Ovulation induction (fertility drugs)

Who it's for

• People with PCOS (now also called PMOS) who don't ovulate regularly
• Anyone with very irregular or absent periods
• People with hormone imbalances, e.g. high prolactin

Key facts

• Tablets such as clomifene or letrozole are usually tried first.
• Injectable gonadotrophins are used if tablets don't work.
• You should be monitored with scans – too many follicles means a risk of twins or triplets.
• Usually available on the NHS when prescribed by a specialist.

What happens

1. 1

   Diagnosis

   Blood tests and a scan confirm you're not ovulating regularly and that your tubes and your partner's sperm (if relevant) are healthy.

2. 2

   Medication

   Tablets for 5 days early in your cycle, or daily injections. Metformin may be added for PCOS with insulin resistance.

3. 3

   Tracking scans

   Scans check how many follicles are growing. If too many develop, the cycle may be cancelled to avoid a multiple pregnancy.

4. 4

   Timed sex or IUI

   You'll be told the best days to have sex, or IUI may be timed with a trigger injection.

How long it takes: Each cycle is one menstrual cycle. Usually tried for up to 6 cycles before moving on.

Success rates

• For people whose only issue is not ovulating, ovulation induction can work well – many will ovulate and a good proportion will conceive within 6 cycles.

Each clinic's published rates – compared with the UK average – are on its profile in the clinic finder.

Costs

Cheaper than IUI or IVF. Privately you pay for scans, consultations and drugs.

NHS funding

• Usually NHS-funded when prescribed by a specialist. You'll still pay prescription charges in England unless exempt.

Risks and side effects

• Multiple pregnancy (twins or more) – the most important risk, which is why scans matter.
• Ovarian hyperstimulation syndrome (OHSS) with injectable drugs – rare, but can be serious.
• Side effects such as hot flushes, bloating, mood swings and headaches.