Super Ovulation

Ovulation and Pregnancy

Women are most fertile during the ovulation stage of the menstrual cycle, the time when a mature egg is released from a woman's ovaries to potentially be fertilized. The ovaries are stimulated by follicle stimulate hormone (FSH) and luteinizing hormone (LH), which help a woman's eggs develop and be released. Therefore couples trying to conceive often time intercourse to coincide with the time of ovulation.

However, many females suffer from ovulation dysfunctions which hamper their ability to get pregnant. In fact, is it estimated that a quarter of all female factor infertility cases are the result of ovulation problems. One solution is the use of fertility drugs that stimulate ovulation.

Ovulation Stimulation with Fertility Drugs

There are two classes of ovulation drugs - oral and injectable. Clomid (Clomiphene Citrate) is taken in pill form and is the most widely known fertility drug, often prescribed as the first treatment for ovulation dysfunction Clomid has an 80% success rate of stimulating ovulation.

Gonadotropins are injected fertility drugs that mimic the activities of the body's natural hormones in stimulating ovulation. Some gonadotropins contain LH and FSH, while hCG (human chorionic gonadotropin) acts as a trigger and boosts the natural surge of the LH hormone that normally takes place prior to ovulation. Gonadotropins are considered more aggressive treatment than Clomid and are often used in conjunction with intrauterine stimulation (IUI).

Super Ovulation

One of the risks involved in taking fertility drugs is "super ovulation," which in turn can give rise to a condition called ovarian hyperstimulation syndrome (OHSS). Super-ovulation refers to the production of multiple eggs per menstrual cycle instead of the usual one egg that is ovulated (released). That is, women "super" ovulate. Unfortunately, the consequences of super-ovulating can be quite severe.

Ovarian Hyperstimulation Syndrome

In OHSS the ovaries are over-stimulated and become swollen and filled with fluid. If the bloated ovaries rupture and leak, serious damage can occur. Up to 10% of women who take fertility drugs are affected by OHSS, and especially women who have been administered hCG to stimulate ovulation.

Most cases of OHSS are mild; however severe cases of OHSS can be dangerous.

Mild OHSS Symptoms: bloated abdomen, full feeling, diarrhea, nausea, slight weight gain.

Moderate OHSS Symptoms: extended abdomen, vomiting, diarrhea, weight gain of more than one kilo or two pounds a day, dark and small quantities of urine, thirst, dry skin, dry hair.

Severe OHSS Symptoms: bloating spreads upward from the waist, prominent abdominal distention, very dark and miniscule quantity of urine, shortness of breath, pains in abdomen, chest and calves.

In rare instances, women develop critical complications, including kidney failure, blood clots, and electrolyte imbalance.

Preventing and Treating OHSS

Mild cases of OHSS generally go away on their own with the commencement of menstruation. Women with OHSS are advised to abstain from sex and intense exercise so as not to rupture the bloated ovaries, rest with legs elevated, drink at least ten 8-oz. glasses of fluid each day, monitor their weight gain, and avoid caffeine and alcohol consumption. To treat severe OHSS women are often hospitalized where fluids are released from the body and women are carefully monitored.

OHSS can be prevented by taking lower doses of fertility drugs, monitoring estrogen levels carefully during infertility treatments, and by periodic pelvic ultrasounds examining the ovaries. Some fertility specialists recommend a protein solution called albumin to reduce women's chances of developing OHSS.

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