Treatment Option

Infertility Treatment Options

This slide shows the various treatment options for ovulation induction.A thorough understanding of the presently available treatment options will greatly simplify the management of infertile couples. It than becomes easier to identify couples who will benefit from a particular type of treatment option and others who will not. Now, we will consider each option briefly.

Clomiphene Citrate

The first and foremost drug is, Clomiphene citrate which is the most popular agent for the induction of ovulation and has been in use for more than 35 yrs. It has a structure that shares key similarities with that of oestrogen. This enables CC to bind with receptors in the hypothalamus and pituitary and prevent oestrogen from binding with those same receptors. Because of this, the hypothalamus does not receive feedback information on the actual level of oestrogen in the body. The absence of such signals will be interpreted by the hypothalamus to mean that there is no oestrogen in the body. This leads to increased output of GnRH by the hypothalamus and consequently FSH and LH by the pituitary. The net result of these changes will be the production of one or more oocytes by the ovary.Treatment with CC is commenced at 50mg -100mg(max 150 mg) daily for 5 days in each menstrual cycle beginning from day 3 or 4. CC should not be used for more than 12 cycles in a patient's life time or for more than 6 cycles continuously.

Indications for use of CC are as listed.

Clomiphene citrate & Gonadotropins

Clomiphene citrate can be administered along with exogenous gonadotropins like FSH or hMG preprations and this combination achieves a balance between efficacy and cost. The growth of ovarian follicles, recruited as a result of CC induced increase in endogenous production of FSH is maintained by subsequent hMG or FSH injections.