When these treatments fit
Ovulation induction with or without intrauterine insemination (IUI) is often a first-line option for anovulatory cycles, mild male-factor infertility with adequate motile sperm counts, unexplained infertility, and same-sex families or single parents using donor sperm. It is less commonly the right first step when tubal disease, moderate-to-severe male-factor infertility, or advanced age point more directly to IVF.
Medications used
Ovulation induction uses oral or injectable medications to encourage the ovaries to develop and release a mature egg on a monitored schedule. The choice depends on your diagnosis and history:
- Letrozole — commonly used for PCOS-related anovulation and unexplained infertility
- Clomiphene citrate — the longstanding oral option for ovulation induction
- Injectable gonadotropins — used when oral medications are insufficient, with closer monitoring because of the higher risk of multiples
The IUI procedure
IUI places specially prepared sperm directly into the uterus around the time of ovulation, reducing the distance sperm must travel and bypassing the cervix. It is a short, in-office procedure that most patients describe as similar to a Pap smear. Sperm can come from a partner or a donor and is prepared in the lab beforehand.
Monitoring the cycle
A cycle usually includes a baseline visit, one or two mid-cycle ultrasounds to track follicle development, and a trigger injection (often hCG) to time ovulation precisely. A pregnancy test follows about two weeks after the IUI.
How many cycles before IVF
For most patients pursuing IUI, plans include a specific number of attempts — commonly three to six — before reassessing. Age, ovarian reserve, sperm parameters, and prior response help set that number so time is not lost when a different approach would be more effective.
Risks to review
Ovulation induction increases the chance of multiple pregnancy. With oral medications the risk is modest; with injectable gonadotropins it is higher, which is why monitoring is closer. Ovarian hyperstimulation is uncommon at IUI-level doses but is part of the informed-consent discussion.