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Center for Advanced Reproductive Medicine
School of Medicine  :  Department of Obstetrics & Gynecology

Our Services

 

Controlled Ovarian Hyperstimulation (COH) with Injectable Medications – Gonadotropins (FSH and LH)


The doctors and staff members at the Center who will be working with you want to be very certain that you have a clear understanding of the process and precedures involved in ovulation induction, and that your expectation and hopes are balanced by a realistic understanding of what can be achieved.

What Will Happen?

You will be instructed to self-administer injectable medication; gonadotropins (hMG, Menopur, Bravelle, Repronex, Follistim, Gonal-F, or other brand names) and/or human chorionic gonadotropin (hCG), which are intended to stimulate the ovaries to produce moer than one egg.  These medications contain Follicle stimulating hormone (FSH), Luteinizing hormone (LH) or human chorionic gonadotropin (hCG).

The progess in development of eggs will be monitored by blood test (estradiol, progesterone, and/or LH, as appropriate) and ultrasounds which are performed early in the morning over the course of several days.

Based on these ultrasound visits, a determination will be made of the best time to perform intrauterine insemination or proceed with intercourse.

You may be instructed to self-administer an injection of hCG to “trigger” ovulation of the mature follicles.

What are possible complications?

  1. The ovarian response (development of follicles) may not be adequate, indicated either by low estrogen levels or lack of follicle development identified by ultrasound.
  2. There may be an unexpectedly exuberant response to the medications, placing a woman at risk for multiple gestation (triplets or more) and for the development of ovarian hyperstimulation syndrome.  This may require that the cycle be stopped.

If any of these circumstances should occur, it may be recommended that the stimulation cycle be stopped, and you will need to await another cycle.  The doctors and staff members at the Center will discuss this circumstance individually with you and will outline plans for another attempt.

  1. You may have a reaction to the medications used.  These may range from allergic reactions, but limited to: bloating, emotional symptoms, and/or hot flashes, to pain, abdominal swelling, and over-stimulation of the ovaries.
  2. Twins, triples, or quadruplets may implant (the overall risk of multiple pregnancy is 25%).