Frequently, fertility difficulties are associated with failure of egg development. This problem can be treated with various medications, together with monitoring, usually by ultrasound scans. There are two frequently used groups of drugs to produce this desired effect.

1. Anti-Oestrogens. These are drugs given by tablet form in the early part of the treatment cycle to diminish the natural oestrogen levels. This causes a rebound effect on the ovaries, which in due course makes the ovaries work harder to produce eggs. These drugs are easier to use than some others, but their effects are less predictable and controllable.

2. Gonadotrophins.
These drugs are given by injection. They are naturally occurring hormones produced by the Pituitary Gland in the base of the brain and they directly stimulate the ovaries. These are given from the early part of the cycle, and repeated on alternate days, with the effects of the drugs being monitored by the use of vaginal ultrasound. The dose used is dependent on the appearances of the scan. It is of great importance to patients during this type of treatment that they are seen frequently in order to obtain the close control of ovarian function, which is the great advantage of this treatment, together with a significant predictability of ovulation; when there are up to two or three follicles, a further hormone is used to ensure production of mature eggs, approximately forty hours later. This allows timing of intrauterine insemination to be very accurate and gives an enhanced chance of success.

Using these drugs, there is a risk, however, of a condition called hyperstimulation syndrome where several eggs mature at the same time, causing the ovary to swell. Symptoms on this condition may start with nausea, vomiting and abdominal pain and swelling, and any symptoms of this sort should be immediately reported to the Unit Office. If this is at a time when the office is not open, you will then be directed to another number where you will be able to contact the doctor at any time. If this condition does arise, it is very likely that the particular treatment cycle will be abandoned until all symptoms subside. At all times, the Unit phone is attended either in person, or by an answering machine, and details with regard to seeking medical advice may be obtained by following the instructions on that message. Although it is important to ensure that patients are aware of the risk of this condition, it should be pointed out that it is extremely unusual. Additionally, there are certain potentially undesirable eventualities as a result of this treatment, namely multiple births (if several eggs develop together; when two eggs develop, the risk of twins is one in eighty), infection and ectopic pregnancy (when a pregnancy is formed outside the womb). Again, these are rare situations.

In case of a need to contact the Unit in an urgent situation, please telephone (020) 8597 7414, or out of normal office hours on (020) 8554 1214.