more accurate selection of the next set of measures. However, you should know that conception very rarely occurs immediately in the first month of taking medications; usually it is necessary to carry out 2-3 courses of treatment before obtaining a positive result.

Most popular option

Most often, ovarian stimulation is performed to plan pregnancy with Clostilbegit. The active substance of the drug acts directly on the ovaries, provoking the accelerated development and maturation of follicles in them. Stimulation is carried out by influencing the drug on the hypothalamus and pituitary gland to produce the hormones the body needs. The product "Klostilbegit" is produced in the form of tablets and has analogues. The course of taking the drug is prescribed by a doctor and lasts no more than five days. Typically, the start of treatment coincides with the second day of the cycle, but the exact date depends on the level of hormones in the patient’s body and the characteristics of her natural cycle. That is why you should not use such drugs on your own, because improper use of hormones can lead to negative consequences for the entire body. For the same reasons (due to the individuality of each organism), ovarian stimulation for pregnancy planning is not carried out using folk remedies.

After taking the drug and starting the cycle, you should wait for the expected date of ovulation and inject hCG a day before it to stimulate the mature follicle to burst and release the egg.

The final stage is taking medications that help retain the fetus in the body in the event of pregnancy. Among these are such products as Duphaston, Crinon and Utrozhestan. They are recommended for use from approximately the sixteenth day from the start of the cycle. Other estrogen drugs may also be included in the regimen on the recommendation of a doctor. If there is no positive result from using this method, the woman should be tested again and switch to taking gonadotropins, which imitate the natural processes of the female body.

Carrying out treatment

Any schematic stimulation of the ovaries should be carried out only after a thorough examination of the female body and identification of the cause of problems with conception. The fact is that some diseases can negatively affect the use of hormonal medications and not only fail to give the desired result, but also worsen the overall state of health.

Therefore, before starting stimulation, you should pass the following tests:

• for the presence of HIV and other sexually transmitted diseases;
• for TORCH infections;
• all tests to create a picture of the hormonal state of a woman’s body;
• cytology test;
• analysis of vaginal microflora.

In addition, it is necessary to undergo a number of examinations, including an electrocardiogram, ultrasound examination of the mammary glands and checking the patency of the fallopian tubes. All of this refers to mandatory procedures, but in some situations, ovarian stimulation for pregnancy planning may require additional research (hysteroscopy or laparoscopy).

In addition to all the tests listed for the woman, the partner must also undergo examination. This is necessary to confirm sperm activity and exclude male infertility. Only after carefully studying all the results obtained, a specialist prescribes an individual program to stimulate the functioning of the female reproductive system.

Prohibitions for use

Ovarian stimulation for pregnancy planning is not allowed for everyone, which is why such a thorough examination is necessary before it is carried out.

It is strictly prohibited to use this method to conceive a child for women with:

• somatic abnormalities;
• obstruction of the fallopian tubes;
• hereditary diseases;
• genetic disorders;
• kidney and liver diseases;
• diseases of the cardiovascular system.

In addition, the prohibitions also apply to other, less significant disturbances in the functioning of the body. If they are present, conception, the stimulation process itself, and further pregnancy may fail. Such disorders include any inflammatory diseases of the reproductive system, including sexually transmitted infections. In case of obstruction of only one tube, or any cystic formations, including polycystic disease, ovarian stimulation (reviews from experts confirm) is contraindicated. To obtain a positive result, you must first solve the problem with these diseases, and then begin stimulation.

Side effects

In addition to a number of contraindications, there are a number of negative consequences of ovarian stimulation for pregnancy planning. Since taking hormonal drugs affects the entire body as a whole, this often provokes hyperstimulation of reproductive function. The cause of this effect may be an incorrectly selected dose of the drug or an overly violent reaction of the body to a certain substance. In any case, this once again confirms the need to take medications only on the recommendation and under the supervision of a doctor.

Besides:

• the ovaries often hurt after stimulation;
• a woman has problems with bowel movements;
• general health worsens;
• Fluid accumulates in the body, which leads to swelling;
• many neoplasms in the form of cysts are possible.

The last consequences of ovarian stimulation relate to the procedure while the body has polycystic disease. In such cases, further surgical intervention may be required. However, in some cases, cysts can resolve on their own. In some cases, the consequences of hormonal stimulation can be an ectopic pregnancy.

Twins - happiness or side effect?

Very often, in one cycle, a woman matures several eggs at once, but during natural fertilization only one of them remains. In the case of stimulation of pregnancy with hormonal drugs, both eggs do not have an advantage over each other and provoke multiple pregnancies.

Age-related changes

Since every woman has a certain reproductive age, after which it becomes impossible to conceive a child, after forty years the issue of pregnancy becomes very acute. For women at this age, the likelihood of side effects becomes higher, as well as the likelihood of multiple pregnancies. At the same time, stimulation is an effective method for conception at this age, and this chance should not be neglected.

This procedure is especially often recommended for older women who decide to undergo artificial insemination. The extracorporeal procedure is necessary for women after forty years of age, since she does not have her own viable eggs and needs to turn to donors, especially if the partner has sufficiently high-quality seminal fluid. The side effect in the form of pain soon disappears.

Stimulation of the ovaries (patient reviews indicate this) after the age of forty years gives positive results with timely contact with a qualified specialist in this matter. The main thing is not to delay the implementation of the decision, since with each cycle there are fewer and fewer eggs.

Conclusion

In any case, before carrying out the procedure, in addition to passing the listed tests, you should make sure that there is no allergic reaction to any of the substances used in the procedure. This step will eliminate many negative consequences. You should also undergo the required examination first.

Every year, this procedure helps many women start a full-fledged family, give birth to long-awaited children and realize themselves as real mothers. Today, difficulties with conceiving are no longer serious problems for most women at any age.

But be that as it may, this process must be approached very seriously. After all, not only successful fertilization, but also the health of the expectant mother depends on the right clinic and doctor.

The causes of infertility in women vary. One of them is anovulation - the absence of an ovulatory period. There are several methods for treating this problem, which are based on stimulation of the ovulation process. But their choice depends on the reasons that led to the problem and the degree of anovulation. Sometimes you can cope on your own, using traditional medicine, but in other situations, drug treatment is necessary. Let's look at different methods and principles of their action.

How to induce ovulation - main steps

The absence of the ovulatory process can be due to various reasons. This most often occurs with polycystic ovary syndrome. But there are other reasons, the etiology of which experts continue to study. Not all of these problems can be treated with stimulation, and it is not always possible to cope with the pathology at home.

The ovulation stimulation regimen is prescribed by the doctor in accordance with the identified problem. Therefore, at the first stage, a complete examination of the woman is carried out and the absence of infertility factors that cannot be cured by stimulation (male infertility, absence of fallopian tubes, etc.) is identified. The level of pathology is also determined, and treatment methods are discussed.

Stimulation of ovulation using folk remedies is also carried out under the supervision of a doctor, if the cause can be eliminated using this method. But more often drug treatment is used. Depending on the prescribed drug, its use begins on the 2nd or 9th day of the menstrual cycle and ends after 10–14 days. The duration of the appointment will be determined by the observing specialist.

At this time, a control ultrasound is performed every 2-3 days. After the follicles reach maturity (20–25 mm), the ovulatory process is started using the hCG drug. This is done to avoid the formation of follicular cysts. If the patient is prescribed IVF, the hCG injection is not given, but the mature eggs are removed.

In the normal course of the ovulatory process, the doctor recommends daily sexual intercourse for conception or insemination. After the release of the egg, Progesterone or Utrogestan are prescribed, which promotes the formation of the corpus luteum.

If the process is unsuccessful, repeating three courses in a row, the treatment method is revised.

Preparing to stimulate ovulation

Before stimulating ovulation, you should undergo a complete diagnosis to identify the causes of the absence or disruption of the ovulatory process. The doctor talks with the couple and prescribes examinations for both the woman and her partner. If male infertility is detected, induction will not help. In case of obstruction of the fallopian tubes, laparoscopy is first prescribed, and only then stimulation is performed.

If it is possible to restore ovulation by other methods, then treatment is carried out first. And if it does not lead to positive results, then this procedure is performed.

The examination before stimulation is carried out as follows:

• blood test for HIV and Syphilis;
• detection of group B and C hepatitis;
• ultrasound examination of the mammary glands;
• smear for cancer;
• anti-Mullerian hormone (AMH) level;
• sowing for the presence of fungal and bacterial infections - chlamydia, mycoplasma, trichomonas, ureaplasma, etc.

An important condition is confirmation of the patient’s ability to bear a fetus.

If no contraindications to the procedure are identified, a stimulation regimen is selected and hormonal medications are prescribed to accelerate the maturation and release of eggs.

What is ovulation induction

Ovulation induction is the artificial stimulation of the egg maturation process. It is carried out with medications that accelerate the growth of female cells. The entire process is controlled by ultrasound to avoid negative factors.

When inducing ovulation, one egg or several at the same time can develop, which is also called stimulation of superovulation. It is usually carried out during in vitro fertilization or insemination.

Stimulation of ovulation occurs in polycystic ovaries or in case of disruption of the ovulatory process, which is of a recurring nature - chronic anovulation.

If a woman cannot become pregnant with regular unprotected sexual intercourse for 10–12 months, this is already a reason to consult a doctor for examination. In this case, she may be prescribed ovulation induction, if there are no other serious pathologies that interfere with conception.

Drug stimulation

After eliminating possible contraindications to stimulation, drug treatment is prescribed. The program is selected according to the cause of infertility, body mass index and age of the woman. The choice of medication is also influenced by the future use of eggs - IVF, ICSI or a natural method of fertilization.

There are different drugs to stimulate ovulation, which are used according to specific indications. But it cannot be guaranteed that after the first procedure you will be able to get pregnant. As a rule, only 15% of women have a first successful attempt. The following are the drugs that are most often used to stimulate the ovulatory process.

Clostilbegit "clomiphene citrate"

The most effective medication that helps stimulate ovulation is Clostilbegit, the active substance of which is clomiphene citrate. It is produced in the form of tablets, each of which is 50 mg.

The drug activates luteinizing and follicle-stimulating hormones, which increase the rate of oocyte maturation.

For primary treatment, a regimen is used in which the drug is started on the 2nd or 5th day of the cycle, 1 tablet daily. The appointment lasts 5 days. With a second course, the volume of the drug is doubled (up to 100 mg per day).

Taking this medication has its contraindications:

1. The thickness of the endometrium should not be less than 8 mm, otherwise the fetus will not be able to implant into the uterus.
2. It is forbidden to take the drug longer than prescribed by the doctor to prevent ovarian depletion.
3. You cannot treat with Clostilbegit more than 6 times, otherwise it may provoke early menopause. Usually, after the third unsuccessful attempt, there is no point in continuing treatment with this remedy.

Letrozole (Femara)

If taking Clostilbegit is impossible for some reason, Letrozole can be used as a substitute. The tablets are used from the 3rd day of the cycle, 1 capsule for 5 days. The dosage is prescribed by a doctor and is approximately 2.5–5 mg per day.

The effect of this remedy is not as deep and less long-lasting compared to the previous one. By using Letrozole to stimulate ovulation, you can increase the thickness of the uterine lining. The positive effect is an increase in the sensitivity of the woman’s body to follicle-stimulating hormone, which makes it possible to reduce the dose by 3 times when artificially administering this hormone. There are practically no adverse reactions to the drug.

In addition, agents may prescribe a drug called Femara. This is practically the same Letrozole with a concentration of 2.5 mg per tablet and the addition of excipients.

Gonadotropins

Stimulation of ovulation with gonadotropins is carried out if the body is not responsive to clofimene citrate or there are contraindications to its use. This group of drugs belongs to the second line of induction. Menogon, Puregon, Gonal and other follicle-stimulating agents produced for intramuscular administration are used for treatment.

1. In dose escalation mode. Treatment begins with taking 37.5–50 IU. If after 7 days ripening does not occur, the dosage is increased by 40–100%. More often, this regimen is used in the treatment of polycystic ovary syndrome to avoid complications.
2. In downgrade mode. If the patient's AMH level is low, she is prescribed increased starting doses of the drug, amounting to 100–150 IU. However, this method is rarely used and requires limiting the duration of the course.

Human chorionic gonadotropin is prescribed for the final stage of the ovulatory process to help the egg release from the follicle. The procedure for using the drug is one-time, and is performed after completing one of the above medications. The injection is given intramuscularly, the dosage is 5,000–10,000 IU. But before administering hCG, it is necessary to make sure that one of the follicles has reached maturity and the thickness of the endometrium is at least 8 mm.

The level of hCG growth in the blood contributes not only to the destruction of the follicle, but also to its transformation into the corpus luteum. The second positive quality of the hormone is the preparation of the uterus for the reception of a fertilized egg and implantation of the embryo, as well as in the development of the placenta.

Dydrogesterone (Duphaston)

The drug dydrogesterone, which stimulates ovulation, is available in tablet form and is called Duphaston.

The use of the drug has a dual meaning: an overdose leads to suppression of the process of follicle maturation, but moderate use promotes a progestogenic effect on the endometrium.

Duphaston is prescribed to support the luteal phase at a dosage of 10–20 mg (1–2 tablets) twice a day. The duration of the course is 18 days, then ultrasound diagnostics are performed to confirm pregnancy.

Ovariamine

The drug Ovariamin is classified as a dietary supplement, so no studies have been conducted on its effectiveness. But some specialists may prescribe it because its action is based on taking an extract from the ovaries of cattle, which, according to some, gives positive results in the treatment of infertility. This is explained by the presence of cytamine in the drug, which affects the functioning of the ovaries.

The instructions indicate that Ovariamin cannot harm, but there are still contraindications:

• endometriosis;
• uterine fibroids;
• disruption of the endometrium;
• hyperplastic processes in the mammary glands.

Menopur

Treatment with Menopur is based on the introduction of gonadotropin into the body. The maturation of eggs occurs in an artificially created hormonal background.

The drug can be used only if there are intact eggs in the ovaries.

Before administration, the product, consisting of the main substance and the solvent, is mixed and administered intramuscularly. Each time you need to prepare a new solution.

The drug "Gonal-F" is a very powerful stimulator of the ovulatory process, which is used only if other means have not led to a positive result.

The hormonal product is available in two forms - in the form of a powder for injection and a special syringe pen. Bottles with powder can be in 2 dosages - 5.5 or 11 mcg. And pens with a ready-made solution have three dosages - 22, 33 and 66 mcg.

The invention of the drug in the form of a pen syringe has several advantages:

1. No preparation of solution is required before use.
2. There is no need to calculate the dose yourself.
3. It is convenient to inject yourself.
4. Due to the thin needle, the injection is painless.

Gonal-F has a number of negative consequences, which include:

• PMS syndrome;
• blood clot formation;
• allergies;
• enlarged ovaries;
• ectopic pregnancy;
• cyst rupture.

Therefore, if your period after stimulating ovulation with this drug comes later than expected or is very painful, a thorough examination is necessary.

Cyclodinone is prescribed after ovulation to support the formation of the corpus luteum. But its use is not always appropriate, but only if a woman has an increased level of prolactin, the hormone responsible for suppressing the secretion of gonadotropins.

Cyclodinone normalizes the ratio of follicle-stimulating hormone to luteinizing hormone, which leads to the restoration of the menstrual cycle. But only a doctor can prescribe the drug after detecting a low level of prolactin.

Proginova and ovulation

It is advisable to prescribe the use of Proginova when a woman has problems with the functioning of her reproductive organs. It promotes the development of the uterus and fallopian tubes, and stimulates the growth of the endometrium. The period of administration is immediately after the release of the oocyte, and at the time of maturation of the egg and during the period of ovulation it should not be taken.

Proginov tablets, which stimulate ovulation, are prescribed at the stage of preparation for pregnancy under the IVF program. It helps treat diseases of the female organs associated with a lack of estradiol in the body. It is also recommended for malignant neoplasms, increased hair growth, migraines and nervous disorders.

Stimulation of ovulation using folk remedies

This method includes different techniques:

• diets;
• herbal preparations;
• aromatherapy;
• massages;
• mud therapy;
• taking certain vitamins;
• acupuncture and more.

To be effective, you can combine them, but all of them must be performed under the strict supervision of a gynecologist, as they can lead to complications.

Ovulation can be restored using folk remedies only if there are no serious diseases of the female reproductive system. Therefore, before starting treatment, you should undergo a diagnosis. The use of products and all actions that stimulate ovulation must be coordinated with your doctor. It is possible that in some cases, such types of therapy will not be enough, and they will have to be combined with drug treatment.

Below are the most effective methods most often used by women when the ovulatory process is disrupted.

Sage to stimulate ovulation

Sage contains phytoestrogenic components that promote accelerated maturation of eggs and the formation of the endometrium. So stimulating ovulation with sage decoction is often used as an additional method of natural restoration of the female body.

To prepare the infusion, take 1 tbsp. spoon of dry crushed herb, pour one glass of boiling water and leave for 30 minutes. Take the medicine 1/4 cup per day, or 1 tbsp. spoon three times a day. You should start drinking sage from the 5th day of your cycle for 10–14 days. Then the reception is stopped until the next cycle. The treatment is repeated 3-4 times or until pregnancy occurs.

If you add linden blossom to sage, this will significantly enhance the effect, since linden also has estrogen-like phytoharmones.

Mud to stimulate ovulation

If there are not enough female hormones in the body for natural conception, then mud therapy will help restore hormonal levels. This method is accessible and has no side effects. But for polycystic ovary syndrome, endometriosis and oncology, its use is not recommended.

Treatment with healing mud can be carried out independently. To do this, you need to buy a tube with this product at the pharmacy, heat the mud to the specified temperature and apply it to the skin in the ovarian area. After 20–30 minutes, wash off. The procedure should be done every other day.

If possible, you can visit a sanatorium in the city of Saki or any other one that specializes in mud treatment.

Acupuncture to induce ovulation

Another way to speed up ovulation is acupuncture. But for this you need to find a specialist who knows how to treat infertility. This procedure cannot be carried out independently.

This method works by influencing acupuncture points, restoring the body's functioning. Despite the controversial attitude of medicine towards acupuncture, the technique has more than once given positive results in the treatment of women's problems.

Taking vitamins

One of the reasons for a malfunction of the hormonal system may be a lack of vitamins and microelements necessary for the proper functioning of the body. In this case, taking vitamins will help to regulate the process of ovulation stimulation.

The main “female” vitamin is folic acid. Without it, even bearing a healthy child is impossible. Therefore, you should enrich your diet with vitamin B9. But other B vitamins are also useful for normalizing the functions of the reproductive organs.

The second most important element is potassium iodite, which can easily be replenished by consuming iodized salt.

Vitamins such as A, E and C are always useful for a woman. You can take them separately, but it is better to buy a special fortified complex for pregnant women, which will include all the vitamins and microelements necessary for the health of the body.

But don’t get carried away with pharmaceutical vitamins alone. Eating more vegetables, fruits and greens has a beneficial effect on the ovulatory process.

Nutrition for successful ovulation

To naturally stimulate ovulation, it is necessary to consume foods that help activate the ovaries and increase the level of estrogen in the blood.

• legumes, especially soybeans, beans;
• milk and milk hard cheese;
• bird eggs - chicken, quail;
• fruits and vegetables - carrots, tomatoes, cucumbers, apples, pomegranate;
• wheat sprouts;
• dates;
• pumpkin, flax and sesame seeds.

This diet is complemented by the absence of foods such as cabbage, pears, rice, and figs.

How to stimulate ovulation at home

Before stimulating ovulation, even at home, you must undergo an examination and consult a doctor. Based on the diagnosis, the specialist selects a method of ovarian stimulation.

If the medical indications are good, you can carry out the procedure yourself, but medical supervision must be required, otherwise an incorrect action may provoke rupture of the ovary or cause its early depletion.

You can stimulate the ovulatory process at home using the following methods:

1. Aromatherapy. Essential oils such as anise, sage, rose geranium, basil, cypress, and lavender have a beneficial effect on the maturation of the egg. It is enough to add 3-5 drops to the water when taking a bath.
2. Herbal teas. The admission course is divided into three parts. First, sage is brewed to stimulate follicle formation. Then they take the color of elderberry, which promotes the maturation of the egg. And at the final stage, they drink tea from rosemary and plantain, which leads to the release of the oocyte from the follicle.
3. Diet. It includes legumes, grains and dairy products, as well as seeds, fresh fruits and vegetables, except those that contribute to gas formation.

Stimulation of ovulation during IVF

The procedure for stimulating the maturation of eggs during IVF is carried out if the patient does not have fallopian tubes or her partner has problems with spermatogenesis.

The protocol for stimulating ovulation is selected individually, depending on the pathological processes. There are short and long protocols. With a short protocol, stimulation is carried out immediately from the first days of the cycle. And with a long duration, preliminary preparation for stimulation is carried out.

Drugs to stimulate ovulation are selected after a detailed consideration of the reasons that led to IVF - Clostilbegit is often used. After the follicles reach a certain size, the egg is punctured. If superovulation was stimulated, several oocytes ready for fertilization are taken.

The fertilization process itself takes place in the laboratory, then, after 3–5 days, the embryo is implanted into the uterus of the expectant mother. And after 2-3 weeks they look at the ultrasound to see if the embryo has implanted.

Stimulation of ovulation in polycystic ovary syndrome

To identify polycystic ovary syndrome, an analysis is carried out to determine the level of testosterone and insulin, which will be increased in the presence of pathology. An ultrasound will show an almost 2-fold enlargement of the ovaries. Stimulation of ovulation in PCOS is carried out using hormone therapy, which reduces the level of male hormones.

Stimulation of ovulation in multifollicular ovaries

With multifollicular ovaries, several follicles (7–8) are formed in this organ at the same time, which do not exceed a diameter of 4–10 mm, so the ovaries themselves do not enlarge. Insulin and testosterone, as well as LH and FSH, will be normal with this problem.

Pregnancy with such ovaries is in most cases multiple, this must be taken into account when choosing a method and means for stimulating ovulation.

Pregnancy after ovulation stimulation

If a woman needed stimulation of the ovulatory process to conceive, then her further pregnancy proceeds under constant monitoring - frequent examinations are carried out, more tests are prescribed for hormone levels, etc.

Different drugs have different effects on the future course of pregnancy. Some of them lead to HOC syndrome, while others can cause self-abortion, fetal hypoxia, etc. Therefore, a visit to the gynecologist after artificial stimulation of the ovaries during pregnancy is mandatory.

Artificial stimulation has a number of side effects, which include:

• enlarged ovaries;
• mood changes;
• headache;
• bloating;
• delayed menstruation;
• frequent changes in temperature.

The most dangerous include:

• multiple births;
• spontaneous miscarriage;
• fetal death;
• ectopic pregnancy;
• abortion.

The most dangerous is ovarian hyperstimulation syndrome, which is more often observed with IVF. But even with insemination or natural conception, cases of this problem are not uncommon.

Stimulation and laparoscopy – what you need to know

If a woman’s body does not respond to hormone therapy aimed at releasing the egg from the follicle, surgery will be needed to make an incision in the ovary and help the oocyte release. Thus, laparoscopy is useful for restoring hormonal levels.

If the patient does not ovulate due to obstruction of the fallopian tubes, surgery is also performed. And only after laparoscopy is induction prescribed.

In the absence of fallopian tubes, a woman can only become pregnant with the help of IVF, which also requires stimulation. For this purpose, gonadotropic hormones are used. The most effective method is the use of a combined scheme. It first includes taking Clostilbegit, then adding the gonadotropic drugs Menopur or Puregon, and Pregnil is prescribed to release the oocyte.

Conclusion

If pregnancy does not occur due to a violation of the ovulatory process, it is necessary first of all to find the cause of this problem, and only then begin treatment. And you should know that any of the above methods of stimulating ovulation does not always lead to conception. Sometimes treatment is required for several months. But it happens that after such a procedure the body heals itself, and after a while pregnancy occurs naturally.

A woman's inability to become pregnant becomes a great tragedy for every married couple. A woman is literally haunted by the dream of having a baby and is consumed by the thought of her physical inferiority. Unfortunately, today infertility is becoming one of the common problems of married couples.

If a woman does not ovulate or occurs extremely rarely, ovulation stimulation is undertaken. Thanks to ovulation stimulation, thousands of women become mothers every year.

Medical indications for stimulating ovulation arise in cases where, over a period of more than one year, with regular unprotected sex, a couple is unable to conceive a fetus naturally. For couples over 35 years of age, this period is reduced to 6 months.

To obtain results during stimulation, it is very important to carry out ultrasound monitoring of follicle development, otherwise such a procedure is useless. It makes no sense to stimulate ovulation in case of male infertility.

Carrying out the procedure in the presence of obstruction of the fallopian tubes can lead to an ectopic pregnancy. Therefore, ovulation stimulation should be prescribed only after laparoscopy.

Every woman wonders how to properly stimulate ovulation and what methods exist for this.

Drugs to stimulate ovulation

Before stimulation is prescribed, both spouses are sent for a medical examination. Success is possible when the doctor draws up the most competent protocol for the procedure.

That is, taking medications, taking tests, conducting examinations according to a specific schedule, taking into account the age and individual characteristics of the couple. The doctor also takes into account how the egg will be used later: for IVF, ICSI or for natural fertilization.

In the classical regimen, clostilbegit is taken from days 5 to 9 of the menstrual cycle. With additional stimulation of ovulation using puregon, clostilbegit is prescribed from 3 to 7 days.

The period of admission is accompanied by ultrasound monitoring of the process of follicle maturation. When it reaches 17-18 mm, the woman takes Pregnil and ovulation occurs after 24-36 hours. According to statistics, about 15% of couples manage to get pregnant after stimulating ovulation on the first try. The duration and cause of infertility and the woman’s age also play a role.

Stimulation using traditional methods

Many women consider the “natural” option of stimulation more preferable - taking medicinal herbs. Take boron uterus, red brush leaves and sage to stimulate ovulation, which are freely sold in every pharmacy. For egg maturation, take 1 table 3-4 times a day. spoon for one glass of boiling water of sage infusion in the first half of the new cycle.

Drinking an infusion of boron uterus, rich in progesterone, begins in the second half of the cycle. A lack of progesterone prevents the fertilized egg from implanting into the cavity of the uterine wall and it dies. In order for ovulation stimulation to be most effective, you need to be able to calculate it correctly and the likelihood of conception will be much higher.

Taking a decoction of rose petals is not only pleasant and tasty, but also healthy. Following folk methods, a man and a woman who consume 1 teaspoon of such a romantic decoction before bed will definitely be able to conceive a child.

This phenomenon is explained by the content of vitamin E in rose petals, which has a beneficial effect on fertility. Moreover, women prepare a decoction of white and pink rose petals, and men prepare a decoction of red and dark pink ones. To prepare the decoction, 1 table is enough. spoons of petals per 200 ml of boiling water, followed by soaking for 15 minutes in a water bath.

Taking mumiyo in combination with juices: sea buckthorn, quince, carrot is positively characterized. Take on an empty stomach in the morning and evening. Mixing ratio 1:20.

Stimulating ovulation with vitamins

The expectant mother must provide the need for microelements and vitamins with proper and rational nutrition. First of all, a woman must provide her body with folic acid, since its deficiency in the body can cause intrauterine developmental pathologies. To replenish the body with another essential element - potassium iodide, you should use iodized salt in your food.

How to properly carry out stimulation to avoid “unpleasant consequences”? Hormonal drugs promote the maturation of a full-fledged egg in a woman’s ovaries. The dosage and selection of drugs to stimulate ovulation are calculated individually and are aimed at the formation of eggs capable of fertilization.

The choice of method for restoring ovulation is determined based on the reason for its absence. And it should be recognized that if at the beginning of treatment the reason for the lack of ovulation was not precisely established, then stimulation is unlikely to give a positive result.

When diagnosing the absence of ovulation, the basal temperature chart of a single cycle cannot be used as a basis. It is necessary to be guided by several cycles of observation. Otherwise, the prescribed treatment can cause enormous harm to a completely healthy body in the future. It is better if hormone tests are carried out several times to make sure that there is a problem or its absence in this area of ​​the body.

If thyroid hormones, male hormones and prolactin deviate from the norm, you should not start ovulation stimulation. You should first bring them back to normal so that they do not interfere with ovulation. It is possible that when hormone levels are restored, ovulation will also be restored.

Ultrasound monitoring

Based on repeated ultrasound observations. If there is an “ideal” 28-day cycle, the first ultrasound is performed 8–10 days after the end of the last menstruation. Next, an ultrasound is performed at least every two to three days. This periodicity is determined by the condition of the uterus and ovaries. Ultrasound is stopped when it is established that ovulation has occurred or with the onset of menstruation.

Before stimulation begins, no matter what drugs, you must have the results of your husband’s spermogram on hand, indicating his suitability for natural conception. Stimulation must be strictly controlled by a doctor. Constant ultrasound monitoring will allow you to analyze the body’s response to the stimulation process and the development of follicles! This is the only way to judge with confidence whether the follicles are growing and whether the process of ovulation is occurring.

How ovulation is stimulated: main stages

If clostilbegit is chosen for stimulation, then its administration begins on the 5th day and ends on the 9th. When choosing Menogone or Puregon for stimulation, the intake begins already on the 2nd day of the cycle and ends somewhere after 10, the exact date is determined by the doctor based on observations of the stimulation process.

The start date and duration of the stimulation procedure depends on the condition of the patient’s ovaries and uterus and is determined directly by the attending physician in each case individually. The first ultrasound, performed a few days after the start of the stimulation procedure, is followed by a subsequent ultrasound two to three days later.

Observation is carried out until the follicles reach a size of 20-25 mm. To prevent regression of the follicles and eliminate the possibility of the formation of follicular cysts, an hCG injection is prescribed at this stage. The dose selected by the doctor helps to “start” the ovulation process.

If the process is favorable, ovulation begins 24–36 hours after the prescribed hCG injection. After confirming this with an ultrasound examination, injections of progesterone or utrogestan are prescribed for additional “support” of the corpus luteum of the ovaries. According to patient reviews, stimulation of ovulation with clostilbegit most often leads to conception.

Taking into account the male factor, the doctor prescribes specific timing and frequency of sexual intercourse and insemination during stimulation. If the spermogram is good, then after the hCG injection, sexual intercourse should be daily or every other day until the end of ovulation and the formation of the corpus luteum.

If the use of clostilbegit does not cause ovulation or follicular growth, then after the third unsuccessful course it is recommended to reconsider the treatment methods and conduct additional examination.

Important: It is not recommended to use clostilbegit more than 6 times. Abuse of the drug can cause depletion of the ovaries and cause “early menopause.” And this will jeopardize further attempts to treat infertility using one’s own eggs.

With this outcome, you will have to be content with IVF with a donor egg. Being a drug with a pronounced anti-estrogenic effect, it is better not to take clostilbegit if there is a problem with endometrial growth.

Before carrying out treatment procedures and diagnostics, you should make sure that there are no acute inflammatory processes, which are a contraindication, since they carry the risk of a deterioration in the patient’s general condition.

In the middle of the menstrual cycle, the ovary of a healthy woman releases an egg from the follicle into the abdominal cavity. If this natural process is disrupted, ovulation is stimulated using special medications - ovulation inducers. One of the most commonly used drugs to stimulate ovulation is Clostilbegit.

Stimulation of ovulation by gonal and menopur replenishes the endocrine gland of the pituitary gland with hormones and controls the process of follicle maturation and the onset of ovulation in a woman’s body. Available in the form of injections, injections are prescribed to stimulate ovulation intramuscularly or administered subcutaneously. The ovulation stimulation scheme is drawn up based on the established type of ovulation disorder and the period during which the disorder is observed.

Ultrasound monitoring during this period allows you to avoid the growth of several follicles at the same time. Each examination is accompanied by counting the number of growing follicles, measuring their diameter and determining the thickness of the uterine mucosa.

When the diameter of the leading follicle reaches at least 17 millimeters, Pregnil comes into effect, causing the egg to release from the follicle. Depending on the specific type of marital infertility, intrauterine insemination is performed with the sperm of a donor or husband, or sexual intercourse is performed.

Stimulating ovulation with gonal has a positive effect, confirmed by reviews of women who have successfully become pregnant and will soon celebrate the main event in their lives.

The following medical examinations should precede ovulation stimulation:

• Syphilis;
• Hepatitis B and C;
• Ultrasound of the mammary glands;
• Smear (woman);
• Oncocytology smear (woman); Cultures to detect chlamydia, candida, trichomonas, ureaplasma, gardnerella, mycoplasma;
• Patency of the fallopian tubes;

A prerequisite is the conclusion of a general practitioner about a woman’s ability to bear a pregnancy.

The blood is tested for the presence of antibodies, and therefore immunity to rubella. Patency of the fallopian tubes is one of the important conditions for pregnancy; fertilization occurs here.

Several methods are used to assess patency:

• Laparoscopy;
• Metrosalpingography;
• Transvaginal hydrolaparoscopy.

The assessment method is selected by the attending physician based on the available indications. If inflammation or trauma to the uterine mucosa or intrauterine device is detected, hysteroscopy of the uterine cavity is performed.

Lack of ovulation can cause:

1. Hormonal imbalance, which may be caused by stopping taking contraceptives. The body will need some time to fully restore its functions. This may take several months.
2. Intense sports, illness, stress and others, physical and serious psychological stress.
3. Excessive thinness and lack of fat tissue.
4. Clinical causes such as polycystic ovary syndrome and pituitary dysfunction.

Stimulation of ovulation is one of the most common methods in the treatment of infertility. Before the procedure begins, a preliminary examination of the ovaries is carried out to identify possible contraindications to stimulation.

As a result of the study, preliminary estrogen therapy may be prescribed or the necessary ovulation stimulation scheme and dosage necessary to create optimal conditions and achieve a successful attempt can be built.

With multifollicular ovaries, stimulation of ovulation can lead to multiple pregnancies. This is explained by the fact that several enlarged follicles are formed in the ovaries at the same time. Ovaries with many follicles can be observed on ultrasound at other periods of the cycle.

The development of follicles may be delayed when taking hormonal contraceptives, during breastfeeding, during adolescence, during sudden weight loss, obesity, thyroid dysfunction and other endocrine diseases. Pregnancy with such ovaries is quite compatible and will proceed normally in the absence of other disorders.

Some patients identify multifollicular ovaries with the concept of polycystic ovary syndrome. However, the main difference between multifollicular ovaries and polycystic ovaries is the normal volume of the ovary.

The number of follicles does not exceed 7-8, the diameter is 4-10 mm, and the content of LH and FSH, insulin, and testosterone in the blood is within normal limits. Thus, the diagnosis of multifollicular ovaries cannot be considered a disease. Rather, it is a specific condition that is not the cause of infertility, irregular menstrual cycle, etc.

With polycystic ovary syndrome, testosterone and insulin levels are increased. The volume of the ovaries is almost twice as large, the ovarian capsule is thickened. Stimulation of ovulation in polycystic disease includes hormone therapy, which reduces the level of male hormones. Already within the first months after prescribing the drug, the result is noticeable. Ovulation stimulating drugs include clomiphene citrate and metformin.

The problem of infertility is a common problem for married couples. In half of the cases, the reason lies in male infertility. That is why the examination is prescribed to both spouses. For examination, men undergo a spermogram, which is carried out after 3-5 days of abstinence.

Stimulation of ovulation during IVF

IVF (In Vitro Fertilization) took place for the first time in 1978 in England. The method is used for infertility caused by problems of the fallopian tubes, ovulation, and sperm quality. IVF is used to conceive a child in women over 45 years of age.

The method involves fertilizing an egg outside the woman’s body and then placing the embryo in the uterus. Of course, the price of the IVF method of stimulating ovulation is the highest compared to other methods.

The main indications for IVF are defects or absence of fallopian tubes. In vitro fertilization is recommended if there is an insufficient number or complete absence of sperm in the male seminal fluid.

Between the 19th and 23rd day of the menstrual cycle, a drug is administered to prepare the woman’s body for hormonal stimulation. Next, the follicles are stimulated under constant ultrasound control. Once the follicles reach the desired size, a puncture is performed and the egg is sent for fertilization. The embryo is transferred to the uterus after a few days, and a pregnancy test is performed two weeks later.

To minimize possible risks, a comprehensive examination is carried out before IVF treatment.

The main risks of the IVF procedure:

• allergic reactions;
• ovarian hyperstimulation syndrome;
• ectopic pregnancy.

The drug Clostilbegit is prescribed to stimulate ovulation in women and in men for the treatment of oligospermia. Those who stimulated ovulation with clostilbegit confirm that the drug promotes increased production of hormones in the pituitary gland and hypothalamus, after which in women the functioning of the ovaries is stabilized and causes the maturation of the follicles.

Stimulation of ovulation at home

At home, you can experiment with aromatherapy using herbal oils of anise, cypress, basil, and sage to stimulate ovulation. When bathing, adding 3-5 drops of rose geranium and lavender oils to the bath will help normalize hormonal levels. Such ovulation stimulation will be less expensive than treatment with ovulation-stimulating pills.

Stimulation of ovulation must certainly be carried out under the qualified supervision of a doctor and be based solely on medical indications. The consequences of improper ovulation stimulation can be extremely complex. An incorrect dose of drugs or neglect of examination can cause irreparable harm to the female body.

Improper stimulation can result in ovarian rupture or lead to early exhaustion. At home, you should include in your diet foods that stimulate ovulation: grains, quail eggs, dairy products, vegetables and fruits, seeds (flax, sesame, pumpkin). Reviews of women who have undergone ovulation stimulation can be read on numerous forums.

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