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, it is necessary to undergo a thorough examination so that with self-stimulation not to harm 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.

Such a measure is ideal in the case of polycystic ovarian disease, as well as for patients with a variety of menstrual irregularities, anovulation and other abnormalities. But it should be carried out only after normalization 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 suitable option incentives 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

Medicinal herbs quite effectively stimulate ovulatory processes. Stimulation by medicinal plants is carried out in several stages: First, sage is taken, which stimulates follicular formation, then elderflower, 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

Good stimulating effect essential oils. They can be inhaled, rubbed, most importantly, used regularly. Inhaling the pleasant aromas of basil or anise, sage or cypress, a woman starts intense 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

Healing mud is considered to be a fairly effective and fairly common way to stimulate ovulation, which helps to increase the activity of 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 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 the 35-year mark. 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.

Preparations for stimulating ovulation are varied. The choice of therapy depends on the problems that cause infertility. To determine the cause, you need to seek help from a specialist. Only after a diagnosis has been made can a treatment be chosen.

Also, many patients resort to home remedies to restore fertility. If funds are used irrationally, the risk of additional complications increases. Due to these factors, you should definitely visit a specialist and undergo a series of examinations.

Important aspects in planning pregnancy are indicators of the health of the reproductive system of men and women. In order for a woman to conceive and bear a healthy child, she needs full ovulation and the correct menstrual cycle.

The cycle of a woman proceeds in several stages. The countdown of each cycle starts from the first day of the next menstruation. From the same day, work is activated hormonal background. First stage menstrual cycle is built by the active work of estrogen. The hormone is involved in the preparatory activities of the body for a possible conception.

A special layer is needed to secure the fetus. It lines the uterine cavity. Immediately after menstruation, this tissue is very thin and dense. Its value does not exceed 5 mm. Gradually, under the influence of the hormone, the layer increases. There is also a change in its structure. The fabric becomes fluffy and porous. The size increases to 13 mm. In such a layer, the cell can gain a foothold.

Estrogen is also involved in the formation of the follicle. This formation serves as a capsule for the maturation of the egg. In each cycle, a woman produces 1 egg. If more cells appear, then the chances of multiple pregnancy increase. The follicular sac is formed under the ovary. Its cavity is filled with luteal fluid and cells. The growth of the bag depends on the amount of follicle-stimulating hormone. This substance is produced in the hypothalamus and provokes the walls of the follicle to active stretching. By the time of ovulation, the bag should be at least 21 mm in size.

From this stage, the ovulatory phase begins. Estrogen gives way to luteinizing hormone. This substance helps the fluid in the follicle to increase volume. A sharp increase in LH contributes to an increase in the follicle by 4-5 mm. The walls of the bag stretch and tear under the pressure of the liquid. The cell leaves the shell. The ovulatory period is coming. From that day on, the family should begin to actively plan.

For conception to occur, a zygote is needed. It is formed by the fusion of the RNA of the spermatozoon and the female germ cell. To do this, the cell must descend into the uterine cavity. The passage is through the fallopian tubes. They serve as a natural barrier to protect a woman from improper fixation of the fetus. The inner layer of the pipe consists of many growths. The villi are contractile. The contraction causes the egg to move quickly into the uterine body.

The day after ovulation, LH is replaced by progesterone. Progesterone serves as a source of nutrition for the fetus. Its main amount is produced in the shell of the bursting bag. The hormone is yellow. Due to this, the formation derived from the hormone is called the corpus luteum. If during the cycle a woman becomes pregnant, the body begins to increase in size. For full bearing, it should not be less than 25 mm. If there was no conception, the body stops producing the hormone. The endometrial tissue is shed. The next menstruation is coming.

Based on these data, the following factors are necessary for conception:

• the presence of ovulation;
• growth of LH;
• formation of a dominant follicle;
• lush endometrial layer.

If one of these conditions is absent, pregnancy does not occur. To determine which of the factors is violated, a woman needs to consult a doctor. For this reason, before planning, you should visit a reproductive specialist.

How to determine the presence of fertility

Prolonged absence of pregnancy indicates the presence of pathological processes in the body. The first step for a woman is to determine if she is ovulating. Fertility can be determined by a variety of methods. Doctors suggest using the following methods for determining fertility:

Many patients are guided by subjective signs. A woman believes that ovulation can be determined by a change in the structure of cervical mucus and pain in the side. But not always these symptoms can be a sign of ovulation. To accurately establish the ovulatory phase, one of the listed methods should be used.

The most common way is to use special test strips. The surface of the strip is treated with a special composition. It reacts to the presence of LH in the urine of the patient by changing its color. The more hormone the liquid contains, the brighter the test is colored. If the strip is pale or white for a long time, the release of LH does not occur. This is a sign of anovulation.

Modern gynecologists recommend another novelty for self-determination of fertile days. This is a microscope. It helps to determine fertile days by changing the image. The study is carried out on salivary fluid. Approaching ovulation is accompanied by a picture that looks like a clover leaf. If a woman saw a similar image, ovulation will occur in a day. If such an image does not appear, the woman is not fertile.

You can clarify the results of a home study using ultrasound diagnostics. It is carried out by a gynecologist from the fifth day of the menstrual cycle. On the screen, the specialist sees a clear image of the ovaries. The main objective of this method is to identify the dominant follicular sac. It is found on the 5th-7th day of the cycle. Next, the growth of the dominant is monitored. On the day of the expected release of the egg, the doctor examines the retrouterine space. The main sign of this process is the presence of free liquid. If the liquid is not detected within 1-2 days, the rupture of the bag has not occurred. The dominant is either blown away, or it develops into a cystic neoplasm. The cyst in most women is excreted with the next menstruation.

Follicle metering allows the doctor to accurately determine whether the patient is ovulating. If it is absent, funds are needed to stimulate ovulation. Selection of drugs is carried out only after a series of diagnostic measures. Before starting the procedure, the causes of infertility should be established.

Causes of pathology

There are various reasons for the disappearance of fertility. The following causes of infertility are distinguished:

• long-term use hormonal drugs;
• changes in hormone levels;
• various diseases of the reproductive system.

Often, a violation of the ovulatory phase is observed in women who are protected by hormonal drugs. Such drugs cause a decrease in the activity of the ovaries. The paired organ stops producing cells. This phenomenon occurs due to a prolonged blunting of the production of LH and progesterone. The ovaries go to sleep. In this pathology, the appearance of a large number of small formations on the ovary is observed. If a woman has this problem, ovulation stimulation is prescribed.

It is also necessary to stimulate ovulation in the presence of hormonal failure. The ovary ceases to produce a cell when the level of follicle-stimulating hormone is low. This situation is characterized by the absence of a dominant follicular sac. Hormonal failure can also affect the excretion of the cell. The study establishes a low amount of LH. The second phase of the cycle occurs without ovulatory interruption. To restore both phases, specialists stimulate ovulation with hormonal drugs.

Various pathological processes in the reproductive system can also affect the fertility of a woman. A dangerous disease is an oncological lesion of the uterus or ovaries. In oncology, ovulation stimulation is not used. The procedure is prescribed only after the elimination of negative processes in the body.

Ovarian stimulation methods

Physicians use various drugs to stimulate ovulation. Often there are appointments based on Clostilbegit. These ovulation stimulating pills help to form a dominant follicle.

The procedure begins on the fifth day of the menstrual cycle. Initially, the doctor prescribes a small dose of the drug. A woman takes one pill of clostilbegit every day. On the ninth day, the first folliculometry is performed. The doctor must establish the presence of the dominant and its size. Further control is carried out every other day. Upon reaching the dominant required sizes the doctor prescribes a special hormone responsible for the rupture of the wall.

This substance is found in the blood of a pregnant woman. Chorionic gonadotropin is available as a dry powder. Each ampoule contains at least 1 thousand units. drug. For the release of the egg, it is necessary to enter from 4 thousand units. substances up to 10 thousand. The dose is determined by the doctor based on the results of the formation of the follicle. What is this stimulation? All administered drugs contribute to the restoration of the hormone responsible for a particular process. Clostilbegit helps to form the follicular sac. HCG increases the tension of the walls of the bag and breaks them.

After the hCG injection, the doctor examines the further behavior of the follicle. If rupture does not occur, further folliculometry is not performed. Ovulation stimulation is carried over to the next cycle. If the cell exit has taken place, stimulation continues.

The increase in the second phase occurs under the influence of progesterone drugs. Progesterone is produced in various types. Many doctors recommend giving preference to the natural analogue of the hormone. This drug does not adversely affect a woman's body weight and does not cause adverse reactions.

A progesterone drug is prescribed for 14 days. If conception does not occur, the pills are canceled.

Stimulation of the ovaries in the next cycle is carried out with an increased dose of Clostilbegit. On this preparation, 4-5 schemes can be carried out. After the absence of conception, this therapy is canceled. Do not use the drug for a longer period. Against the background of a constant stimulating effect, depletion of egg reserves is observed. A woman may have an early menopause. After it, pregnancy does not occur.

What else is done to stimulate ovulation? The least harmful procedure for the ovaries is performed with the preparation of chorionic gonadotropin. To activate the ovaries, it is necessary to start the procedure from the second day after menstruation. The first cycle is administered to a woman every other day, 2 thousand units. drug. on the 12th day it is necessary to undergo an ultrasound diagnosis. The approach of ovulation is determined by the size of the dominant. If it has a diameter of up to 23 mm, it is necessary to increase the dose of hCG. The patient is given 5,000 IU at a time. hormone. After the injection, the Douglas cavity should be examined for the presence of follicular fluid. Its presence indicates a positive outcome of the procedure.

If there is no liquid, the procedure should be repeated. For its implementation, the dose of the drug must be reduced. HCG in this case is administered daily. The study of the ovaries is carried out on the tenth day. The lack of response from the ovaries indicates an incorrect statement of the causes of infertility. The patient is undergoing an additional examination.

You can also activate the work of the ovaries with other drugs. Some vitamin preparations have a stimulating effect. Tocopherol is used to enhance cell production. It is used 1 capsule every other day. This substance causes an increase in estrogen. The conversion of estrogen to FSH is carried out by folic acid. From the fifth day, a woman takes 2 g of the drug twice a day. Additionally, it is necessary to increase the contractility of smooth muscles. Behind this function responds with pyridoxine and thiamine. Vitamins are taken until the 14th day of the cycle. After that, thiamine, pyridoxine is canceled. Tocopherol is prescribed every other day by capsule. Folic acid is reduced to 1 g in a day. The scheme is extended to the next cycle. If pregnancy does not occur, treatment can be continued at the listed doses.

Many couples face such a delicate problem as infertility. To quickly eliminate the disease, future parents should contact a reproductologist. The doctor will prescribe the necessary examination, which will determine the cause of the pathology. After the diagnosis is made, a treatment method is selected. If the cause of the problem is sluggish ovarian activity, the doctor uses ovulation stimulation. After this procedure, the problem is fixed.

Ways to stimulate ovulation

Ovulation induction helps thousands of women become mothers every year. Let's take a closer look at who needs and can stimulate the maturation of eggs, and who is contraindicated, and what drugs are most often used in this procedure.

So, ovulation stimulation is carried out for women who, for some reason (but not included in the list of contraindications), do not ovulate or very rarely ovulate. Drug "causing" the maturation of the egg is recommended for couples who have not been able to "naturally" conceive a child for more than a year, without the use of contraception, of course. Or couples in which partners are older than 35-40 years old, in this case, you can wait less than a year - on average, 6 months.

Even if there is no ovulation, its stimulation is undesirable, or rather useless, if it is not possible to conduct timely ultrasound monitoring of the development of the follicle or with male infertility. It is dangerous to stimulate the onset of ovulation in women with obstruction of the fallopian tubes, due to the high likelihood of an ectopic pregnancy.

Medical stimulation

If there are indications for her, the doctor prescribes both spouses to undergo an examination and pass a series of tests, including: a blood test for HIV, hepatitis B and C, syphilis, women take gynecological smears, etc. If necessary, the patency of the fallopian tubes is assessed.

Ovulation is usually stimulated with clostilbegit and other gonadotropic hormone medications. It is very important to draw up the most successful procedure protocol. The doctor draws up this kind of schedule for taking medications, conducting examinations and taking tests, taking into account the age of the woman, the length of the time period for non-occurrence of pregnancy and other individual characteristics of each infertile couple. And also depending on whether ovulation is stimulated for subsequent egg collection for IVF or ICSI or to increase the likelihood of pregnancy in a natural way.

The classical scheme includes taking clostilbegit from the 5th to the 9th day of the menstrual cycle. A slightly modified scheme - when ovulation stimulation with puregon is carried out in addition to the first drug. In this case, clostilbegit is taken from the 3rd to the 7th day of the cycle. During this time, ultrasound monitoring of the maturation of the follicle is carried out several times, and when it reaches a size of 17-18 mm, the woman takes the drug Pregnil, which directly causes ovulation. This happens 24-36 hours after taking the medicine. The doctor must report the most auspicious time for sexual intercourse.

Enough frequently asked question to those women who know from their own experience how ovulation is stimulated - from what attempt the pregnancy occurred. According to statistics, the first time it turns out to conceive a child only in 10-15 percent of couples, in total, up to 65-70 percent of all protocols end in luck.

Stimulation by folk methods

Despite the fact that the stimulation of ovulation with drugs is not too expensive pleasure, many women prefer a more "natural" option - taking various medicinal herbs considered by the people. Stimulation of ovulation by folk methods most often involves taking infusions of three herbs: sage, hog uterus and red brush. They can be easily found on sale in almost any pharmacy. So, in the first part of the cycle, it is recommended to drink sage infusion (1 tablespoon per cup of boiling water) 3-4 times a day. It is said to promote the maturation of the egg, the growth of the endometrium and other conditions necessary for the onset of pregnancy.

In the second half of the cycle, you can start drinking the boron uterus. They say that it contains progesterone - one of the main hormones for early pregnancy. With a lack of progesterone, the fertilized egg dies, after futile attempts to penetrate the uterine wall. A decoction of a hog uterus is prepared in the same way as from sage. Many of those who have experienced firsthand what ovulation stimulation is with folk remedies say that it is very good to combine the upland uterus with red brush grass, which is also an excellent remedy for the treatment of many gynecological diseases.

There are other folk ways to induce ovulation, for example, such a pleasant and even somewhere romantic - to drink a decoction of rose petals. The benefit of this infusion lies in the content of vitamin E in it in a fairly high concentration. The positive effect on the treatment of infertility of mummy, aloe and quince juice has long been known. So - there are plenty to choose from. However, you also need to be careful with herbs, traditional medicine is also medicine, and each of its remedies may have contraindications. If ovulation stimulation is carried out under the supervision of a doctor - the drugs prescribed by a specialist have no contraindications for you, you can be sure of this. But no one has properly studied the negative properties of herbs, therefore, it is not at all clear what is better - to be stimulated with the help of official medicine or folk ... We can only say unequivocally that the first option is more effective.

To improve efficiency folk remedies ovulation stimulation, it is also necessary to be able to calculate this very ovulation in order to increase the likelihood of conception. There are many methods for this: ranging from measuring basal body temperature and scheduling and ending with ultrasound monitoring.

Vitamin therapy for ovulation stimulation

A woman preparing to become a mother needs to pay special attention to her diet, because it is from it that a person receives most of the vital vitamins. Expectant mothers need vitamins and microelements more than other women. What substances are necessary for ladies planning a child?

First of all, such women need folic acid. The lack of this substance in the body is very dangerous for the fetus, as it can lead to intrauterine developmental pathologies. Another essential element is potassium iodide. On initial stage enough to sprinkle your food iodized salt, instead of the usual one.

On the net you can find information that ovulation stimulation is unthinkable, vitamins if not consumed. It is interesting that even schemes are given on which day of the cycle to drink vitamin C, on which - E, A, etc. Evidence-based medicine does not support these experiments. Also, the intake of complex vitamins will not provoke the maturation of the egg.

Here are the basic things to know about ovulation induction. modern medicine has every opportunity to give the joy of motherhood to almost every woman. Don't miss your chance!

Ovulation induction is called stimulation artificial method the process of egg maturation. It is carried out with medications that accelerate the growth of female cells. The whole process is controlled by ultrasound to avoid negative factors.

With the induction of ovulation, one egg can develop or several at the same time, which is also called superovulation stimulation. It is usually carried out during in vitro fertilization or insemination.

Ovulation is stimulated in polycystic ovaries or in violation of the ovulatory process, which is repetitive - chronic anovulation.

If a woman cannot get pregnant for 10–12 months with regular unprotected intercourse, this is already a reason to see a doctor for an examination. In this case, she may be prescribed ovulation induction if there are no other serious pathologies that interfere with conception.

Reasons for not ovulating

Ovulation is a monthly process in the body that is necessary for the conception of a child. Its absence or improper development leads to the fact that pregnancy becomes impossible.

Many factors influence the ovulation process. Most often, they are all “subject to” hormonal imbalance. We list the main causes of anovulation:

• Inflammatory and infectious diseases pelvic organs;
• Insufficient body weight (less than 48 kg), due to which the production of female sex hormones is limited or stops;
• Stress;
• Excess weight;
• Pathological changes in the thyroid gland;
• Prolonged use of hormonal contraceptives;
• Constant physical activity;
• Frequent use of synthetic additives in food.

If the causes of changes in natural processes in the female body lie in external factors, then it is enough to eliminate them and the menstrual cycle and ovulation will return to normal. Disorders caused by hormonal imbalances require treatment with medications.

1. Unstable hormonal background as a result of stress, taking hormonal contraceptives. Usually, the restoration and normalization of the functions of the sexual and reproductive systems of a woman can take from 1 to 3 months.
2. Excessive heavy sports, intense pace of life, stress and unstable psycho-emotional state.
3. Anorexia and excessive dieting.
4. Physical defects of the genital organs of a woman and dysfunction of the ovaries.

Due to various circumstances, eggs do not ripen in the female body.

Lack of ovulation can be caused by such factors:

• hormonal imbalance (for example, long-term use of contraceptives). It takes time for the body to be able to restore its functions. Sometimes it takes months;
• physical activity, passion for sports;
• illness;
• light weight (less than 50 kg);
• gynecological diseases.

The main types of stimulation

After passing all the tests and a complete examination of the couple, the doctor offers one of the types of treatment.

In the first option, a woman is prescribed soft drugs to activate correct operation ovaries. The second type of stimulation involves the use of more powerful drugs and is indicated if the previous treatment could not help in the problem of infertility. The combined treatment option involves the use of medications from the first and second regimens.

Ovulation after ovarian stimulation with medication gives a better chance of conceiving naturally without resorting to IVF.

Clostilbegit for conceiving a child

Clostilbegit is another pharmaceutical preparation, the purpose of which is to stimulate and, accordingly, conceive a child. Despite the fact that the active ingredient in this drug is clomiphene, Klostilbegit differs from the previous drug. The principle of action of this remedy is similar to Clomiphene. But, in addition to activating the production of pituitary hormones, it affects another hormone - prolactin, which is responsible for the presence of milk in the breast.

These tablets should be taken once a day from the fifth to the ninth day of the cycle. The starting point is the beginning of menstruation. If the attempt to get pregnant is not successful, then during the second cycle, the doctor may recommend an increase in the dose of the drug. It should be remembered that drinking this remedy is often impossible.

The use of Clostilbegit more than 5 times during a lifetime is prohibited, which is associated with negative influence substances on the work of the ovaries (the substance can cause their depletion). During the course of treatment with Klostilbegit, it is necessary to control the endometrium, because a thin endometrium can be the cause of pregnancy loss.

Stimulation of the ovaries for pregnancy planning folk remedies

Any drug therapy is not a magic wand, but a serious intervention in the body with its consequences.

Effects of stimulation:

• Exacerbation of diseases of the gastrointestinal tract.
• The occurrence of depression.
• The occurrence of blood clots due to thickening of the blood.
• Ovarian hyperstimulation syndrome, which is expressed in impaired renal function, rupture of an ovarian cyst.
• Weight gain.
• Ectopic pregnancy.
• Ovarian exhaustion (premature menopause).
• Hormonal disorders.

Stimulation does not guarantee pregnancy. If there is no result, you need to conduct a deeper examination of the body and identify the causes of the failure.

The absence of ovulation, as the only cause of infertility, is often genetically determined and cannot be treated. Therefore, the activation of the process does not bring results.

Often a woman manages to get pregnant a few months after stimulation, when the body "wakes up" and began to produce eggs on its own.

Sometimes problems with ovulation are associated with long-term use of birth control pills.

If a woman needed stimulation of the ovulatory process for conception, then her further pregnancy proceeds under constant control - frequent examinations are carried out, more tests are prescribed for hormone levels, and so on.

Different drugs affect the future course of pregnancy in different ways. Some of them lead to the HSS syndrome, while others can cause self-abortion, fetal hypoxia, and so on. Therefore, a visit to the gynecologist after artificial stimulation of the ovaries during pregnancy is mandatory.

What methods can be used for stimulation, so as not to resort to the help of doctors? Here are some recipes.

• Sage. This herb should be brewed and drunk instead of regular tea from days 5 to 15 of the cycle. Sage is known to suppress prolactin, which often prevents pregnancy.
• Roses and plantain. The dried fruits of these plants are poured with boiling water in the same proportion. Next, you need to let the broth brew and strain it. Take the composition immediately after the end of menstruation until the middle of the cycle.

It should be noted that despite many positive reviews, such therapy is not carried out during the period of preparation for in vitro fertilization.

Medications and regimens

Often you have to resort to medical treatment. The regimen and specific drugs must be prescribed by the attending physician.

In no case do not self-medicate and follow all the doctor's instructions!

Clostilbegit (tablets)

Clostilbegit (clomiphene) is a drug that increases the level of gonadotropins: FSH, LH, prolactin.

Interesting! Initially, the remedy was used to protect against unwanted pregnancy, but its opposite effect was found.

After using the drug, there is a high probability of multiple pregnancy. The body reacts especially violently with polycystic ovaries.

The drug is available in the form of tablets. Begin treatment on the 5th day of the cycle and continue until the 9th day. After 10 days, control ultrasound is performed to check the degree of maturation of the follicles.

When the follicles grow to 20-25 mm, an injection of hCG (chorionic gonadotropin) is given so that the process does not regress. The ovulation process begins 2-3 days after the introduction of the hormone. At this time, the necessary daily sexual intercourse.

After ovulation, the corpus luteum remains. To help him synthesize progesterone, hormonal drugs are prescribed: Duphaston and Utrozhestan.

Clomiphene has an antiestrogenic effect and can interfere with spermatozoa by changing cervical mucus. To prevent this from happening, use estrogen-boosting agents: Proginova, Microfollin.

If there was no progress in the first cycle, this is an indication to increase the dosage for the next month. The absence of a result for 3 months is regarded as a decrease in sensitivity to Clostilbegit. Then they switch to hormones.

Usually stimulation with clomiphene does not work in patients with:

• Overweight.
• Increased blood pressure.
• Swelling due to impaired renal function.

Contraindications for use:

• Ovarian cyst.
• Renal failure.
• Malignant tumors.
• Bleeding of unknown origin.
• Hypersensitivity to the components of the remedy.

Treatment with the drug can cause side effects:

• Headaches, dizziness.
• Depression, insomnia.
• Tides.
• Pain in the lower abdomen.

Rarely, the size of the ovaries increases, which returns to normal after discontinuation of the drug.

Long-term use (more than 5 times) provokes the onset of early menopause, therefore it is prohibited. If the patient is trying to conceive through IVF, a donor egg will have to be used. Also, the drug has a negative effect on the growth of the endometrium and is contraindicated in the initially thin endometrial layer.

Drug Gonalom

Gonal-F is the most powerful ovulatory stimulant. Its active substance - Follitropin alfa - is similar in its action to the pituitary follicle-stimulating hormone (FSH). It is prescribed in the absence of effect from other drugs.

Available in a syringe pen, so it is convenient to use. Start taking the first week of the cycle and continue for 14 days. The dosage is selected by the doctor, depending on the characteristics of the patient. If the planned pregnancy has not occurred, then take a week break and repeat the course.

This tool has a significant number of side effects:

• Headache, nausea, vomiting.
• Formation of a cyst on the ovary.
• Syndrome of hyperstimulation.
• Ectopic pregnancy.
• Miscarriage of pregnancy.
• Tumors of the mammary gland.
• Thrombus formation.

Hormones

If there are no results of treatment with clomiphene, then stimulation with gonadotropins is indicated. These hormones are produced in the anterior part of the pituitary gland, stimulate the growth of the follicle. They also produce multiple follicles necessary for artificial insemination.

Gonadotropin preparations: Menogon, Furegon. Means are administered intramuscularly. Treatment starts on day 2-3 of the cycle to mimic the natural process of follicle maturation.

Ultrasound control is required on days 6-7, 10-11, 13-16. Perhaps more frequent conduction to detect the difficulty of the process: uneven growth of follicles, late maturation. These problems can be solved with timely detection.

These hormonal drugs have a powerful effect, cause multiple side effects:

• Headache.
• Weakness.
• Nausea.
• Temperature increase.
• Rupture of an ovarian cyst.
• Enlargement of the ovaries.
• Thrombus formation.
• Stomach ache.
• Ectopic pregnancy.

Taking drugs is carried out under the strict supervision of a doctor, given the negative impact of drugs on the body.

However, hormone treatment gives good results, pregnancy occurs in 60%.

HCG injection

HCG - human chorionic gonadotropin. When stimulated, an hCG injection is given at the moment the desired size of the follicle is reached in order to provoke its rupture. The drug is produced in the form of a powder, which is diluted with a solution for injection.

A woman can make an injection on her own. Sometimes after the injection, the follicle does not break, but continues to grow and turn into a cyst.

The use of hCG gives false positive results pregnancy tests for 12-14 days, so you need to control the growth of the hormone in dynamics.

Duphaston

Duphaston is a synthetic analogue of progesterone. It promotes conception and helps the embryo to gain a foothold in the uterus.

Stimulation with Duphaston is carried out in the second phase of the cycle, when the follicle has ruptured. The beginning of the reception falls on the 16th day and continues until the doctor is convinced of the onset of pregnancy.

Further reception is possible for medical reasons, if there is a threat of miscarriage. Cancel the drug when the level of progesterone returns to normal.

Usually the drug is well tolerated and does not cause serious side effects.

When using drugs for stimulation, several medications can be prescribed that help the follicles to ripen and burst properly. Treatment in this case is prescribed hormonal, because due to the deficiencies of a certain hormone, the egg does not fully mature. The ovulation stimulation scheme for IVF also often involves the use of several drugs.

Clostilbegit (Clomiphene)

A drug that directly activates the ovaries. In essence, stimulation causes the body to produce a hormone directly in the pituitary gland of the brain, which causes the ovaries to work and promotes the maturation of follicles and the release of an egg. Stimulation of ovulation with Klostilbegit is considered the most effective and common.

Human Chorionic Gonadotropin (hCG)

A hormonal drug that helps to properly and safely develop pregnancy. The amount of gonadotropins affects the regulation of the genital organs. HCG can be used as in pure form, by injection, and in tablets: Gonal, Puregon and Menogon.

HCG injection

An injection of hCG when stimulating ovulation involves the use of several drugs of the hormone-containing group. Most often appoint Pregnil. This drug promotes the release of the egg from the follicle. The drug has a mild effect on ovulation, and the injection allows you to activate the natural work of the ovaries.

Progesterone and estrogen preparations

Such medications are prescribed to increase the level of progesterone, a hormone that is responsible for attaching the embryo to the mucous layer of the uterus. As in the case of chorionic gonadotropin, progesterone can be injected in its pure form or drugs can be used in tablets that contain the required dose of the hormone.

Proginov tablets contain estrogen, and it improves blood circulation and protects the pregnancy from miscarriage. Do not confuse Proginov tablets with Cyclo-Proginov dragees. The drugs are similar in composition, but they should not be used on their own.

Cyclo-Progynova is a biphasic drug that contains two hormones: estrogen and a derivative of progesterone. It is usually prescribed if there is no menstruation (in menopause). In the blister when buying a medication, you can see tablets of two colors. Duphaston is prescribed in the absence of ovulation or incomplete maturation of the egg.

Ovulation inducing drugs can be used in combination. Medications with progesterone and estrogen are best taken together so that there is no hormonal failure.

And so drugs stimulating ovulation, usually allows you to get the desired result in 3-5 months. The doctor prescribes medicines, adjusts dosages and determines the interaction with other medicines, makes adjustments to the usual lifestyle and nutrition.

All funds are assigned to individually and depending on the identified pathology, the state of health of the woman, age, individual intolerance. The treatment regimen is drawn up after a series of mandatory examinations: blood test, smear, ultrasound.

Self-medication in the absence of ovulation is prohibited. Medication may cause side effects and cause dangerous consequences. With an incorrectly selected dosage, pregnancy will not occur, the clinical picture will only worsen.

Before prescribing a medical procedure, the spouses are sent for examinations. It is necessary so that the doctor can correctly draw up the procedure for treating drugs. Clostilbegit tablets are often prescribed to stimulate ovulation, the scheme for each patient is individual.

When can I use ovulation induction pills?

There are several ways to stimulate the ovaries. The most popular of them:

• Decoctions of medicinal herbs;
• Mud treatment;
• Acupuncture;
• Physiotherapy.

However, with serious hormonal disruptions gynecologists recommend taking pills that stimulate ovulation. The choice of the drug and the scheme of its administration is a responsible task. The weight, height, age and health characteristics of the woman are taken into account. Therefore, only an experienced gynecologist should deal with this issue. Independent appointments in this case are not allowed.

All drugs to stimulate ovulation are divided into two groups:

• Indirect inducers (drugs that "help" follicles form and grow)
• Triggers (simulate the release of LH, which contributes to the maturation of the egg).

Consider the most famous drugs to stimulate the ovaries and the features of their effect on the body.

"Klostilbegit" ("Clomiphene citrate")

"Klostilbegit" is a remedy that is well known to women as a stimulant of the ovulation process. It helps to form and grow full-fledged follicles. The drug stimulates the production of hormones necessary for ovulation:

• Follicle-stimulating;
• Gonadotropins;
• luteinizing.

Release form - tablets.

Let us give an example of one of the schemes for the use of the drug.

If menstruation occurs regularly, then treatment with "Klostilbegit" is started on the 5th day from the beginning of the cycle. Starting from that day, the woman takes medicine every day for five days. This scheme assumes that ovulation after stimulation will occur in the period from 11 to 15 days of the menstrual cycle. There are cases when, after treatment, it was not possible to achieve a result (ovulation did not occur). Then next month the drug is drunk according to the same scheme, but in an increased dosage.

If both schemes have not brought results, the reception of "Klostilbegit" is stopped. 3 months after the first course, you can conduct a second one. It is important to consider that the total dosage of the drug for 1 course should not exceed 750 mg.

The medicine has a number of side effects:

• Nausea, often turning into vomiting;
• Flatulence;
• Drowsiness;
• Headache;
• Reduced rate of mental reaction;
• Depression;
• Violation of the quality of sleep;
• Loss of appetite;
• Pain in the lower abdomen;
• Unpleasant sensations in the chest;
• A slight increase in body weight;
• Allocations white color from the vagina.

During the reception of "Klostilbegit" you need to give up driving and work that is associated with an increased concentration of attention. The drug, designed to stimulate follicular growth, increases the risk of multiple pregnancies.

Letrozole (Femara)

Stimulation with Letrozole has been used relatively recently. Previously, it was used as part of the complex treatment of breast cancer or postmenopausal changes in a woman's body. Now "Letrozole" when stimulating ovulation is prescribed as an alternative to "Klostilbegit" when it is ineffective. Also, "Femara" is indicated for use when there are contraindications to taking "Klostilbegit".

Release form - tablets of 2.5 mg.

The drug improves the condition of the endometrium and the ability of the ovaries to “feel” the follicle-stimulating hormone. Such possibilities of the drug allow you to reduce the dosage during treatment with follicle-stimulating hormone by three times. Therefore, they are often used in combination. Moreover, using Letrozole for stimulation, patients note the minimum number of side effects, the manifestation of which is mild.

The drug is started on the third day of the menstrual cycle. Treatment should not exceed five days. The dosage is selected by the doctor individually for each woman.

Gonadotropins

Gonadotropins are the means of controlled induction of the second line. They are used intramuscularly or subcutaneously.

The first scheme is a daily slow increase in the dosage of the drug.

If after a week an adequate ovarian response to treatment is noted, the dose is stopped increasing, leaving it unchanged in the following cycles. If the ovaries do not respond to taking the drug, the next cycle is started with a dosage increased by half the previous one. This scheme is considered the most acceptable for polycystic ovaries. Thus, the required dosage is gradually selected. Side effects most likely will not occur.

The second scheme is a daily slow decrease in dosage.

Treatment begins with very high dosages, gradually reducing them. This scheme is shown to women with the following pathologies:

• Low ovulation reserve;
• Small volume of ovaries;
• amenorrhea;
• Surgical intervention on the ovaries in history.

Gonadotropins include two drugs: Gonal and Puregon.

Stimulation of ovulation by "Gonal" takes place in the first half of the menstrual cycle. The main component of the drug is a hormone derived from the germ cells of Chinese hamsters. It must be injected under the skin. To make it easier for the patient to give an injection, the medicine is placed in a special syringe pen.

"Gonal" is assigned if the use of "Klostilbegit" has not brought results. Like its predecessor, the drug causes many side effects:

• Dizziness;
• Lack of appetite;
• Violation of the quality of sleep;
• Dryness of the vagina;
• lethargy;
• diarrhea
• Acne rash.

Treatment begins at the beginning of the cycle. Its duration is from 10 to 14 days.

Puregon stimulation also "prepares" mature follicles at the beginning of the menstrual cycle. Release form:

• Powder for the preparation of an injection solution;
• Ready solution for injection;
• Solution for subcutaneous administration in a capsule.

The drug can be used subcutaneously and intramuscularly. The main component is also synthesized from Chinese hamster FSH. With its help, the female ovaries begin to actively produce follicles necessary for conception. Treatment is carried out from the 2nd day of the cycle. Its duration depends on the response of the ovaries: from 7 to 14 days.

"Menogon" and "Menopur"

"Menogon" and "Menopur" belong to the category of drugs made from human menopausal gonadotropins. Stimulation of ovulation by "Menopur" helps not only to "grow" the follicles, but also "control" how they mature (due to the activation of estrogens). The drug can also be used by men to increase the production of testosterone. This hormone is essential for successful fertilization.

Both drugs have a large list of contraindications. The dosage is selected individually, taking into account the condition of the patient. The entire course is conducted by ultrasound monitoring of the condition of the ovaries.

"Proginova"

The drug "Proginova" for ovulation is used as an addition to the powerful effects of "Klostilbegit". Estrogen is the main component of Proginov. It helps to "soften" the effect of clomiphene citrate after ovulation has occurred.

The treatment regimen is as follows:

• On the fifth day of the menstrual cycle, "Klostilbegit" is prescribed;
• The medicine is taken until the ultrasound diagnosis confirms that the follicles have reached 20-25 mm;
• They make an injection of hCG, which is needed for the “successful” extraction of eggs from the follicles;
• After 2-3 days, ovulation occurs;
• Appoint "Proginov".

The main task of the drug containing estrogen is to prevent ovarian exhaustion.

HCG to stimulate ovulation is used at the final stage of "help" to the ovaries. It is synthesized from the urine of pregnant women, since at the initial stage of pregnancy the body produces it in large quantities: it is necessary for the normal development of pregnancy.

An injection of hCG to stimulate ovulation is needed in order to ensure the release of the egg from the follicle. The hormone helps the follicle to transform into a corpus luteum. Which is vital for the conceived embryo. Before the baby has a placenta, it will provide him with everything he needs.

Therefore, an injection of hCG can be administered 3 times a week until the end of the menstrual cycle. Such treatment will help support the functioning of the corpus luteum, that is, the onset of pregnancy.

vitamins

Vitamins for ovulation are as important as the concentration of the right hormones. They are prescribed individually or in combination to all couples who want to conceive a child. If ovulation stimulation is planned, vitamins are prescribed 1-2 months before the start hormonal treatment. They continue to be taken during and after therapy.

For conception, the body of a woman needs the following vitamins:

• Vitamin D. Needed for the production of female sex hormones;
• Vitamin A. With its help, a follicle is formed and the composition of cervical mucus is restored;
• Vitamin E. Without it, the egg will not be able to fully mature in order to leave the follicle;
• Vitamin C. Promotes optimal blood flow throughout the body, which allows you to "carry" the useful substances they need to the ovaries.

Folic acid is especially important for ovulation. It "helps" to increase the duration of the luteal phase of the menstrual cycle, increasing the viability of the egg.

Drug Gonalom

Hormones

HCG injection

Duphaston

Before starting treatment, the doctor must necessarily warn the patient that such an intervention is undesirable to carry out more than 5-6 times in a lifetime.

• Firstly, the more stimulation is done, the more the woman's ovarian reserve is depleted, which cannot be replenished.
• Secondly, the stimulation of ovulation deals a strong blow to the endocrine system and can cause oncological diseases after 40 years.

Clomiphene citrate

Traditionally, most of the procedures aimed at ensuring that the ovaries intensively produce follicles are performed using preparations with the main active ingredient Clomiphene (most often Clostilbegit). Stimulation of ovulation with Clostilbegit and the subsequent hCG angle in most cases lead to the formation of several eggs.

1. In order to contribute to the effective process of ovulation, a woman must take care of replenishing the deficiency of vitamins and trace elements, which can provide a regular and proper diet. The use of a sufficient amount of folic acid will contribute to the proper development of the fetus and will minimize the likelihood of intrauterine pathologies.
2. As a rule, any artificial intervention in the natural processes of the body is fraught with negative consequences. Therefore, to stimulate ovulation, even after birth control pills, it is necessary to be extremely careful and under the vigilant supervision of a professional. Proper selection of the drug and its dosage directly depend on the individual characteristics of the female body and are calculated in accordance with the indications of the regular formation of fertile eggs.
3. The reason for the lack of ovulation is paramount in choosing the method of artificial stimulation. Before prescribing a “treatment”, it is necessary to accurately determine the cause of the absence of a natural pregnancy. Otherwise, ovulation pills are unlikely to give the desired effect.
4. It is a mistake to believe that you can take a graph of the basal temperature of the current cycle as a schedule for taking ovulation pills. The schedule for monitoring the level of basal temperature and its fixation should last at least 2 to 3 months continuously before planning the drug. Otherwise, the uncontrolled or improper use of ovulation pills can cause irreparable damage to the female body. Therefore, hormone tests should be carried out regularly until the cause and problem of conception is established.
5. If the tests show a lack of thyroid hormones or prolactin, then there is no need to take pills to stimulate ovulation. The natural normalization of the content of these hormones in a woman's body can lead to successful conception without the use of special drugs.

1. Taking Klostilbegit as a conception pill usually starts on the 4th - 5th day of the cycle and ends on the 9th - 10th.
2. Puregon or Menogon tablets are taken from the 2nd day of bleeding and last about 7 to 9 days. The timing and dosage of the drugs are prescribed by the gynecologist based on the condition of the woman and the course of the ovulation stimulation process.
3. Regardless of the drug, the doctor can create an individual stimulation schedule at the initial or subsequent stages, based on the state of the internal genital organs at the initial stage and during the stimulation process.
4. A visit to the ultrasound and taking the drug is carried out until the follicles reach a size of 16 - 25 mm. This stage is dangerous by the process of regression with the subsequent formation of follicular cysts. It is at this moment that an injection of hCG is prescribed to activate ovulation directly.
5. In a normal course, after the injection, ovulation occurs. Depending on the body, the period ranges from 24 to 36 hours.
6. The ovulation confirmation phase ends with an ultrasound examination and a cycle of progesterone hormone injections to support the ovarian corpus luteum.
7. Based on the characteristics of the male half of the couple, the gynecologist prescribes a schedule of sexual intercourse and the frequency of insemination. If the sperm quality is sufficient, then after a dose of hCG, sexual intercourse will be sufficient with regularity every other day until the last day of the end of ovulation - until the formation of the corpus luteum.
8. After three unsuccessful attempts to ovulate with the use of one drug, it is recommended to take a break and change pills.

Procedure procedure

The stimulation of ovulation itself consists in taking hormonal drugs, which are selected individually and prescribed according to a special scheme (it is called a protocol). Hospitalization of the patient is usually not carried out. The effectiveness of the procedure is monitored according to ultrasonic folliculometry.

Preparations for stimulation

There are several main groups of hormonal drugs that stimulate ovulation.

It should be noted right away that stimulation is not an easy procedure that must be done once. This is a set of procedures for which you will need to pay extra. So, besides the procedure itself, you will additionally need to pay:

• diagnosis at the initial stages of treatment;
• consultations of various doctors (geneticists, endocrinologists and others);
• additional treatment that is intended for fertilization (removal of polyps on the uterus, physiotherapy).

The average cost of this procedure in Moscow will cost 15 thousand rubles. In other cities, prices will be slightly lower, but you should definitely take into account the complex of additional ones that you need to go through to get a successful result.

Many women who are faced with the problem of conception know what ovarian stimulation is for pregnancy planning. However, there are also representatives of the weaker sex who hear about this manipulation for the first time. What is it?

Stimulation is the effect on the female genital organs, in particular, on the ovaries, with medications. During the procedure, there is an increase in the release of certain hormones by the pituitary gland. Thus, the doctor can correct the condition of the woman in the direction he needs. Preparations for stimulation - a great variety. Not all of them are used for every woman. Choosing a list of medicines is the prerogative of the doctor. However, this should be done only after the diagnosis.

Stimulation of the ovaries for pregnancy planning is always performed during in vitro fertilization. This condition is mandatory even when a woman has a stable cycle and regular maturation of follicles.

Another indication for manipulation is the absence of ovulation in a woman for six consecutive cycles. It is worth recalling that such a situation completely deprives a woman of fertility.

An indication for ovarian stimulation is the desire of a couple to conceive two or more children at once. If the representative of the weaker sex is in such a situation that she needs to remove the ovaries, then the procedure is carried out in order to freeze the cells for their further fertilization.

How to stimulate the ovaries for pregnancy planning? First, a woman needs to be examined. The most important of all diagnostic manipulations is ultrasonography. During the procedure, the specialist examines the ovaries, determines their size and the presence of dominant follicles. The state of the endometrium is also established.

Stimulation of the ovaries involves the use of hormonal agents. Depending on the condition of the woman and her preferences, the preparations may be in the form of capsules for oral use and solutions. The latter are administered intramuscularly, intravenously or subcutaneously. Stimulation is usually carried out from the second or fifth day of the cycle.

How to stimulate ovulation at home

On some women folk methods have no effect at all. If the endocrine system is more sensitive, then herbal preparations can contribute to the maturation of one, maximum two eggs.

Sage is a phytoestrogen, so it should only be taken in the first phase of the cycle. It stimulates the ovaries to produce follicles and also promotes the accelerated growth of the dominant follicle. Brew two tablespoons of raw materials with a glass of boiling water.

Insist for an hour, strain and drink half a glass in the morning and evening until ovulation occurs.

sporysh

Knotweed grass not only stimulates the maturation of the follicle, but also improves the quality of sperm, so when planning conception, both partners can use an infusion of this herb. Brew two teaspoons of raw materials with half a glass of boiling water and leave for 4 hours, and then strain. Take 3 tablespoons three times a day, starting from the 5th day of the menstrual cycle and until the moment of ovulation.

If the maturation of several eggs is necessary for IVF, then it is better not to take risks and instead of folk remedies, drink pills to stimulate ovulation prescribed by a doctor.

• diets;
• herbal preparations;
• aromatherapy;
• massages;
• mud therapy;
• the use of certain vitamins;
• acupuncture and more.

For effectiveness, you can combine them, but all of them must be performed under the strict supervision of a gynecologist, as they can lead to complications.

You can restore ovulation with folk remedies only if there is no serious illnesses female reproductive system. Therefore, before starting treatment, it is necessary to undergo a diagnosis. The use of products and all actions that stimulate ovulation must be coordinated with the doctor. Perhaps, in some cases, it will not be enough to carry out such types of therapy, and they will have to be combined with drug treatment.

Below are the most effective methods most commonly used by women in violation of the ovulatory process.

Sage to stimulate ovulation

Sage contains phytoestrogen components that contribute to the accelerated maturation of eggs and the formation of the endometrium. So the stimulation of ovulation with a decoction of sage is often used as an additional method of natural restoration of the female body.

To prepare the infusion take 1 tbsp. a spoonful of dry chopped grass, pour one glass of boiling water and leave for 30 minutes. Take the medicine 1/4 cup a day, or 1 tbsp. spoon three times a day. You should start drinking sage from the 5th day of the cycle for 10-14 days. Then the reception is stopped until the next cycle. So repeat the treatment 3-4 times or until pregnancy.

If you add linden blossom to sage, this will greatly enhance the effect, since linden also has estrogen-like phytoharmones.

Mud to stimulate ovulation

If there is not enough female hormones in the body for natural conception, then mud therapy will help restore the hormonal background. This method is available and has no side effects. But with polycystic ovaries, endometriosis and oncology, it is not recommended to use it.

Healing mud treatment can be carried out independently. To do this, you need to buy a tube with this remedy at the pharmacy, heat the mud to the specified temperature and apply it to the skin in the ovarian area. Wash off after 20-30 minutes. The procedure should be done every other day.

If possible, you can visit a sanatorium in the city of Saki or any other that specializes in mud treatment.

acupuncture to induce ovulation

Another way to speed up ovulation is acupuncture. But for this you need to find a specialist who knows how to treat infertility. This procedure cannot be carried out on your own.

This method works by influencing acupuncture points restoring the functioning of the body. Despite the controversial attitude of medicine to acupuncture, the technique has repeatedly given positive results in the treatment of women's problems.

Taking vitamins

One of the reasons for the failure of the hormonal system may be a lack of vitamins and minerals necessary for the proper functioning of the body. In this case, taking vitamins will help to establish the process of stimulating ovulation.

The main "female" vitamin is folic acid. Without it, even bearing a healthy child is impossible. Therefore, you should enrich your diet with vitamin B9. But other B vitamins are also useful for normalizing the functions of the reproductive organs.

The second most important element is potassium iodite, which can be easily replenished by consuming iodized salt.

Vitamins such as A, E and C are always useful for a woman. You can take them separately, but it is better to buy a special fortified complex for pregnant women, which will include all the vitamins and trace elements necessary for the health of the body.

But do not get carried away with pharmaceutical vitamins alone. Eating more vegetables, fruits and greens is beneficial for the ovulatory process.

Before you stimulate ovulation even at home, you need to undergo an examination and consult a doctor. Based on the diagnosis, the specialist selects the method of ovarian stimulation.

If the medical indications are good, you can carry out the procedure yourself, but the doctor's supervision must be mandatory, otherwise the wrong action may provoke a rupture of the ovary or cause its early exhaustion.

You can stimulate the ovulatory process at home using the following methods:

1. Aromatherapy. Essential oils such as anise, sage, pink geranium, basil, cypress, lavender have a beneficial effect on the maturation of the egg. It is enough to add 3-5 drops to the water when taking a bath.
2. Herbal teas. The course is divided into three parts. First, sage is brewed to stimulate the formation of follicles. Then take the color of elderberry, which contributes to the maturation of the egg. And at the final stage, they drink rosemary and plantain tea, which leads to the release of the oocyte from the follicle.
3. Diet. It includes legumes, grains and dairy products, as well as seeds, fresh fruits and vegetables, except for those that contribute to gas formation.

There are other drugs that are responsible for stimulating ovulation: a decoction with big amount vitamin E, prepared from rose petals, aloe juice and quince. Do not forget about the vitamins necessary for the expectant mother: folic acid, potassium iodide and others. It must be taken into account that folk remedies may be more effective and beneficial, but their side effects are less studied.

1. folk methods.
2. Taking medication.

Let's consider both options. So, let's start with the fact that many couples make a mutual decision to start stimulation in a soft or natural way, that is, to be treated with folk remedies and not resort to taking medicines. On the one hand, this is good. It doesn’t matter what the woman’s age is, only one thing is important - the load on the body will not be so significant.

Herbs for ovulation

Stimulation of egg maturation is performed using natural medicinal tinctures and herbal decoctions. List medicinal plants is: sage, red brush and upland uterus. Phytopreparations are sold in any pharmacy, the cost is low, so the treatment will be available to everyone.

How to speed up ovulation:

1. Sage. It contains a lot of estrogen. It is necessary to take sage according to all the rules so as not to harm the body. We make a decoction like this: take 1 tbsp. pharmaceutical dry grass, pour 250 ml of boiling water, close the lid and leave for half an hour. Then we filter medicinal tincture and take it according to this scheme: 10 days for ¼ cup 1 time per day, start taking it from the 1st phase of the cycle on the 5th, maximum 7th day, drink 3 months in a row. You can enhance the effect and add dry linden to the sage. Raw materials are taken in equal proportions. The decoction accelerates the maturation of the egg and the growth of the endometrium (favorable conditions for conception). Attention! It is forbidden to take sage for polycystic.
2. From the 2nd half of the cycle, you can start taking the boron uterus. The herb contains the main hormone progesterone, which is necessary for early term pregnancy. During fertilization, the egg may die if the body does not have enough of this hormone. A decoction is prepared in the same way, 1 tbsp is taken. in a day.
3. The grass of the upland uterus goes well with the red brush, it successfully treats female diseases.

There are other popular methods of ovulation stimulation. For example, a romantic method of treatment is to drink tea from rose petals. The petals contain a large amount of vitamin E, which has a positive effect on the female body.

You can also combine the intake of medicinal herbs with aloe juice, a popular drug for thousands of diseases "Mumiye" and even eating ordinary quince. The list will continue with a decoction of plantain, rosemary, elderberry flowers. When ovulation has taken place, the medication is continued.

Mud for stimulation

Along with taking herbal decoctions, you can try such a method of treatment as the use of therapeutic mud. Doctors recommend that a woman go to the popular resort of Saki, which has many sanatoriums specializing specifically in the treatment of women's diseases.

Treatment scheme: warm mud, as an independent component or in combination with kelp, is smeared on the abdomen for 20 minutes, then washed off with water. This treatment is used every other day until ovulation occurs. To improve the effect, tampons with mud are inserted into the vagina for 20 minutes.

It is prohibited to stimulate ovulation in case of polycystosis, neoplasms of any nature and endometriosis.

Acupuncture for stimulation

Have you found a professional? Great, then, take a course of acupuncture. Only before you lie down on the couch and trust the specialist, it is necessary to clearly explain the purpose of the treatment. With the help of acupuncture, it is possible to influence the dormant parts of the body and thus “reach out” and start the work of the organs, having achieved the stabilization of the cycle.

Contraindications

Stimulation of ovulation is a serious procedure when potent hormonal drugs are taken. Therefore, examination before stimulation is an obligatory stage of preparation for treatment. Such precautions are essential. After all, infertility can have other causes. For example, obstruction of the fallopian tubes.

Before stimulating ovulation, the doctor prescribes the following studies:

• Collection of information about the reproductive health of a woman (age, presence or absence of pregnancy in the past, identified pathologies of the reproductive system, etc.);
• Check for patency of the fallopian tubes;
• Ultrasound diagnostics, with the help of which the presence of inflammatory processes, the condition of the ovaries and appendages are determined;
• Blood tests that determine the correct ratio of female sex hormones;
• Diagnosis of the functioning of the thyroid gland, since it is directly related to the "distribution" of hormones in the female body;
• Checking the quality of the partner's seminal fluid (spermogram);
• A test that determines the compatibility of partners.

Ovarian stimulation for pregnancy planning is not performed in such cases:

• Inflammatory processes in the organs of the reproductive and urinary systems;
• Obstruction of the fallopian tubes;
• Menopause;
• The period before menopause;
• Low sperm motility in a partner.

Indications for the procedure - the absence of ovulation or problems in the endocrine system.

Especially relevant is the stimulation of ovulation in polycystic ovaries. This is the name of the pathology, during which the natural structure and work of the ovaries is disturbed. Many small formations of cysts develop on their body, which prevent the egg from maturing. Such violations occur under the influence of a failure in the hormonal system.

Another serious obstacle to conception is multifollicular ovaries. Follicles are not able to "grow" a full-fledged egg. With multifollicular ovaries, ovulation stimulation is a prerequisite, because without it, pregnancy will not occur. Stimulation will also help women who have metabolic disorders: with obesity or underweight.

Stimulation of the ovaries for pregnancy planning is not carried out with polycystic disease. In other words, if your reproductive organs produce several dominant follicles every month that do not rupture, then the procedure can only make the situation worse. In this case, select individual approach to each patient. Sometimes surgery is also required.

Ovarian stimulation is not carried out to plan pregnancy with menopause. Theoretically, while in menopause, a woman can conceive a child with the help of certain hormonal drugs. However, most experts consider such an act frivolous. Indeed, with the age of a woman, the risk of having a child with abnormalities increases.

Carrying out procedures is contraindicated if the representative of the weaker sex has an increased sensitivity to the selected medications. Also, a woman's ovaries are not stimulated if her partner has fertility problems. In such a situation, it is necessary to find a good specialist and first restore the fertility of a man.

Stimulation is not carried out in the presence of problems with the endometrium. After all, even if fertilization occurs, the embryo simply cannot attach itself to the wall of the reproductive organ.

Negative effects of ovulation stimulation

It is possible to stimulate ovulation with the help of hormonal drugs only after a thorough examination and under the supervision of a doctor. All medicines are potent, so side effects occur during treatment.

Also, after ovulation stimulation, dangerous complications can occur:

• hyperstimulation;
• cysts on the ovaries;
• Rapid weight gain;
• Hormonal imbalance.

If a woman has not been examined, stimulation will be harmful to her, since dangerous side effects most often occur due to insufficiently thorough diagnosis before the procedure.

If follicles do not grow during stimulation, then this is not a reason to despair. According to the observations of doctors, the second attempt to "help" the ovaries is always more effective. In the case when stimulation did not help to become pregnant, a woman is recommended to turn to the help of reproductive technologies.

If the girl agreed to the procedure for increasing ovulation, then you need to remember that negative consequences may occur after it. The main of these consequences after the stimulation of ovulation is the depletion of the ovaries. But it can only occur if the patient long time takes drugs.

There may also be other consequences:

• the appearance of problems with weight;
• the occurrence of problems of the gastrointestinal tract;
• ovarian rupture;
• hormonal problems.

Attention! It is worth noting that after stimulation, the child is born healthy in 100% of cases, since this procedure does not affect the condition of the fetus.

An alternative method of stimulation and reviews about it

Most gynecologists and reproductologists report that the use of folk remedies for stimulation can be dangerous. Few people manage to get the desired result from such an intervention. However, almost every representative of the weaker sex can expect complications.

Most women throughout stimulation folk recipes one drug is used. Whereas conventional manipulation involves a multi-phase change of drugs. Reviews of women about this technique are twofold. Some say that they managed to get pregnant, while others scold this principle of intervention.

How is the process of ovulation stimulation going?

Why and how is ovulation stimulation performed?

A large number of pathologies - chromosomal, endocrinological, gynecological and others - are accompanied by a lack of ovulation. As a result, a woman who may otherwise be completely healthy is unable to conceive. Stimulation of ovulation helps to solve the problem, which consists in the introduction of a certain hormonal drug, the dose and method of administration of which is carried out by the doctor.

The essence of the method

Ovulation stimulation is a method used to treat female infertility caused by ovulation disorders. It is based on the effect on the ovaries of a woman by analogues of those hormones that are normally produced in the female body. Their antagonists may also be used. The effectiveness of the stimulation method is 60-75%.

The purpose of the use of hormones is to artificially stimulate the maturation of eggs, if it is found that they are formed in the ovaries, their structure is not disturbed, only they do not fully mature. If the structure of the developing egg is disturbed, stimulation is not used.

The fact how effective the method will be in a given case will depend on:

• reasons for the lack of ovulation;
• woman's age;
• type of drug;
• the presence of other factors in her or her spouse that support infertility.

Indications for the procedure

Stimulation of ovulation is carried out in such cases:

1. Hormonal dysfunction that cannot be cured in any other way.
2. Inability to become pregnant within a year of regular sexual activity, in the absence of identified pathology in a woman and a man.
3. As preparation for artificial insemination methods - IVF and ICSI.
4. Low or, conversely, a high body mass index of a woman.
5. Polycystic ovaries.

What tests need to be done?

Preparation for stimulation

Before prescribing drugs, both spouses should be carefully examined. They donate blood to determine:

• antibodies to HIV;
• Treponema pallidum antigens (RW);
• markers of hepatitis B and C;
• crops from the genital tract in order to detect: trichomoniasis, candidiasis (thrush), PCR examination of smears for the genome of mycoplasma, gardnerella, ureaplasma.

Separately, a woman passes:

• smears from the cervical canal and vagina for purity and atypical cells;
• Ultrasound of the small pelvis;
• Ultrasound of the mammary glands;
• determination of antibodies to the TORCH-complex of microbes (rubella, toxoplasmosis, cytomegalovirus, chlamydia);
• examination by a therapist, ECG and other tests for the presence of common diseases that may be a contraindication to carrying a pregnancy;
• determination of the patency of the fallopian tubes using one of these methods: laparoscopy, X-ray examination of the uterus and tubes with contrast, ultrasound with contrast;
• blood levels of female sex hormones, prolactin, thyroid hormones, testosterone are determined several times; when their level changes, a correction is carried out;
• folliculometry is performed, which, to start ovulation stimulation, should show one of the following results:

1. no development of follicles in the ovaries;
2. the follicle develops, stopping in growth, not reaching the right sizes, no ovulation;
3. the dominant follicle develops, stops, not reaching the required size, there is no ovulation;
4. the dominant follicle grows to the desired size, but does not break, that is, ovulation does not occur.

Before stimulating ovulation, a man submits for analysis the sperm obtained after the absence of coitus for 3-5 days.

Assessment of ovarian reserve

After both spouses are examined, and the doctor concludes that nothing should prevent conception, and they do not suffer from such diseases in which there is a chance of having a sick child, the ovarian reserve is determined. This term refers to the estimated response of a woman's ovaries in response to ovulation stimulation: whether the procedure will cause the maturation of several eggs, or not. With the help of an assessment of the ovarian reserve, it is determined:

• does ovulation stimulation itself make sense;
• what should be the intensity of the procedure;
• the choice of the optimal stimulation protocol is made;
• preparations and their doses for this woman are selected.

This test is especially important for women over 35 and those who suffer from unexplained infertility.

How is ovarian reserve tested?

The doctor chooses one of the following methods for determining this indicator:

1. On the 2-3 day of the cycle, the level of such hormones in the blood is determined: follicle-stimulating (FSH), luteinizing (LH), estradiol. An increase in their concentration above normal during this period indicates that the response to stimulation will be poor.
2. After determining FSH on the 3rd day of the cycle, from 5 to 9 days, the woman is prescribed "Klostilbegit" at a dose of 100 mg per day. On day 10, blood is again given to the FSH level: its significant increase indicates that the ovaries are not ready for stimulation.
3. A test with stimulation with drugs that act in the same way as the substance produced in the hypothalamus - gonadotropin-releasing hormone (GnRH). At the same time, the level of estradiol in the blood is determined in a woman, then she receives an injection with a test dose of this drug, after which the same hormonal metabolite is again determined. The fact that a good response to stimulation is predicted is indicated by an increase in the concentration of estradiol.

Methodology

Procedure procedure

The stimulation of ovulation itself consists in taking hormonal drugs, which are selected individually and prescribed according to a special scheme (it is called a protocol). Hospitalization of the patient is usually not carried out. The effectiveness of the procedure is monitored according to ultrasonic folliculometry.

Preparations for stimulation

There are several main groups of hormonal drugs that stimulate ovulation.

Clomiphene (clostilbegit, clomid)

This is a drug whose action is to stimulate the production of gonadotropic hormones. It specifically binds to the receptors of the hypothalamus and pituitary gland, triggering the synthesis of sex hormones in these glands; in large doses inhibits their secretion. Has an antiestrogenic effect; does not stimulate the production of male sex hormones and progestogens. Can be used for dysfunctional uterine bleeding.

It should not be prescribed more than 5-6 times in a lifetime, as it leads to premature exhaustion of the ovaries, that is, early menopause. Clomiphene is also not used for problems with endometrial growth. The drug is contraindicated in inflammatory processes of the reproductive female organs, with renal and hepatic insufficiency, pituitary insufficiency. It can also not be used in the case when ovarian failure is accompanied by increased secretion of prolactin.

Clomiphene citrate is prescribed, usually from 5 to 9 days of the cycle. Its dose depends on what structure of the ovaries the doctor saw on the ultrasound:

• with polycystic or multicystic ovaries, the daily dose is 50 mg;
• with a normal structure, 50-100 mg per day can be used;
• if the ultrasound describes the ovaries as "exhausted", estrogen stimulation is first needed, then Clomiphene 100 mg / day is used.

"Klostilbegit" is not prescribed by itself. Its application is included in the following protocol:

1. the above dose is applied until, according to ultrasound, the follicle reaches a size of 18-25 mm;
2. stop the introduction of "Clomiphene", enter chorionic gonadotropin in the form of an injection, which should cause the release of the egg;
3. throughout the second phase of the cycle, the woman takes progesterone preparations ("Progestogel"; "Utrozhestan");
4. from 5 to 21 days, estrogen preparations are prescribed ("Divigel", "Estrogel", "Proginova").

Menopausal gonadotropin

It is a hormone produced by the pituitary gland. It is obtained from the urine of women during menopause; contains FSH and LH in approximately equal amounts. Its task is to regulate the phases of the cycle in a non-pregnant woman. It stimulates the growth and development of follicles, increases the level of estrogen in the blood. Under its action, the proliferation of the endometrium occurs. To stimulate the release of the egg 1-2 days before the end of the introduction of "Menopur" ("Pergonal", "Humegon"), a preparation of chorionic gonadotropin is used.

The effectiveness of the drug is judged on the basis of ultrasound of the ovaries, as well as the level of estrogen in the blood. The dose is selected individually: start with 75 mg / day, gradually increasing it until the level of estrogen in the blood increases or the follicle begins to mature. After that, the dose is left unchanged.

The drug "Menopur" is used:

1. in the event that the stimulation with "Klostilbegit" is ineffective;
2. if there is no ovulation due to hypothalamic-pituitary disorders;
3. if ovulation is stimulated in the complex of assisted reproductive technologies.

The drug is contraindicated in:

• anomalies in the development of the reproductive organs;
• unclear bleeding from the uterus;
• tumor diseases of the reproductive system;
• tumors of the pituitary or hypothalamus;
• tumors that produce male sex hormones;
• hypersensitivity to the drug.

Recombinant follicle stimulating hormone

This is a hormone synthesized using genetic engineering technologies, similar in action to natural FSH. Commercial names - "Gonal-F", "Puregon".

The drug is effective for those women who have a suppressed secretion of their own gonadotropic hormones, has a more powerful effect compared to urinary gonadotropins. It applies:

• with polycystic ovary syndrome, when Clomiphene therapy was not effective;
• if FSH and LH are significantly reduced in the blood;
• as hyperstimulation in assisted reproductive technologies.

Contraindications to Gonal are the same as to Menopur.

Chorionic gonadotropin

This is an analogue of the "pregnancy hormone" produced only during this period. It is necessary for the maturation of eggs, ensuring adequate ovulation. It is used in the scheme with Menopur, Gonal or Clomiphene.

If Horagon (Pregnyl, Profazi) is used in conjunction with Menopur or Clomiphene, a side effect may develop this drug- ovarian hyperstimulation syndrome. They may even break.

Gonadotropin-releasing factor agonists

The action of these drugs is aimed at suppressing a sharp increase in the level of luteinizing hormone, which normally causes ovulation. As a result, the follicles mature better. The drugs "Diferelin", "Leuprorelin", "Buserelin" are used in the IVF program, together with one of the above drugs.

These drugs are used both in the form of ultrashort courses and for a long time. At the beginning of treatment, the level of luteinizing hormone rises for a short time, there is a lack of estrogens.

Taking GnRH agonists causes a large number of side effects:

• dryness in the vagina;
• sweating;
• headache;
• mood swings, especially depression;
• tides.

Gonadotropin-releasing hormone antagonists

They immediately suppress the production of sex hormones (especially LH) by the pituitary and hypothalamus without any initial increase. Stimulation of ovulation in the case of the use of these hormones is less prolonged: either a single or three times their administration is used.

These drugs, in combination with Gonal-F, allow follicles to grow faster than in other situations; while the dose of "Gonal" can be reduced. In addition, fewer follicles are stimulated and the resulting embryos are of higher quality. The drugs are used in IVF programs.

How is stimulation done?

Stimulation of ovulation is carried out according to one of the developed protocols, that is, according to a regulated method that describes the dose, method and duration of administration of each of the drugs included in the standard. The stimulation protocol is selected taking into account:

1. results of an assessment of the ovarian reserve;
2. woman's weight
3. the results of previous procedures that stimulate ovulation.

Contraindications for ovulation stimulation

General contraindications for stimulation

Ovulation stimulation is not carried out with:

• pathological processes that will prevent conception and / or the normal course of pregnancy: tumor diseases of the female reproductive organs, extensive adhesions in the fallopian tubes;
• lack of effect during the stimulation procedure, carried out before 6 or more times.

A relative contraindication is age over 35 years. This is due to the fact that in this case, the chances of having a sick child are significantly increased.

Possible complications of stimulation

Almost all drugs to stimulate ovulation can lead to the development of hyperstimulated ovary syndrome, which begins to manifest itself after the introduction of chorionic gonadotropin drugs. This manifests itself:

• the appearance of large ovarian cysts;
• accumulation of fluid in the abdominal, pleural cavities;
• lowering blood pressure;
• decrease in the level of daily urine;
• blockage of blood vessels.

A side effect of ovulation stimulation can also be allergic reactions and multiple pregnancies.

Thus, one of the basic drugs (“Menopur”, “Gonal” or “Klostilbegit”) is used to stimulate ovulation, the choice is made by the doctor based on the woman’s hormonal background, age, and ovarian reserve. Additionally, gonadotropin-releasing agonists or antagonists are prescribed (the latter are considered more effective). Additionally, drugs containing progesterone or estrogen may be used. A few days after the use of these drugs, chorionic gonadotropin is administered once, after which either IVF is performed, or the woman is recommended to start sexual intercourse.