Controlled Ovarian Hyperstimulation
The process of controlled ovarian hyperstimulation (COH) or “superovulation” is indicated when conventional low level infertility treatments have failed to produce a pregnancy. The aim is to cause the ovaries produce multiple eggs or “oocytes” and facilitate egg maturation, in order to numerically increase the chances of successful fertilization. The objective is to stimulate the ovaries to produce between two and four eggs. Occasionally, more eggs may form and you will have the option of canceling the cycle. Other options may be available and your physician will discuss them with you.Success rates for COH cycles tend to run between 20- 25% depending on patient age and other factors. Indications for doing COH include undiagnosed infertility, mild endometriosis, minimal pelvic adhesions and ovulation disorders. In order to be a candidate for COH, it is imperative that at least one fallopian tube be open
Some side effects of this treatment include; bloating, multiple gestation, irritability and fluid retention.
Some of the various stimulation protocols include:
- Oral stimulant medications from day 3-7 with follicular monitoring and possible blood testing.
- Injectable fertility medications with ultrasound monitoring and blood testing. An injection to release the egg at maturity (hCG) will be included with this protocol.
COH is often not performed every cycle, as the ovaries may need time to rest after a stimulated cycle.
We prefer to limit this treatment to a maximum of three to four cycles. If a pregnancy does not occur in that length of time, we will meet with you and your partner and suggest alternative options.
