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Injections usually begin on day 3 of the menstrual cycle and continue for several days until the developing follicles are approximately 16-20 millimeters in diameter. During the stimulation with gonadotropins, patient's follicles are monitored closely with ultrasounds and estradiol levels (blood tests). Gonadotropins are used in women who do not normally ovulate, or in those who do not ovulate in response to clomiphene citrate. Controlled Ovarian Hyperstimulation (COH) – during a COH cycle gonadotropins are used to stimulate the ovary to produce ~ 2-4 eggs. IVF – during an IVF cycle, a higher dose of gonadotropins is used to induce the growth of multiple follicles. The gonadotropin medications are usually well tolerated since these hormones are identical to those produced naturally by the pituitary gland. Ovarian hyperstimulation syndrome (OHSS): this syndrome is characterized by ovarian enlargement, followed by abdominal pain, abdominal distention, weight gain and circulatory problems. Multiple gestations: Twins occur in about 20 to 25% of COH cycles and in up to 40% of IVF cycles depending on the number and quality of embryos transferred. Fertility Preservation and Delaying Childbirth: What to ConsiderPosted May 15, 2016Fertility preservation can help delay childbirth for men and woman who experience serious health issues.
Understanding Your Monthly CycleKnowing your menstrual cycle improves your chances of getting pregnant. During a regular menstrual cycle, one follicle is naturally selected to grow, resulting in ovulation and release of only one egg. Daily dosage and the length of time needed for adequate stimulation, vary from patient to patient and cycle to cycle. Additionally, gonadotropins may be used to produce multiple follicles for insemination or an ART procedure such as in vitro fertilization. They are excreted quickly from the body and do not leave long lasting effects on the menstrual cycle.
To reduce the risk of severe OHSS close monitoring of follicle development as well as estradiol levels are required.
The risk of multiple gestations can be significantly reduced by limiting the number of embryos transferred during an IVF cycle, or by canceling a COH cycle in which too many follicles develop.
It is intended for general informational purposes only and does not address individual circumstances.

The probability of having twins while taking this medication is 7% (meaning 7 out of 100 women who get pregnant with clomid will have twins). With the use of gonadotropins, multiple follicles are stimulated to grow, resulting in ovulation and release of more than one egg. When the ultrasounds and estradiol levels indicate that the follicles are ready, an injection of another hormone called HCG is given to induce ovulation. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health.
Between day 2 and 14, those hormones also help thicken the lining of your uterus to get ready for a fertilized egg. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site.
Ovulation may be accompanied by insemination or timed intercourse, depending on your particular situation. These drugs can't be ingested orally and are, therefore, administered by injection, usually subcutaneously.
A hormone called luteinizing hormone (LH) surges, triggering the release of the egg that's most ripe. At the same time, your cervical mucus becomes more slippery to help sperm make their way to the egg. It's All in the TimingWomen are born with about 1-2 million eggs, but only release 300 to 400 through ovulation. The egg travels down a fallopian tube, one of the two tubes that connect your ovaries to your uterus.
If fertilization doesn't happen within 24 hours of the egg leaving the ovary, the egg dissolves. Sperm can live for about 3 to 5 days, so knowing when you are ovulating can help you and your partner plan sex for when you're most likely to conceive.  Tracking Your Most Fertile DaysGenerally, the highest chance of pregnancy is when sex happens1-2 days before ovulation. If you have a regular 28-day cycle, count back 14 days from when you expect your next period to start.
Your cycle may be longer or shorter, so an online ovulation calculator may help you identify the likely day. Tracking Ovulation by TemperatureAfter your body releases an egg, the hormone progesterone kicks in to help build and maintain the lining of the uterus.

So taking your temperature with a basal thermometer every morning before getting out of bed can help you figure out if you ovulated. These thermometers are available at the drugstore and are inexpensive, but they aren't as accurate as other methods for tracking ovulation. The Last Phase of Your Monthly CycleDuring the second half of your menstrual cycle, the hormone progesterone kicks in to help prepare the lining of your uterus for a fertilized egg. If the egg isn't fertilized and doesn't implant, it disintegrates, progesterone levels fall, and about 12 to 16 days later, the egg -- along with blood and tissues from the lining of the uterus -- is shed from the body.
If you're overweight or obese, losing weight can boost your fertility and chances of getting pregnant.
According to the American Society for Reproductive Medicine, a drop in weight of 5%-10% can dramatically improve ovulation and pregnancy rates. Age Affects Your Conception ChancesFertility goes down with age, especially after the mid-30s.
Experts say you should talk to your doctor if you're under 35 and have been trying to conceive for more than 12 months, or over 35 and have been trying for more than 6 months. Fertility Declines in Older Men, TooStudies show that sperm count and sperm movement decrease as men age, as does sexual function. One study found that it took men age 45 or older longer to get a woman pregnant once the couple started trying. If your partner is older, you may want to talk to your doctor about ways to boost your chances. Infertility treatments can include fertility drugs to stimulate ovulation and in vitro fertilization, which involves removing eggs from the ovaries, fertilizing them (shown at left), and then implanting them into the uterus. How Home Pregnancy Tests WorkHome pregnancy tests check your urine for the "pregnancy hormone," called hCG, that your body makes once a fertilized egg implants in your uterus.

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