An irregular menstrual cycle suggests that ovulation (the release of an egg) may not be occurring each month. This is a relatively common and easily correctable cause of infertility.
Drugs (tablets or injections) may be given to help stimulate the development and release of an egg. Timed sexual intercourse can then take place allowing the best chance of spontaneous conception.
Although all of these treatments increase the risk of multiple pregnancy, careful monitoring helps minimise this risk by advising patients to abstain from intercourse if too many eggs have developed.
Ovulation induction is an option for couples where the woman’s fallopian tubes are normal and the man’s semen is of good quality.
Tablets – Clomiphene & Tamoxifen
The simplest form of treatment is with tablets (Clomiphene or Tamoxifen), which are usually given in the first few days following a period. The response is monitored by regular ultrasound scans to ensure too many eggs are not developing at the same time and to check the thickness of the lining of the womb (endometrium). A course of treatment might be 6 months.
Injections – Gonadotrophin Injections
Tablets are not always effective and sometimes hormone injections (gonadotrophin) are required to stimulate egg production. There is a greater risk of increased egg production and, therefore, multiple pregnancies with these more potent drugs. Women receiving these treatments are monitored much more frequently by ultrasound scans and hormone assessment (oestradiol). Once there are one or two mature eggs within the ovary a further injection, is given to help the egg to be released. A course of treatment might be 6 months.