Medicines for ovulation. What drugs stimulate ovulation

AT last years anovulation (lack of ovulation) remains a painful topic for many couples. Ovulation induction activities can help many women achieve long-awaited motherhood. Let's talk about who needs ovulation stimulation, how it happens, what drugs to stimulate ovulation can help, well, and when stimulation is undesirable.

Stimulation of ovulation is actively used in modern reproductive medicine. Pregnancy as a result of the procedure occurs in 70% of cases. It should be noted that this method of conception is not suitable for all infertile women.

Stimulation is allowed if normal eggs are formed in the ovaries, but they are due to some internal pathologies not fully mature. It is also recommended to do the procedure for women suffering from polycystic ovaries or having irregular ovulation. But when sick or defective eggs are formed in the ovaries, inflammatory processes in the internal genital organs, hormonal imbalance, ovulation stimulation is not recommended by doctors until other diseases that affect a woman's fertility are completely cured. Doctors do not allow the procedure to be performed when taking certain potent drugs, as well as to patients in old age.

Stimulation of ovulation allows thousands of women to finally feel what the happiness of motherhood is. Ovulation stimulation is usually prescribed for couples who, during the year, with regular entry into unprotected sexual relations, fail to conceive. If both partners are older than 35 years, then the period for establishing infertility is reduced to six months. Before starting stimulation, a woman needs to undergo a fairly extensive medical examination, which includes the following tests:

• for hepatitis;
• for syphilis;
• for HIV;
• for the presence of antibodies to rubella in the blood;
• Ultrasound of the state of the mammary glands;
• smear for the presence of pathogenic microorganisms;
• a smear on foci of inflammation in the uterus and genital tract;
• Ultrasound or HSG for the degree of patency of the fallopian tubes.

According to the results of the medical examination, the gynecologist identifies the cause of infertility and makes a conclusion: is the woman capable of becoming pregnant and bearing a healthy and full-fledged child. First of all, the doctor evaluates the patency of the fallopian tubes, because it is through them that the mature egg moves and meets the sperm. If you stimulate ovulation when the tubes are characterized by low patency, then the risk of an ectopic pregnancy increases.

To exclude the possibility of foci of inflammation or injury on the mucous membranes of the uterus, the gynecologist must perform hysteroscopy. Also, a man needs to undergo a medical examination to confirm the viability of his spermatozoa. If a man is infertile, then it is useless for a woman to stimulate ovulation.

What is ovulation stimulation drugs?

Usually, ovulation is stimulated with the help of Clostilbegit, an antiestrogen agent, as well as drugs based on gonadotropins, hormones that regulate the functions of the reproductive organs. The most popular and highly effective drugs are Menopur and Gonal-F.

Stimulant medicines are produced both in tablet form and in the form of ampoules for injection. Dosage and time of administration medicinal product only the attending physician establishes; it is impossible to carry out the stimulation procedure without medical supervision.

All the time while the course of ovulation stimulation lasts, the woman should observe changes in basal temperature and monitor the state of the hormonal background, and the gynecologist should monitor the growth of the follicle and the maturation of the egg in it on the ultrasound machine. Sexual relations during this period must be practiced, if not every day, then at least every other day.

Stimulation of ovulation with drugs is carried out no more than 3-5 times in a lifetime, because with each subsequent procedure, the dose of the active substance increases, which can provoke the extinction of ovarian functions and the premature onset of menopause.

Ovulation stimulation pills

At the initial stage of ovulation stimulation, drugs are used that accelerate the development of the largest follicle in the ovary. There may be several such follicles. Then the patient is given medications that contribute to the rupture of the follicle, the release of the egg from it, and the preparation of the mucous membranes of the uterus for the introduction of the zygote. Most widely gynecologists use the following drugs to stimulate ovulation:

1. Clostilbegit;
2. Gonal-F;
3. Letrozole;
4. human chorionic gonadotropin;
5. Dydrogesterone.

How is the stimulation of ovulation with Clostilbegit

Stimulation of ovulation with Klostilbegit is widely used in medicine. The active substance of the drug Clostilbegit, produced in the form of tablets of 50 mg, is clomiphene citrate, which binds estrogen receptors in the hypothalamus. As a result of the action of the drug, there is an excessive formation of follicle-stimulating and luteinizing hormones. Clostilbegit is prescribed mainly to women who have cystic ovarian disease.

The drug should be taken from the second or fifth day menstrual cycle. If for some reason a woman has no menstruation for one or more cycles, then the start of the reception can be scheduled on an arbitrary day. The daily dose of the drug at the first stage of stimulation is 50 mg, the course lasts five days.

If a positive effect does not occur, but you need to proceed to the second stage, in which 100 mg of the stimulant should be consumed within five days. Such treatment is allowed for no more than six menstrual cycles. The maximum amount of the drug consumed should not exceed 150 mg per day. It is worth noting that 85% of women become pregnant four months after the start of taking Klostilbegit.

Approximately 25 - 30% of patients have resistance to the action of the drug. The drug helps women with a low body mass index especially poorly. medical specialists Most often, the absence of a positive effect is explained by the excessively strong antiestrogenic effect of Clostilbegit, due to which blood circulation in the uterus decreases at the time of the introduction of the zygote, the process of maturation of the endometrium is disrupted, and the amount of secreted cervical fluid decreases. Especially adversely affect female body high doses of the drug with unreasonably long-term use. Therefore, doctors advise: if fertilization has not happened within four months of taking Klostilbegit, abandon this drug treatment and move on to other methods of stimulation.

Stimulation of ovulation with Gonal-F and Puregon

If the woman's body is resistant to Clostilbegit, the gynecologist may prescribe Gonal-F or its analogue Puregon, a drug that stimulates the pituitary hormone follicles in ampoules for subcutaneous injection. Taking the medication begins on the first day of menstruation or five days after the end of the use of the contraceptive. If there is no menstruation, then treatment is carried out from the day on which she would supposedly have to go. The course of stimulation lasts a week, repeated for six menstrual cycles.

Doctors practice two ways of introducing Gonal-F. With the first method, the dosage of the drug is gradually increased every day. The starting dose for a week is 37 - 50 IU. If the doctor sees on the ultrasound machine that the medicine accelerates the growth and development of follicles in accordance with the norm, then at the end of the week the dosage does not change. If there is no reaction from the follicles, then the volume of the administered medication is increased by 50%. This way of consuming Gonal-F is the most optimal for women suffering from polycystic ovaries, as the doctor can confidently select the required maximum dose of the drug, at which complications are impossible.

The second method of drug administration implies, on the contrary, a gradual decrease in dosage. The starting dose for the first week is very high, 100 - 150 IU. This option of taking Gonal-F is recommended for women over 35 years of age, as well as for irregular periods, small ovarian volume, after surgical intervention on the internal genitalia. However, this method of stimulation is rarely used in practice, since it requires a lot of experience and high qualifications of a medical specialist.

Stimulation of ovulation with Letrozole

Letrozole was originally used to treat menopausal women for breast cancer. Today, the drug is used as a highly effective ovulation stimulator. Often it is prescribed to replace Klostilbegit. The drug is produced in the form of tablets. The stimulation process begins on the third day of the menstrual cycle, the course lasts 5 days. The daily dose is 5 mg, that is, two tablets. The drug has an antiestrogenic effect of medium intensity, helps to increase the synthesis of follicle-stimulating hormone by the pituitary gland, increases volume and improves physical state mucous membranes of the uterus. Compared with Clostilbegit, the drug is less powerful, its effect extends for a short time, but side effects recorded infrequently.

Stimulation of ovulation based on hCG

Stimulants based on chorionic gonadotropin have the action of luteinizing hormone produced by the pituitary gland. These drugs are used at the second stage of ovulation stimulation, accelerate the process of rupture of the follicle and the release of a mature egg from it, participate in the preparation of the mucous membranes of the uterus for the introduction of the zygote. The most popular and widely used gonadotropin-based drug is Pregnyl, which is available in powder form of various dosages in one package with a solvent for intramuscular injection.

The use of the drug is possible only if the thickness of the endometrium in the uterus is at least 8 mm, and the diameter of the dominant follicle in the ovary reaches at least 18 mm. It is necessary to enter chorionic gonadotropin every three days, 1500 IU. The course lasts 10 days. Ovulation usually occurs two days after drug administration.

Stimulation of ovulation with dydrogesterone

Dydrogesterone is produced in the form of tablets of 10 mg. In pharmacies, it can be found under the name Duphaston. The drug has a progestogenic effect on the uterine mucosa. The stimulant is used in the second half of the menstrual cycle. The daily dose is 20 mg. The duration of the course is at least 18 days. For greater efficiency, it is allowed joint reception Dydrogesterone and Pregnil.

Stimulation of ovulation with vitamins

If a woman wants to get pregnant and give birth to a healthy child, then she must receive a sufficient amount of vitamins and minerals daily. And for this, she needs to eat properly and fully. The main vitamin that must be ingested by the expectant mother is B 9 or folic acid. If a pregnant woman is deficient in this substance, then the embryo in her womb runs the risk of acquiring serious pathologies of physical and mental development. A woman who wants to conceive a child should definitely include cereals, milk and dairy products, eggs, fresh vegetables and fruits, seeds. It is also recommended to eat foods rich in iodine.

How to stimulate ovulation at home with folk remedies

It is very important to understand that doing experiments on your own, trying to stimulate ovulation, is not advisable. That is, you should not personally install drugs for yourself or use herbal infusions. In the best case, this simply does not lead to anything.

At home, you can apply aromatherapy. It can be used as an additional therapeutic measure. It is not bad to use aromatic oils of lavender and pink geranium - they stabilize the hormonal background and calm the nervous system.

You can include in your menu products that will help stimulate: these are quail eggs, fresh fruits, vegetables, dairy products.

A positive mental attitude is also important. Try not to worry, do not worry because you cannot get pregnant yet. Tune in to the fact that everything will work out, rely on your gynecologist - and the desired pregnancy will finally come.

All other methods of ovulation stimulation must be carried out only under the serious supervision of a specialist, since only a doctor knows how this process should proceed so that it is safe for health.

When is ovulation stimulation contraindicated?

In no case should you engage in stimulation of ovulation on your own whim and without strict control by your doctor. This is a complex and rather dangerous procedure, which should be carried out exclusively for medical reasons. The consequences of improper or excessive stimulation can be dire. If a woman treats the procedure negligently, does not want to undergo an examination and take tests, takes an excessive dose of pills, then by doing so she causes irreparable damage to her own health.

Quite often, overstimulation leads to early exhaustion of the ovaries, and in some cases even rupture. Excessive intake of hormones in the body can provoke the release of several eggs from the ovary at the same time, which inevitably leads to multiple pregnancy with complications. Preparations based on gonadotropins negatively affect the functioning of the thyroid gland, mammary glands and adrenal glands. But a much more terrible consequence of improper stimulation is the so-called hyperstimulation.

This state is already early stage accompanied severe pain, disruption of the digestive tract, excessive gas formation, vomiting, diarrhea. When the disease reaches a late stage, the pain becomes simply unbearable, a woman in the pelvis, and sometimes in other organs, accumulates fluid, and the ovaries grow to unnatural sizes, cysts form on them. A woman has to go to the hospital for a long time, where the fluid is removed through a surgical operation. It's for this reason ovulation stimulation should be performed solely for medical reasons, after checking all the tests and under the strict supervision of the attending physician.

In gynecology, situations are often encountered when a woman cannot conceive due to the lack of ovulatory periods, i.e. due to anovulation. In such clinical cases, it is necessary to stimulate the maturation and release of the egg. There are many methods to stimulate ovulation at home. But the specific choice is determined by the degree of anovulation. In some cases, you can cope with the problem yourself, using home methods, while in others you can not do without medical intervention.

If the patient suffers from anovulation, or the egg rarely matures and leaves the follicle, then stimulation of such a process is shown, thanks to which thousands of patients have already managed to experience the happiness of motherhood.

• Usually indications for stimulation are such situations when more than a year of regular sexual intercourse in the absence of protection does not lead to conception.
• If the spouses are older than 35 years of age, then the time during which it is not possible to become pregnant is reduced to six months.
• Stimulation of ovulation at home and even in the clinic is meaningless if male infertility occurs.
• If the patient suffers from tubal obstruction, then stimulation can provoke an ectopic fixation of the embryo. Therefore, patients are advised to undergo laparoscopy first, only after the procedure, in the absence of obstruction, stimulation is allowed.

Methods for stimulating the exit of the female cell

Many women repeatedly ask themselves how to stimulate ovulatory processes and how this can be done. First of all, you need to undergo a thorough examination so that with self-stimulation you do not harm your own health. Home stimulation is a rather difficult task, but with the right approach, it is quite doable.

For stimulation, you can use medications and vitamins, herbs and certain nutrition programs, healing mud or essential oil therapy, etc. More recently, the diagnosis of "female infertility" could destroy the happiness and life of many patients, but with the help of stimulating the maturation and release of the egg, such women appeared real chance.

This measure is ideal in the case of polycystic ovarian disease, as well as for patients with a variety of menstrual disorders, anovulation and other abnormalities. But it should be carried out only after the normalization of thyroid hormones, androgens and prolactin, otherwise the stimulation will be ineffective. In general, there are many methods, so everyone will be able to choose the most convenient option for themselves. Although any choice should be agreed with the doctor, since only he will be able to choose the most appropriate stimulation option in each individual case.

vitamins for ovulation

One of the effective methods to stimulate ovulation is vitamin therapy. For successful maturation and release of the egg, a woman must have a sufficient supply of trace elements and vitamin substances in her body. To achieve this, you need to provide the diet with the necessary nutrition, correctly compiling the daily menu. To begin with, it is worth enriching the body with folic acid, which is so important that when it is deficient, various intrauterine pathologies occur.

In addition, it is necessary to replenish the required content of potassium iodide, for which iodized salt is included in the diet. If you decide to take complex vitamin preparations, then it is better to choose from those recommended for nursing and pregnant women. In the diet, be sure to include as many vegetables, berries, herbs and fruits as possible. These foods are an important stimulating factor for ovulation. It is also recommended to eat more fish, and it is better to refuse black coffee and tea or drink such drinks very rarely. It is imperative to give up unhealthy habits like alcohol or cigarettes, which have an extremely negative effect on the maturation and release of cells.

Medicines

A fairly effective simulation technique is the use of medicines. Stimulate follicular growth can drugs like:

If the follicles grow to the desired size, then the patient may be given injections of human chorionic gonadotropin. They are administered one day after taking the last pill from the above list. The most common hCG injections are Horagon, Profazi or Gonakor. In a day, the ovulatory period should begin.

herbal stimulation

Quite effectively stimulate ovulatory processes medicinal herbs. Stimulation medicinal plants carried out in several stages: First, they take sage, which stimulates the formation of follicles, then elderberry color, which promotes the maturation of the follicle, and then rosemary with plantain, which provokes the activity of the ovulatory period.

Sage contains a lot of phytoestrogen components, which are analogues of female sex hormonal substances. But in order to achieve the desired result, it is necessary to follow the rules of application and dosage. Sage grass is poured into a thermos with a glass of boiling water, tightly closed and kept for about half an hour. Infusion three times a day, use a large spoon. Reception starts from the fifth day of the cycle and is carried out for 1.5-2 weeks, after which it is stopped until the next cycle, starting again after the end of menstruation. Such courses must be repeated at least 3-4 or until conception, if it comes earlier. To enhance the effect, you can add lime blossom (large spoon) to sage, which also contains estrogen-like phytohormones.

Plantain seed is also a highly effective ovulation stimulant. A decoction is prepared from 200 ml of water and 20 g of seeds. The mixture is put on a slow fire and, bringing to a boil, simmer for another five minutes. Then the broth is kept for about 40 minutes, filtered and drunk 30 g before meals. The course of therapy lasts 3 weeks, starting from the first day of the cycle. It would be useful to give this decoction to the future father, especially with possible reproductive problems in a man. Also effective is bathing a woman in a bath with plantain, which is prepared by adding a decoction of 100 g of a mixture of roots and leaves of plantain, filled with boiling water, to the water. Such baths should be taken daily for at least 14 days.

Rose petals rich in tocopherol, which activates ovarian activity, also help well in stimulating the ovulatory period. Therefore, taking a decoction of the petals will only help stimulate ovulation. Fresh petals (20 g) + boiling water (200 ml) are placed in a bath for 20 minutes, then kept for another hour. The tincture is taken daily at night. The duration of therapy is about 4-8 weeks.

diet therapy

A special diet is excellent for ovulatory stimulation. In order for the ovaries to begin to work actively, and the body to intensively produce estrogen hormones, you need to thoroughly approach the preparation of a daily diet. I must have food items like:

• Soybeans and beans;
• hard cheeses;
• Homemade cow's milk and chicken eggs;
• Quail eggs;
• germinated grains of wheat;
• Carrots and apples;
• Tomatoes and cucumbers;
• Dates and pomegranate;
• Flax, sesame and pumpkin seeds.

But there are a number of products that are not recommended for use by women who want to get pregnant. Such products include rice and cabbage, pears, figs, etc.

Essential oils for ovulation

Essential oils have a good stimulating effect. They can be inhaled, rubbed, most importantly, used regularly. inhaling pleasant aromas basil or anise, sage or cypress, a woman starts intensive hormonal production. For convenience, you can use an aroma medallion. Baths with the addition of lavender oil have a positive effect on the hormonal background of patients.

Rose oil, which is used in sitz baths, can also help you get pregnant. 13 drops of oil are added to a basin of warm water. You can use it inside, dropping a drop on tsp. honey or water. Such techniques are performed four times a day.

Mud procedures

A fairly effective and fairly common way to stimulate ovulation is considered to be healing mud, which helps to increase activity. female hormones, eliminates all kinds of inflammation and helps to get pregnant. This procedure is especially recommended for diagnosed ovarian polycystosis. For mud therapy, you need to take pharmacy mud, it is better if it comes from the city of Saki, which is famous for the presence of sanatoriums that relieve women's reproductive problems.

Healing mud is produced in the form of tubes, which must be heated to the required temperature, and then applied with small strokes to the ovarian area, where they are left for half an hour. But before using this method of stimulation, a gynecological consultation is required.

The main stages of stimulation

If Clostilbegit is chosen as a stimulant, then it is taken on the 5th-9th day of the cycle, and Puregon or Menogon begin to drink already from 2 to 10 days. The exact timing should be set by the doctor depending on the situation. When to start stimulation and how long to continue procedures or courses depends on the health of the uterus and ovaries, which is determined by ultrasound examination. The doctor periodically prescribes control ultrasounds to the woman until the follicles grow to 21-25 mm in size. And in order to avoid the formation of follicular cystic formations or follicular regression, patients are prescribed hCG injections. This procedure contributes to the launch of ovulatory processes.

If everything goes well, then already 1-1.5 days after the chorionic injection, the follicle will burst and the female cell will begin to emerge. If ultrasound diagnostics shows ovulation, then the patient is prescribed injections of Utrozhestan or Progesterone to further support the corpus luteum. When using Klostilbegit, as the patients say, most often it is possible to achieve conception.

Important! The doctor also takes into account the male factor, so he specifies the specific timing and frequency of sexual intimacy in the process of stimulation. With good spermograms after hCG injection, sexual contacts should be carried out every day or a day before the end of the ovulatory period.

If after a three-time application of Clostilbegit a positive result cannot be achieved, then it is recommended to undergo a more thorough diagnosis and use other therapeutic methods. Before stimulation, the patient must pass laboratory tests for syphilis, HIV and hepatitis, a smear for microflora and oncocytology, ultrasound diagnostics of the mammary glands, check the patency of the fallopian tubes, etc. The therapist must conclude that the patient is able to bear the child.

Stimulation for in vitro fertilization

If a woman has tube pathologies or ovulatory problems, or her husband does not have enough quality sperm for conception, then in vitro fertilization becomes a chance for parenthood. With this procedure, the female cell is fertilized in the laboratory, and not inside the body, and then the embryo is placed in the uterus. The method is expensive but effective.

To perform it, the patient is injected with a hormonal stimulator during the period of 19-23 days of the cycle. Under ultrasound control, follicular stimulation is performed, and when the follicle grows to the required size, a puncture is performed and the cell is sent for fertilization. After a few days, the embryo is placed in the uterus, and after a couple of weeks, they check whether the conception has taken place, that is, whether the cell is fixed in the uterine wall. Most often, Clostilbegit is used for stimulation, which effectively stimulates ovarian activity.

Stimulation Contraindications

Not all patients can ovulate. For example, if there are pathological processes in the female body that prevent conception and full bearing, then stimulation is not carried out. Such pathologies include adhesions in the tubes, tumors of reproductive structures, etc. In addition, stimulation is not carried out if such a procedure has not given any positive dynamics 6 times before.

Relative contraindications for a stimulating procedure include an age exceeding 35 years. Such a limitation is due to the fact that in such a clinical situation, the probability of having an unhealthy child with a disability or developmental anomalies seriously increases.

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Every woman at some point in her life thinks about having a baby. For many, this desire is quite feasible. But sometimes you have to stimulate ovulation for successful conception.

Ovulation stimulation is a modern reproductive technique with great efficiency

called ovulation induction modern method solution to the problem of infertility. The procedure is based on a targeted effect on the organs of the female reproductive system of special drugs that enhance the release of hormones that are needed for successful conception.

Medicines in the complex process of fertilization are selected individually for each patient.

Complementary therapy helps the egg to successfully go through all the stages of maturation. Thanks to this, she becomes ready for fertilization, natural or artificial.

Method efficiency

Stimulation of ovulation (reviews from those who have become pregnant confirm this information) helps women conceive a child after one attempt at the procedure in only 10-15% of cases.

To increase the likelihood of pregnancy allows the patient to undergo treatment equal to 4 cycles of therapy. In this case, the chances of obtaining a successful result are 20-38%.

Women who continue to undergo ovulation stimulation are more likely to conceive than those who stop after the first attempt. Their chances of successful fertilization are 65-70%.

Indications for stimulation

This procedure helps quick solution problems that affect the functioning of the female reproductive system. If a married couple for a long time fails to conceive a child, then they should think about ovarian stimulation.

The main indication for the procedure is the absence of ovulation in a woman. Infertility can be triggered by malfunctions endocrine system or diseases of the genital organs. Doctors also recommend stimulation for couples over 35 years old.

The specialist prescribes ovulation stimulation, which many people know about from the reviews of those who have become pregnant, using this method only after both partners have been examined.

Such a diagnosis is carried out in order to exclude male infertility.

There are other indications for stimulation:

• Using the method in order to prepare for artificial insemination;
• If a woman has a low or high body mass index;
• With the detection of polycystic ovaries.

Also, stimulation of egg maturation is prescribed in the presence of hormonal dysfunction, which is not amenable to traditional treatment.

Who is contraindicated in stimulation of egg maturation

Ovulation stimulation (reviews from those who have become pregnant contain this information) is not allowed for every woman who wants to cure infertility. The procedure has its own absolute and relative contraindications.

The group of absolute contraindications includes:

1. Diseases that are inherited;
2. genetic abnormalities;
3. Obstruction of the fallopian tubes;
4. Diseases internal organs which may worsen during pregnancy.

In the presence of such conditions, it is forbidden to carry out the procedure.

The group of relative contraindications includes:

• Infectious diseases that are sexually transmitted;
• Obstruction of one fallopian tube, which proceeds without anomalies;
• Inflammatory processes in the organs of the reproductive system.

The doctor may prescribe the stimulation of egg maturation to the patient if she manages to recover from diseases that fall into the category of relative contraindications.

Preliminary hormonal tests

The study of the hormonal background of the patient is mandatory before the stimulation. The specialist should study the level of the following hormones in the body of a woman:

• Follicle stimulating. It is an indicator of ovarian reserve. The level of this hormone in the female body helps the specialist to choose the most optimal method of infertility treatment;
• Luteinizing. It provides well-coordinated work sex glands and is responsible for the production of sex hormones;
• Estradiol. Responsible for the normal functioning of the female reproductive system and the development of secondary sexual characteristics;
• Prolactin. The hormone is responsible for reproductive function. With its insufficient content, failures occur in the menstrual cycle;
• Testosterone. Its deficiency negatively affects the ability to conceive a child;
• Hormones thyroid gland (TSH, T3, T4). They affect the work of many body systems, including the sexual one.

Infertility in most cases is caused by hormonal imbalances. The results of the tests will help the doctor understand which hormone in the woman's body should be corrected in order to improve her work. reproductive system.

Medical examinations prior to ovulation stimulation

Before prescribing a patient to undergo ovarian stimulation, the doctor should familiarize himself with the results of the tests she underwent. Namely:

• Permeability of the fallopian tubes.

Diagnosis of this indicator is carried out using hysterosalpingography, echohysterosalpingoscopy and laparoscopy. If an obstruction is found in the patient, then the procedure in her case will be meaningless, since it is in the tube that conception occurs;

• HIV. This analysis is very important, because in the event of a successful conception, the child can become infected with a dangerous disease from the mother.

To find out if a woman is a carrier of the virus, a specialist will take a blood sample from her and send it for analysis. The result of the analysis will be received after a few days;

• Syphilis.

Another disease that is transmitted from mother to child. If a woman cares about the health of her unborn baby, she should undergo this analysis. If the diagnosis is confirmed, doctors will recommend temporarily abandoning the procedure;

• Hepatitis B and C.

If a woman is sick with hepatitis, then she endangers the life of her unborn child. In addition, the antigen present in the patient's body can cause fetal death;

• ultrasound.

The procedure makes it possible to visually assess the state of the female reproductive system and its readiness for fertilization. During the study, attention is drawn to the presence or absence of cystic neoplasms in the organs, which are an obstacle to a healthy conception;

• Breast monitoring.

It is carried out in order to study their structure. The study helps to identify cystic formations in the mammary glands that must be eliminated before stimulation begins;

• Gynecological smear.

It allows you to determine the presence of chlamydia, candida, trichomonads, ureaplasmas, gardnerella and mycoplasmas in the patient.

If there are venereal disease pathogens in the sample, the woman will be denied the procedure until she is fully recovered. Otherwise, pathogenic microorganisms will prevent conception;

• A smear for oncocytology. The study allows at an early stage to identify cancer cells in a woman's body.

Note! Most of the necessary tests are given repeatedly.

A number of tests will have to pass to the partner a patient who plans to become a mother. For men, it is mandatory to check for the presence of sexually transmitted diseases. You will also need to take a spermogram.

How ovulation is stimulated with medications, the main stages

Stimulation of ovulation (reviews from those who became pregnant by this method, contain this information) is carried out in several stages. The timing of the start and duration of therapy is determined by the attending physician.

The procedure, which involves the use of Clostilbegit, is carried out on the 5th day of the cycle. By the 9th day it is finished. If the doctor decided to use gonadotropins for stimulation, then the course of therapy will begin on the 2nd day of the cycle. Finish it in 10 days.

A couple of days after the start of stimulation, it is necessary to conduct the first ultrasound examination. In the future, ultrasound should be done every 2-3 days. The term of mandatory research is determined by the condition of the ovaries and uterus.

The procedure that stimulates the ovaries is carried out until the follicle grows to 20 mm. After the woman is given an injection of hCG. It is necessary to accelerate ovulation and prevent the formation of follicular cysts.

Subject to successful treatment, a woman will ovulate a day after the hCG injection. Another ultrasound can confirm this process. From this moment, Progesterone injections are prescribed, which are needed to maintain the ovaries.

During the period of stimulation, a woman should have regular sexual intimacy with her partner. Usually, experts recommend having unprotected sex every other day.

With the drug method of ovulation stimulation, various drugs are used, which are selected individually for each woman. On the network you can see a lot of reviews from those who became pregnant with the help of funds, which will be discussed further.

Stimulation of ovulation with Clostilbegit

The use of Clostilbegit is prescribed after the patient has passed all the tests. This drug is intended for direct stimulation of the ovaries. Thanks to him, the production of hormones of the gonadotropic group, which play an important role in the process of maturation of the follicle, increases in the genitals.

The drug is taken from the 2nd day of the cycle. The entire course lasts 5 days.

To calculate the optimal dosage of the drug, the doctor must know the age of both partners and the period during which they are trying to conceive a child. Their test results are also taken into account.

Stimulation of ovulation with Gonal. Gonal F to stimulate ovulation

The drug is one of the most powerful ovulation stimulants. It helps to compensate for the lack of follicle-stimulating hormone. The drug has a positive effect on the menstrual cycle and the growth of follicles.

Stimulation with the drug is carried out for 28-30 days. Its dosage depends on at what period of the menstrual cycle the injection is given. It is allowed to increase the dose of the drug until the desired result is achieved.

Proginova as part of a scheme to stimulate ovulation

The drug is prescribed in case of a lack of estrogen in the blood. It helps to normalize the menstrual cycle.

The drug is usually used together with Clostilbegit. This is because the second remedy contributes to the inhibition of estrogen production. And Proginova solves this problem.

The composition of the drug contains the substance choriogonadotropin alfa. It several times accelerates the process of maturation of the follicles, and also stimulates the ovaries.

Ovulation after an injection of Ovitrel occurs no earlier than 24 hours later. For this reason, women who are undergoing therapy with this drug are recommended to enter into an intimate relationship with their partner on the day of the injection and one day after it.

The drug is a kind of aromatase inhibitor, which has an antiestrogenic effect.

It increases the thickness of the endometrium. Due to this, the probability of successful attachment of a fertilized egg to the uterus increases.

Stimulation with drugs of this group is prescribed in case of no result after treatment with Clomiphene. They help the egg to ripen if, for some reason, it is not able to independently prepare for the upcoming fertilization.

Therapy with gonadotropins is completed after the formed follicle reaches the desired size, and the endometrium acquires the required thickness for the normal fixation of the fertilized egg.

HCG injections are often used to stimulate the ovaries. They have a follicle-stimulating and luteinizing effect.

The drug contributes to the normal maturation of the follicle. It also has a positive effect on the process of activation of functions. corpus luteum.

It is customary to inject hCG on the 2nd day of the cycle.

Dydrogesterone

The drug gained fame effective remedy from infertility with minimal side effects. It does not affect metabolism. Its active components are excreted from the body 72 hours after taking the drug.

Unlike most of these drugs, Dydrogesterone can be taken even after pregnancy in order to maintain it.

Folk remedies to stimulate ovulation

Most women, fearing for their own health, prefer folk remedies that stimulate ovulation. Many reviews from those who have become pregnant with the help of alternative medicine are positive.

Infertility treatment with medicinal herbs can be carried out along with drug therapy. Just to get started, you need to get the consent of a specialist. Traditional medicine offers treatment with natural remedies, which are much safer than pharmacy drugs.

When stimulating the ovaries folk remedies you must follow a number of rules:

• Herbs can be taken no more than 3 courses;
• Stimulation of ovulation medicinal plants, as indicated in the recommendations from doctors and the reviews of those who became pregnant in this way, it is necessary to carry out from the 15th to the 25th day of the cycle;
• Decoctions are prepared only in a water bath. For infusions, hot water is used, heated to 70-80 degrees;
• At the time of menstruation, therapy should be stopped.

Being engaged in the treatment of infertility with folk remedies, it is necessary to do ultrasound regularly.

Stimulation of ovulation with sage

Sage is used at the initial stage of treatment in order to accelerate and grow a healthy follicle.

To prepare a medicinal drink based on it, it is necessary to brew the leaves of the plant (1 tsp) in a glass of hot water. For 15 minutes, the remedy should be infused. After a woman needs to drink 1/3 of the infusion before eating. The procedure is repeated 2-3 times a day.

Useful are douching infusions of sage. To prepare a single serving, it is enough to brew 1 tbsp. l. leaves in a glass of hot water.

Such treatment can be carried out within 3 months. Therapy is stopped at the time of pregnancy.

Since ancient times, the upland uterus has been used to treat infertility. A healing decoction is made from it.

To prepare a drink, pour a glass of water 1 tbsp. l. plants. This mixture should be boiled for 5 minutes on a steam bath. After it is insisted for at least 3 hours. Take the finished medicine based on the boron uterus 4 times a day, 1 tbsp. l.

The red brush solves the problems of menstrual cycle failure and infertility. A tincture and a douching solution are made from it.

To prepare a medicinal drink, you need to take 50 g of crushed dried root and pour 0.5 liters of vodka into it. The medicine is infused for 30 days in a dark place. The finished product is recommended to take 25 drops 3 times a day for a whole month.

To prepare a solution for douching, just mix 0.5 liters of warm water and 1 tsp. red brush tinctures. The procedure is carried out in the mornings and evenings during the week. After that, you need to take a break for 7 days.

Vitamin therapy for ovulation stimulation

In addition to the main treatment, experts prescribe vitamin complexes to women who are undergoing ovulation stimulation. The main focus is on preparations containing vitamins B, E and C. The course of vitamin therapy should last at least 3 months.

• It is drunk during the entire menstrual cycle. It enriches the body with vitamin B, which affects the development of the follicle;
• Tocopherol. A lack of vitamin E leads to suppression of the growth of the follicle. It does not allow the cell walls of the genital organs to collapse and contributes to the normal release of a mature egg;
• Vitamin C. It is recommended to take after the onset of ovulation. She nourishes the ovaries beneficial substances, normalizes hormonal levels and minimizes the risk of miscarriage.

Vitamins that contribute to the onset of pregnancy can be taken separately or in combination with other useful trace elements.

What else is important to know about ovulation stimulation

The procedure for ovarian stimulation has many nuances that a woman should be familiar with before agreeing to infertility treatment with this method.

Choice of ovulation induction methods

There are several methods for stimulating ovulation:

1. The use of medications;
2. The use of folk remedies;
3. Reception of vitamin complexes.

The most effective is the drug method of ovarian stimulation. It allows you to achieve a positive result in a short time. But you need to understand that medications contain chemicals that cause side effects. This is the main drawback of the method.

Stimulation with folk remedies based on herbs is safer for the female body. This method is ideal for patients who are prohibited from taking hormonal drugs. Therapeutic effect such treatment is achieved very slowly.

Vitamin therapy can successfully stimulate ovulation only if other methods are used.

The choice of a suitable method of ovarian stimulation depends on the reason for the lack of ovulation, the presence of certain diseases in a woman, as well as the phase of the menstrual cycle.

Prices for stimulation in well-known private clinics

The cost of ovarian stimulation depends on the drugs used during the procedure. Additional services provided by a private clinic are paid separately.

Initial consultation of a gynecologist-reproductologist (including ultrasound) in private clinic Moscow or other large cities of Russia costs from 1500 to 3000 rubles. And IVF with minimal stimulation (1 attempt) - from 100,000 rubles.

How much can you stimulate the ovaries?

The World Health Organization recommends ovulation stimulation with any medication for no more than 6 cycles. If during such a number of courses of therapy a woman failed to become pregnant, then she should undergo a more thorough diagnosis in order to find out the real cause of her infertility.

Stimulation of ovulation during IVF

IVF method is offered to women who have been diagnosed with infertility caused by the lack of ovulation or problems in the functioning of the fallopian tubes. It is successfully performed on patients over 45 years of age.

When using IVF, the fertilization of the egg occurs outside the female reproductive system. Once this process is completed, the embryo is placed in the patient's uterus.

In order for the fetus to take root, a woman undergoes special training between the 19th and 23rd day of the cycle. It involves the introduction into the body of a drug that stimulates ovulation.

As soon as the follicle grows to the desired size, the specialist makes a puncture, and the egg is sent for fertilization. A few days later, the finished embryo is placed in the uterus.

After 2 weeks, the woman is offered to take a pregnancy test to find out the result of the procedure.

Precautions for inducing ovulation at home

In the treatment of drugs and folk remedies that have a stimulating effect on the ovaries, precautions must be taken.

Note! You can not try to independently accelerate the onset of ovulation with the help of herbal decoctions and infusions without consulting your doctor about this.

If a woman’s infertility is caused by a tubal factor, she should not use decoctions from a hog uterus and sage as a therapy. Such treatment can provoke an ectopic pregnancy.

Possible negative consequences and complications from ovulation stimulation

Stimulation of the ovaries can have negative consequences. They are expressed in such types of ailments:

1. Enlargement of the ovaries;
2. Headache;
3. Hot flushes;
4. Frequent mood swings;
5. Bloating.

Infertility treatments due to lack of ovulation rarely cause the following: complications:

1. tubal pregnancy;
2. Spontaneous miscarriage;
3. ovarian hyperstimulation;
4. swelling of the extremities and abdominal wall;
5. Stomach ache;
6. Decreased blood pressure.

Doctors call the most dangerous complication of ovarian hyperstimulation syndrome. This phenomenon is observed during natural conception in only 5% of cases. Women who have undergone IVF are most susceptible to its development.

Ovulation stimulation is the only way for most women to conceive and carry a baby. For the method to work, it is necessary to responsibly approach the preparation for the procedure and its implementation.

Women you should trust your health to qualified specialists who are ready to provide professional assistance to their patients.

What is ovulation stimulation:

Stimulation of ovulation - effectiveness reviews:

Modern medicine makes it possible for couples who want to have a baby to fulfill their dream, despite all sorts of difficulties. Stimulation of ovulation is one of the components of the reproductive technique, its effectiveness reaches 75%. The technique helps to get pregnant women who are going to have IVF, as well as patients who, for one reason or another, do not ovulate.

What is ovulation?

- the stage of the woman's menstrual cycle, during which the mature follicle breaks and a ripe and ready-to-fertilize egg comes out of it. The entire process of ovulation is controlled by the hypothalamus by secreting hormones. In the follicular phase until the onset of ovulation, the follicle increases in size under the influence of the FSH hormone. When the follicle reaches a certain size, under the regulation of the estrogens secreted by it, the mechanism of egg maturation starts. After the follicle is fully mature, it ruptures in order to release the egg. This moment is called ovulation.

Then the mature egg moves through the tube into the uterine cavity. If an egg is fertilized during ovulation, it enters the uterus and attaches to its wall. If fertilization does not occur, the egg dies within 12-24 hours. When does ovulation occur? With a 28-day menstrual cycle, a mature egg leaves the follicle on average on the 14th day, but minor deviations are also considered normal.

The fertilized egg enters the uterine cavity, but if fertilization does not occur, it dies.

What symptoms can a woman observe during ovulation? These may be temporary pain in the lower abdomen, as well as increased sex drive. A gynecological examination shows an increased amount of secreted mucus from the cervix.

Reasons for not ovulating

The lack of ovulation in most cases is a consequence of hormonal failure, which, in turn, can occur due to the following reasons:

1. When a woman stops taking hormonal contraceptives, the body needs time to recover.
2. Excessive physical exercise(lack of ovulation is often observed in women who are professionally involved in sports).
3. Stress, fatigue.
4. Thin women often suffer from a lack of ovulation. This is due to the fact that during ovulation, special hormones are produced. For the normal course of this process, the condition must be met: adipose tissue in a woman's body must be at least 18% of the total body weight.
5. Diseases of the genitourinary system and other pathologies.

Examination before stimulation

Before stimulating ovulation, a woman needs to undergo an examination to determine if there are any contraindications to the procedure. If none are found, after the examination, the doctor makes a conclusion:

1. The scheme of treatment.
2. Dosage of drugs.
3. The need for additional therapy.
4. A list of medicines that are most suitable for the patient's body.

Before the ovulation stimulation procedure, the patient must undergo:

Clostilbegit

Clostilbegit refers to direct stimulation drugs that lead to increased production of hormones in the ovaries. Interestingly, the drug was originally developed as an oral contraceptive, but showed exactly the opposite result.

For successful treatment with clostilbegit, it is important to draw up the correct protocol; the scheme of such therapy for each couple should be individual. The protocol indicates all the nuances of the results of the examination of the couple, as well as the individual characteristics of the man and woman:

• the period during which the couple could not conceive a child,
• test results,
• male and female age
• survey results.

Based on the diagnosis and the health status of the couple, the specialist chooses which method of fertilization will be carried out: natural or extracorporeal.

Stimulation of ovulation with clostilbegit begins on the 5th day of the menstrual cycle. On the 7th and 14th days of the cycle, an ultrasound is performed in order to follow the maturation of the follicle.

In the middle of the cycle, when the follicle reaches 20 mm in diameter, the woman is prescribed Chorionic Gonadotropin (hCG is a hormone secreted by the placenta during gestation). The level of this hormone begins to rise with the onset of pregnancy, by the 12th week it increases several thousand times, by the 3rd trimester it gradually decreases.

A low level of hCG at the beginning of pregnancy is an alarming symptom indicating a miscarriage or a threat. After the introduction of the drug containing hCG, two days later, the woman ovulates. During this period, the couple needs to increase the frequency of sexual intercourse in order to increase the chances of pregnancy after ovulation stimulation.

After an ultrasound, a woman is prescribed drugs with progesterone, they provide support for the corpus luteum of the ovaries. With the help of ultrasound, the doctor conducts regular monitoring of treatment, this makes it possible to correct therapy, as well as to avoid a large number problems and mistakes. Clostilbegit can not be used an unlimited number of times (no more than six), as the drug leads to depletion of the ovaries, and, as a result, to the onset of menopause.

To make it easier for you to understand how stimulation occurs, we offer you a brief scheme for ovulation stimulation with clostilbegit:

Side effects after stimulation

Even modern drugs that are used to stimulate ovulation can provoke the development side effects, among which:

• polyp formation and
• ovarian rupture,
• endometrial hyperplasia,
• hormonal disbalance,
• hyperstimulation,
• depletion of the ovaries, followed by an early menopause,
• disorders of the gastrointestinal tract and central nervous system.

The drug Gonal and Duphaston

Stimulation of ovulation with gonal differs from the stimulation scheme with clostilbegit. The drug is prescribed from the first to the 7th day of the menstrual cycle with regular menstruation. The duration of the course of treatment depends on the results of the ultrasound and the level of estrogen in the woman's blood. The drug usually needs to be taken from one to two weeks, the dose is gradually increased. 2-3 days after the last gonal intake, the woman is injected with the hCG hormone.

For 2 days after this, the couple is recommended to have sexual intercourse, since at this time the chances of conceiving a child are highest. If the course of treatment did not give results, it is repeated in the next cycle, but the dose of the drug is increased. When ovulation is stimulated with duphaston, side effects rarely occur, the drug also does not affect metabolism and is excreted from the body within 72 hours after ingestion.

Stimulation and IVF

- a method of artificial insemination, when the insemination of the egg is carried out in a laboratory. After that, the fertilized egg is planted in the patient's uterine cavity. IVF requires multiple mature eggs. In the period 19-23 days of the menstrual cycle, the doctor injects a drug to prepare the patient's body for stimulation.

After that, the follicles are stimulated under ultrasound control. As soon as the follicles reach the desired size, a puncture is performed, after which the egg is sent for fertilization. A few days later, the embryo is placed in the uterus, after 14 days a pregnancy test is performed.

Is ovulation stimulation carried out with? Yes, this procedure is often the only way out for women who cannot get pregnant precisely because of PCOS.

Folk methods

Stimulation of ovulation with folk remedies can be carried out using the following herbs:

• the boron uterus contains the hormone progesterone, which affects the functioning of the reproductive system,
• sage promotes the maturation of the egg, as well as the growth of the endometrium.
• the red brush is used to treat many pathologies of the reproductive system: cervical erosion, mastopathy, uterine cystosis.

These herbs most often need to be taken in combination under the supervision of a physician. In no case do not self-medicate, as seemingly harmless herbal decoctions can be harmful to your health.

Ovulation stimulation is considered the most common and popular way to achieve a long-awaited pregnancy. But it has its pros and cons.

We will talk about how the artificial stimulation of natural processes for a woman takes place, what drugs are used and what results can be achieved in this material.

What it is?

Every or almost every month in the body healthy woman fertile, ovulation occurs. After menstruation during the first half of the cycle, which lasts approximately 14 days, follicles mature in the ovaries. One of them, the dominant one, bursts in the middle of the cycle and releases an egg ready for fertilization.

Ovulation and subsequent periods are usually separated by 14 days. If the cycle lasts 28 days, then ovulation should be expected on the 14th day of the cycle if the individual characteristics are such that the cycle has a duration of 30 days, then ovulation occurs on the 16th day, with a cycle of 32 days, ovulation usually occurs on the 18th day.

Ovulation Calculator

Cycle duration

duration of menstruation

• Menstruation
• Ovulation
• High chance of conception

Enter the first day of your last menstrual period

Ovulation occurs 14 days before the start of the menstrual cycle (with a 28-day cycle - on the 14th day). Deviation from the mean value is frequent, so the calculation is approximate.

Also, along with the calendar method, you can measure basal temperature, examine cervical mucus, use special tests or mini-microscopes, take tests for FSH, LH, estrogen and progesterone.

You can definitely set the day of ovulation through folliculometry (ultrasound).

Sources:

1. Losos, Jonathan B.; Raven, Peter H.; Johnson, George B.; Singer, Susan R. Biology. New York: McGraw-Hill. pp. 1207-1209.
2. Campbell N. A., Reece J. B., Urry L. A. e. a. Biology. 9th ed. - Benjamin Cummings, 2011. - p. 1263
3. Tkachenko B. I., Brin V. B., Zakharov Yu. M., Nedospasov V. O., Pyatin V. F. Human Physiology. Compendium / Ed. B. I. TKACHENKO. - M.: GEOTAR-Media, 2009. - 496 p.
4. https://ru.wikipedia.org/wiki/Ovulation

But this is ideal, but in practice small deviations from the rules are acceptable.

The release of the egg occurs within one hour, then for another day it retains the ability to fertilize and waits for the sperm in the fallopian tube. Conception is only possible during ovulation., because the process of egg release is regulated by the pituitary gland, which begins to produce luteinizing and follicle-stimulating hormones.

Under the influence of FGS (a hormone that stimulates the growth of follicles), in the first half of the cycle, an increase in the follicle occurs, under the influence of luteinizing hormone (LH), the egg itself inside it can mature in a fairly short time.

After the egg is released, it slowly moves through the tube towards the uterine cavity. If fertilization occurs, then the embryo descends into the uterus, and if conception did not happen, then the egg also descends into the uterus and dies there within a day.

As a result of hormonal failure, ovarian dysfunction, and for a number of other reasons, the cycle provided by nature can be disrupted, and therefore a woman can experience anovulatory cycles, that is, cycles without ovulation.

These can be cycles when the egg does not mature, or matures, but does not leave the follicle. In this case, it is impossible for a woman to get pregnant naturally.

Doctors come to the rescue, who can stimulate the ovaries to plan pregnancy. Most often this is done with hormone therapy.

Stimulation of ovulation gives a real chance for conception to couples who have not been able to get pregnant on their own for a long time. The procedure belongs to the category of assisted reproductive technologies.

Indications - for whom is it performed?

This method annually helps tens of thousands of women to find the joy of motherhood. First of all, stimulation is indicated for women with polycystic ovaries, with various manifestations of their dysfunction, including age-related ones. Medical artificial stimulation of ovulation is usually not for women over 40.

With complaints about the inability to get pregnant, a woman turns to a gynecologist. The doctor studies not only the condition of her reproductive organs, but also the features of the menstrual cycle. Such diagnostics include mandatory tracking of follicle maturation using ultrasound diagnostics.

If this examination shows that ovulation is not occurring, preparation for stimulation begins.

The main indication for drug stimulation of the ovaries is the absence of pregnancy during the year, provided that the spouses are not protected and live a regular sexual life. If the spouses (especially a woman) are already 35 years old or more, then the waiting period for conception in a natural way is reduced to six months.

The procedure is contraindicated in women suffering from obstruction of the fallopian tubes.: Otherwise, an ectopic pregnancy may occur. Also stimulation is not given to patients with inflammatory processes in the ovaries and other pelvic organs.

Another indication for stimulation is the absence of menstruation, which arose against the background of hypothalamic-pituitary insufficiency.

The reason for the procedure may be preparation for IVF or intrauterine artificial insemination - insemination. Doctors are usually quite successful in stimulating the multifollicular ovaries, and there are stimulation schemes for endometriosis.

At hormonal disruptions, when ovulation is often "late", stimulates late ovulation.

Also the procedure is indicated for women with significant metabolic disorders, which is manifested by obesity or, conversely, underweight, because under these conditions it is often impossible for a couple to get pregnant on their own.

Methods of artificial stimulation

There are many ways to support ovarian function and help ovulation occur.

In addition to drugs, pills and injections as part of hormone therapy, which is used to restore the ovaries and provoke the release of an egg from a mature follicle, folk remedies that women practice at home are widespread. These are herbs, mud therapy, vitamin therapy and some physiotherapy procedures, such as acupuncture.

Some even practice yoga for conception. Some asanas (poses), according to women, complement well complex treatment and contribute to the improvement of the whole organism in general and the reproductive system in particular.

Despite the huge number of recommendations and ways to achieve what you want, the main method with proven effectiveness, in which the effect is to a lesser extent explained by the usual fortunate combination of circumstances, is medical hormonal stimulation.

How is drug stimulation, preparation

After a woman visits a doctor, she and her partner are recommended to undergo a detailed examination to establish the true cause of family infertility. A woman is assigned the whole range of laboratory tests from general and detailed blood and urine tests to blood tests for infections, including sexually transmitted ones.

It is necessary to do a blood test for hormones(lutenizing, follicle-stimulating, progesterone, prolactin and a number of others, if the doctor considers it necessary).

woman mandatory ultrasound of the pelvic organs and mammary glands. Sometimes a laparoscopic diagnosis may be required to make sure that the fallopian tubes are patent.

The woman's sexual partner takes blood tests for infectious diseases, genital infections, and also undergoes a spermogram to determine the quality of his germ cells, since with male infertility, without exception, all ovulation stimulation schemes will not give any result.

If a pathology inside the uterus is suspected, hysteroscopy is performed.

As soon as the first stage, diagnostic, is left behind, the second stage begins - the treatment of existing inflammatory diseases and hormonal imbalance. Sometimes at this stage, a woman manages to get pregnant., since the pathologies that caused her failures in the ovulatory cycle, in most cases, can be treated.

Women who are overweight or underweight (weight less than 45 kilograms) are prescribed a course of body weight correction. According to the observations of specialists, it is sometimes enough for a patient to reduce her weight by only 10% in order for ovulation to begin to occur on its own.

The third stage is stimulation itself. Ovulation stimulation protocol schemes can be different. The doctor determines the specific drug, its dosage, duration and frequency of administration on an individual basis, taking into account the age, weight and gynecological history of the patient.

Sometimes the turn does not reach the hormones. Pregnancy occurs before the third stage in the event that a woman manages to completely reconsider her attitude to unsuccessful attempts to get pregnant. Fear, anxiety, worries, grief, disappointment at the psycho-physical level trigger the blocking of estrogen production, so ovulation does not occur.

If a woman learns to properly relate to failures, perceive them as a temporary phenomenon and extremely harmful to her health, the ovulatory cycle is often restored without medication at all.

At the initial stage, doctors try to prepare the endometrium of the uterus. With a thin endometrium, conception, even if it occurs, may not lead to pregnancy, because it will be difficult for the embryo to gain a foothold in the uterine cavity. For preparation, a course of treatment with preparations of female sex hormones is carried out.- Proginova, the external drug Divigel and other drugs are used that contain the hormones estrogen and progesterone.

As a rule, from the 5th day of the cycle, special preparations are prescribed, at the same time, doctors monitor the maturation of the follicle by ultrasound.

Activities should begin immediately after the end of menstruation.

It is possible that a woman will have to visit the ultrasound diagnostic room from the 10th day of the menstrual cycle every day. As soon as one of the follicles reaches a size of 17-18 mm, stimulation can be carried out and after 24-36 hours, expect the onset of the cherished moment - ovulation itself.

Still in preparation a woman must donate blood for a hormonal analysis in order to determine the level of AMH- Anti-Müllerian hormone, which is "produced" by the growing structures of the follicles.

If a woman's own AMH level is low, the ovarian response to stimulation will be weak and the effectiveness of the protocol will be significantly reduced. The level of this hormone during examination in dynamics will also allow doctors to see the effectiveness of stimulation and prevent excessive hyperstimulation.

You can stimulate the ovaries up to three times in a row, that is, for three cycles. If conception does not occur, a break is required so that the ovaries can rest from the "hormonal attack" and recover. During this time, the man and woman visit the doctor again, who can make adjustments to the treatment regimen.

A total of 5-6 pacing cycles are considered acceptable.. If they did not bring results, the method is recognized as ineffective for this pair., they are recommended other assisted reproductive techniques, including surrogacy, removal of mature healthy eggs from the ovaries with subsequent in vitro fertilization, fertilization of a donor egg with the husband’s sperm, etc. It all depends on the true causes of infertility and whether a woman develops her own healthy germ cells.

It is not worth insisting on continuing to stimulate ovulation, after 5-6 courses there is a high probability of irreversible exhaustion of the ovaries, their premature aging.

To stimulate ovulation, you do not have to go to the gynecological hospital. A woman can stay at home, in her usual conditions. She must strictly adhere to the prescribed schedule of visits to the doctor for ultrasound control, and also take all prescribed drugs in full accordance with the indicated individual dosage.

Drugs - list

All drugs that are included in the schemes of ovulation stimulation protocols are divided into two large groups:

• follicle growth stimulants;
• ovulation triggers.

The first ones are prescribed from the 5th day of the cycle (immediately after menstruation), and the triggers are introduced one-time - when the ultrasound shows the complete readiness of the follicle to release an egg. They imitate the release of luteinizing hormone, under the influence of which the egg quickly matures and leaves the follicle.

After ovulation has taken place, drugs are prescribed that help the ovaries maintain the functions of the corpus luteumso that pregnancy, if it occurs, can develop normally. Let's look at the drugs of all these groups in more detail.

"Klostilbegit" ("Clomiphene citrate", "Clomid")

This drug is widely known to women planning a pregnancy, as it has proven itself as a means of stimulating the ovulatory process. The drug is a stimulant for the formation and growth of follicles in the ovaries.

In certain doses, it helps the production of follicle-stimulating hormone FSH, luteinizing hormone (LH) and gonadotropins. The tool is available in the form of tablets.

There are no general recommendations on the dosing regimen of the drug, because the dose depends on how the ovaries will respond to taking this medication - it can be reduced or increased at the discretion of the attending physician.

If a woman's menstruation occurs fairly regularly, there are no long-term failures, then treatment with Clomid begins on the 5th day of the cycle (count from the first day of menstruation). According to one of the common schemes, the drug is taken every day for five days, in this case, ovulation is expected presumably from the 11th to the 15th day of the cycle.

If there is no ovulation, then in the next cycle another scheme is introduced, in which the drug must be taken from the 5th day of the cycle for 5 days, but at a double dosage.

If both schemes do not show results, treatment is interrupted for three months, after which the course may be repeated..

For each course, a woman should not take more than 750 mg of the drug. After the second course, if it did not bring the long-awaited result, treatment with Clomid is recognized as completely ineffective and other methods of assisted reproductive plan are chosen.

Side effects of the drug can cause discomfort to a woman. These are nausea, vomiting, flatulence, headache, increased drowsiness, lethargy of movements and mental reactions, therefore, for the duration of treatment, a woman is advised to refuse to drive a car and work associated with high risks to life.

Many women, while taking Clomid, notice that they are overcome by a depressive mood, their sleep and appetite are disturbed. There may be pain in the lower abdomen, slight pain in the chest, white liquid discharge from the genitals.

"Klostilbegit", as well as other drugs that stimulate follicular growth, increase the risk of subsequent onset of multiple pregnancy. Many women note that during the treatment they gain some weight.

Analogues of this remedy are Clomiphene, Serofen, Serpafar.

"Letrozole"

This nonsteroidal drug also enhances FSH production and promotes ovulation However, experts consider it more effective than Clomiphene, although Clomiphene remains the first choice.

Letrozole has much less side effects which makes it more pleasant to take. In addition to the regulation of hormones, the drug improves the condition of the endometrium. There are also several schemes by which this remedy can be taken in tablets.

In the first case, 2.5 mg is prescribed from the third day of the cycle for five days; in the second scheme, a woman is recommended to drink the drug from the fifth day of the cycle at a dose of 5 mg.

The best results are shown by the use of this tool in the composition complex therapy: on the second to sixth day of the cycle, "Letrozole" is prescribed at a dosage of 2.5 or 5 mg per day, then from the 7th to the 10th day of the cycle, the woman is injected with FSH in injections, and then an injection of hCG is given at a dosage of 10,000 units, as soon as dominant follicle reaches the desired size according to ultrasound (from 18 mm).

Analogues of the drug - "Letrosan", "Femara".

"Gonal-F"

This drug also belongs to the group of drugs, stimulate the growth and development of follicles in the ovaries in the first half of the menstrual cycle. It contains a recombinant hormone, which, thanks to the efforts of genetic engineers, was obtained from the ovary cells of female Chinese hamsters.

The drug is administered subcutaneously, it is sold in special syringe pens that are easy to use. "Gonal-F" is prescribed if stimulation with the first drug in the order of appointment - "Klostilbegit" is ineffective.

Similar actions of this drug are typical for many hormonal drugs - these are headaches, dizziness, drowsiness and lethargy, lack of tone, dryness in the vagina, changes in appetite, insomnia. Sometimes women report diarrhea, temporary blurred vision, acne, weight gain.

The agent is injected subcutaneously. The doctor will make the first injection, and the subsequent woman will be able to inject herself yourself at home.

The stimulation course begins in the first days of the cycle and lasts up to 11-14 days. The dose of administration is determined by the doctor, usually starting with 75-10 IU and gradually increasing the dosage.

With each subsequent injection, a woman needs to choose a new injection site, do not inject into one zone.

Analogues of the drug - "Horagon", "Ovitrel".

"Puregon"

This preparation can also be used for the initial preparation of the follicles in the first half of the cycle. It is available in the form of a powder for solution for injection, as a ready-to-use solution and a solution in cartridges. The liquid is administered intramuscularly and subcutaneously. The drug in the "pen" is administered in only one way - subcutaneously.

The drug contains recombinant FSH from the same Chinese hamster, which in many respects outperforms FSH obtained from human urine. It is safer and easier to carry.

Under its influence, several follicles begin to actively grow in the ovaries of women, which can then be used in any of the assisted reproductive methods.

The dose depends on how the patient's ovaries will "respond" to the impact.. Daily monitoring of ultrasound and the determination of estrogen in the blood will help the doctor to have a good idea of ​​​​what exactly is happening in the woman's gonads, and not to miss the moment of ovulation.

The initial dose is 50 IU, then, if there is no ovarian response, the dosage is increased daily and monitored when the response appears. Treatment begins on the second day of the menstrual cycle, it lasts about 7-14 days (it all depends on when it is possible to achieve growth of follicles and an increase in the concentration of estadiol in the blood). The stimulation is completed by an injection of hCG at a dose suitable for ovulation induction (usually 10,000 IU).

Chorionic gonadotropin (hCG)

This drug is obtained from the urine of pregnant women, since this hormone is produced in large quantities during the initial period of bearing a baby - most intensively up to 12 weeks. An injection of this drug in a dosage of 5000 to 10000 IU is used in order for the very fact of ovulation to occur so that the egg can leave the follicle stimulated in the first stage.

Then the drug can be administered every two days until the date of the expected menstruation in order to maintain the functions of the corpus luteum, which produces sex hormones, which are necessary to maintain pregnancy.

If pregnancy is confirmed, hCG can also subsequently be used up to 10-11 weeks if there is a threat of miscarriage due to low intrinsic hCG levels.

If a woman has a threat or fact of ovarian hyperstimulation on ultrasound, then they refrain from using hCG. It is also not recommended to use chorionic gonadotropin for women with kidney and liver pathologies.

Among the side effects of the drug are irritability and mood swings, headaches, drowsiness. HCG also increases the chance of conceiving twins or triplets, and this fact cannot be ignored when planning a pregnancy.

The analogue of the drug is "Pregnil".

Dydrogesterone (Dufaston)

This is a popular hormonal drug, most importantly active substance which is an analogue of progesterone. The tool can be indispensable in the second half of the menstrual cycle, because it helps to maintain pregnancy, promotes proper implantation, regulates many processes, setting the woman's body to a new state for her.

Ovulation "Duphaston" has no effect, but here after it, it becomes very important, because it strengthens the possible positive result stimulation. The drug does not affect the growing embryo, and therefore its use in the first weeks and months of pregnancy is not prohibited, and sometimes recommended.

The dosage is prescribed individually depending on the result of a blood test for progesterone, as well as the purpose of taking - pills can be prescribed not only to control the level of the hormone, but also to prevent the threat of miscarriage, to prevent miscarriage, if such facts have previously occurred.

From "Duphaston" women do not get fat, do not lose concentration, and therefore they can continue to drive a car without restrictions while taking this drug.

Vitamins to stimulate ovulation

Vitamin preparations are included in the standard treatment regimens for female and male infertility. When ovulation is stimulated, vitamin intake is indicated 1-2 months before the cycle chosen for stimulation, as well as throughout the entire time that stimulation is in progress, and then until pregnancy is confirmed.

Sometimes in order to establish regular ovulation, it is enough to adjust a woman's lifestyle, her diet and prescribe her vitamins, so vitamin support at the stage of pregnancy planning is of great importance.

Vitamins D, A, B12, B 9, E, C are especially important for the normalization of ovulatory cycles:

• Vitamins D and D 3 involved in the production of sex hormones in women.
• Without vitamin A the development of the follicle is not bypassed, in addition, retinol is involved in the normalization of the composition of cervical mucus.
• Vitamin E participates in cellular processes, helps the maturation of the egg, contributes to its release beyond the follicle.
• Ascorbic acid (vitamin C) improves blood circulation, which contributes to the enrichment of the ovaries with useful substances.
• B vitamins, especially folic acid, regulate the duration of the luteal phase of the cycle, and also increase the viability of the egg.

• From the beginning of menstruation to ovulation - vitamin E, vitamin A and folic acid.
• From the moment of ovulation throughout the second phase of the cycle - vitamin C, vitamins B, vitamin E.

Specific vitamin preparations should be prescribed by a doctor, taking into account biochemical analysis blood, which shows which substances are needed, and which are enough without synthetic drugs.

An example of a successful vitamin therapy regimen can be as follows:

• Days 1 to 14 of the cycle- cocarboxylase + riboflavin (in injections) daily, as well as lipoic acid and vitamin E in tablets and capsules.

• 15th to 24th day of cycle- riboxin, pyridoxine, folic acid and potassium orate tablets, as well as vitamin E three times a day.

Treatment with folk remedies

Our ancestors knew something about women's health long before such concepts as "stimulation of ovulation" appeared. However, experts tend to believe that probability theory plays an important role in alternative medicine - there is always a chance to conceive, and therefore drinking weed, in principle, will not hurt.

Modern doctors respect folk remedies to improve women's health, but warn against their self-appointment.

Any alternative treatment should be discussed with your doctor so as not to harm.

For folk ways to increase ovulatory ability, there are also certain rules. For example, do not take herbs at the same time hormone therapy medicines, this can lead to ovarian hyperstimulation.

Herbs and roots for female fertility are not taken during menstruation, and it is not recommended to be treated with them for more than 3 months in a row, as well as hormonal medications.

The principle of treatment in alternative medicine is exactly the same as in traditional medicine. In the first half of the cycle, take herbal remedies that help the growth and development of the follicle. This is sage - decoctions and essential oil, a decoction of rose petals, an infusion of plantain seeds.

In the second half of the menstrual cycle, after ovulation, traditional healers recommend taking a boron uterus- This plant contains plant progesterone. Decoctions and infusions are made from it, according to the instructions for use, which is enclosed in pharmacy packages with this herbal tea.

To achieve ovulation, a woman is advised to stop drinking alcohol, do not abuse nicotine, diversify her diet with foods that have the best effect on the functioning of the ovaries. These are liver, lean red meat, sea fish, dairy products.

Efficiency

In the first cycle, when ovulation is stimulated, a woman can become pregnant in about 15% of couples.

During the second and third cycles, the number of positive outcomes, when ovulation can be restored, reaches 70-75%. In general, the effectiveness of drug induction of ovulation is estimated at 70-80%. This is the number of couples who eventually manage to get pregnant naturally.

The rest come to the aid of IVF, ICSI and other assisted reproductive techniques and techniques.

Possible consequences and complications

Stimulation is carried out with hormonal drugs, which would be wrong to underestimate the impact on the female body. The very induction during the cycle often causes pain and discomfort in women. Many complain that the lower abdomen is pulled and even that the ovaries hurt after stimulation. Almost everyone experiences "hot flashes" - hot flashes that come in waves.

One of the most dangerous consequences of stimulation is overstimulation., in which the growth of follicles occurs so rapidly that hyperstimulation syndrome develops. He most often can make himself felt for the first time on 3-4 days after the start of induction.

If signs of such a pathology appear in more late dates- after 7-10 days of the menstrual cycle, the syndrome proceeds quite hard, with vomiting, diarrhea, swelling of the limbs and face, a drop in blood pressure, a sharp deterioration in well-being.

A woman may need qualified help in a hospital setting. Therefore, stimulation should be carried out by a doctor with extensive experience in reproductive programs, who will be able to timely control the processes occurring in the woman's body under the influence of hormones and make the right and informed decisions.