The Medical Letter on Drugs and Therapeutics
Drugs for Ovulation Induction
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Infertility occurs in about 15% of couples. About one-third of cases are due to problems with ovulation or other female factors, another third are due to a male infertility factor, and the remaining third are unexplained. In older women, unexplained infertility is probably caused by diminished quality and quantity of oocytes. The first approach to treatment of female-factor infertility generally is the use of drugs that stimulate oocyte production.

NORMAL OVULATION — Pulsatile release of gonadotropin releasing hormone (GnRH) from the hypothalamus initiates a normal menstrual cycle. GnRH stimulates pituitary release of the endogenous gonadotropins, follicle stimulating hormone (FSH) and luteinizing hormone (LH), which act on the ovary to stimulate oocyte growth. A rapid increase in LH concentrations midcycle (about day 14), the "LH surge", triggers ovulation. Fertilization usually occurs 24-36 hours ... more      

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