Ovulation induction: how to help your body release an egg

Trying for a baby but your cycles are irregular or you don’t ovulate at all? Ovulation induction uses medication and monitoring to trigger ovulation so you get better timing and higher chances of pregnancy. This page explains common options, what to expect, and simple next steps you can take right away.

How ovulation induction works

At its core, ovulation induction makes your ovaries grow a mature follicle and release an egg. Doctors use pills or injections to nudge your hormones into the right pattern. Once the follicle reaches the right size, a trigger shot or timed testing tells you when to have sex or do an IUI (intrauterine insemination).

Common reasons to try induction include polycystic ovary syndrome (PCOS), irregular cycles after stopping birth control, or unexplained anovulation. Before starting, your doctor will usually check thyroid function, prolactin, and basic bloodwork. Fixing untreated thyroid or very low/high prolactin often restores ovulation without further drugs.

Medications, monitoring, and risks

Pills: Clomiphene citrate and letrozole are the two main oral drugs. Letrozole is often preferred for people with PCOS because it can improve live birth rates and usually causes fewer multiple pregnancies. Typical dosing lasts 5 days early in the cycle (for example, days 3–7). Your doctor will pick dose based on your response.

Injections: Gonadotropins are hormone shots that directly stimulate the ovaries. They work well when pills fail, but they need close monitoring with ultrasounds and blood tests. That’s because injections increase the risk of ovarian hyperstimulation (OHSS) and more than one oocyte can mature, raising the chance of twins or higher-order multiples.

Trigger and timing: When an ultrasound shows a mature follicle (often around 18–20 mm), a trigger shot of hCG or a GnRH agonist is given to cause ovulation about 36 hours later. If you plan IUI, clinics usually schedule the procedure around 24–36 hours after the trigger.

Monitoring: Expect at least one or two ultrasound scans per cycle. Clinics may also check estradiol levels. Monitoring keeps treatment safe and helps choose the right time for intercourse or IUI.

Side effects and risks: Oral meds can cause hot flashes, mood changes, or nausea. Injections can cause soreness and higher OHSS risk. All stimulation methods increase the chance of multiple pregnancy compared with natural cycles. Talk to your doctor about risks, especially if you have other health issues like uncontrolled diabetes or high BMI.

When to move on: Try 3–6 cycles with a careful plan before changing strategy. If induction doesn’t work, options include IVF or referral to a reproductive endocrinologist. Small changes—weight loss if overweight, treating insulin resistance, or correcting thyroid problems—can often boost success.

Want practical next steps? Ask your provider about baseline blood tests, a discussion of letrozole vs clomiphene, and how your clinic will monitor a cycle. Clear timing and realistic expectations help reduce stress and make each cycle more productive.