Egging On Ovulation
Intrauterine insemination (IUI) is an intricate procedure requiring many different steps to make it all work and bring about the desired result: conception. One of the most important factors in the IUI procedure is to make sure ovulation occurs at the right time and that your doctor detects this prime state for insemination just as it is about to happen. Doctors today have the option of administering ovulation induction medications to assist the IUI process in the case where infertility is due to ovulatory dysfunction.
Clomid is the least expensive and most convenient of the ovulatory induction medications, since it is an oral medication. However, sometimes Clomid causes a thickening of the cervical mucus, making insemination difficult. Or, the Clomid may not be enough. The next step is for your physician to either take you off the Clomid and move on to injectable medication, or to use the injectable medication in conjunction with Clomid. The most common medication used at this point is injectable hCG (human chorionic gonadotropin), a hormone that stimulates follicle production and egg growth.
Sometimes even these two drugs, Clomid and hCG may not do the trick, and the doctor may decide to add the injectable medication known as follitropin beta.
In the U.S., follitropin Beta is marketed under the following names: Follistim. Follistim AQ, and Gonal f RFF. Follitropin beta mimics the follicle-stimulating hormone (FSH) which is produced by the pituitary gland. This hormone aids in egg development while the eggs are still contained within the ovary.
Sometimes a patient may be treated with yet another hormone, known as gonadotropin-releasing hormone agonist (GnRHa) before beginning treatment with follitropin beta. GnRHA suppresses the release of FSH from the pituitary gland, and its administration ensures your FSH is replaced by just the right amount of follitropin beta to maximize the chances of conception.
If follitropin beta is used in conjunction with hCG, the latter will be given as a single dose after the final dose of follitropin beta. In general, the dose of follitropin beta is injected under the skin (subcutaneous) or into a muscle (intramuscular) beginning with the second or third day of the menstrual cycle. The dose is increased after the fourth day of treatment.
Your doctor will want to monitor your progress, perhaps every other day, to check for side effects and to see if the medicine is working as it should. Most often, the monitoring process includes ultrasound examinations as well as blood tests to measure the amount of hormones present in your bloodstream. After the treatment ends, your progress will continue to be monitored, every other day, for at least a fortnight.