Ovulation problems in women can occur for different reasons. Generally, if a woman menstruates in 28-day cycles, her ovulation is most likely regular. However, some women may have ovulation problems. Women usually consult a physician with the complaint of menstrual irregularity or inability to menstruate. Some women may experience increased body hair growth. Some women may complain of acne and milk coming from the breasts. The cause of the problem should be determined by a physician. First of all, the main problem should be identified and the appropriate treatment method should be determined for this problem. One of the successful treatment methods for women with ovulation problems is ovulation therapy. This treatment method is also known as ovulation stimulation. Who Can Use Ovulation Induction? Ovulation induction is performed by a specialist physician. This treatment method, also known as ovulation monitoring (ovulation induction), the patient must first be examined by a specialist physician. Some tests are applied to the patient by the physician. Ovulation monitoring is a treatment method applied to women. This method is used in women with no ovulation or irregular ovulation. Other situations where the treatment method is used:

• In patients with unexplained infertility
• In cases that occur due to male causes
• In cases related to excess weight
• In patients with early menopause

Ovulation induction is applied to patients due to various reasons. This treatment method is generally used in patients with absent or irregular ovulation. In some patients, the cause of infertility may not be explained. Ovulation monitoring is performed in patients with unexplained infertility. In some cases, problems related to male causes may be seen. In these cases, this method is also used when needed. In order to use the method in overweight patients, the patient must first lose weight. In case of early menopause, different treatment methods can be applied by the physician. Treatment methods applied by the physician may differ according to the diagnosis. When is Ovulation Induction Applied? Ovulation induction can be done at different periods from patient to patient. The physician’s decision is effective in determining the appropriate period for the patient. If an infertility-related treatment method is to be applied, the treatment starts on the 2nd – 5th day of the menstrual period. How the treatment will continue depends on the medication used and the procedure to be performed. If an ovulation-related problem is seen in infertility treatment, the first preferred treatment method is ovulation induction happens. This treatment method is one of the first to be applied and is simple and has a high success rate. Problems with ovulation in patients actually constitute an important part of the causes of infertility. Couples who want to have children can have children by solving the ovulation problem. If there is menstrual irregularity or hormone disorder, this means that there is a problem in ovulation. Whether ovulation (ovulation) occurs or not can be understood by looking at some values. To understand whether ovulation has occurred;

• Hormone tests,
• Endometrial biopsy
• Ultrasonography follow-up is performed.

Whether ovulation has occurred or not is determined by tests and monitoring. According to the results obtained from these procedures performed under the supervision of a physician, it is determined whether ovulation has occurred. There is an important factor at this stage. It is important that the patient’s tubes are open. At the same time, the patient’s tubes must be healthy. In addition, the sperm count of the man must be within normal limits. Otherwise, the success rate of the treatment method applied will be low. In order to maintain the success rate in the treatment method, all steps are taken under the control of the physician and details are included.

How is Ovulation Induction Applied?

Ovulation induction In other words, in order to monitor ovulation, treatment must first be decided. In order to decide on the treatment, the physician should perform some tests on the patient. Necessary tests are performed and the patient undergoes an ultrasonography examination. Then, if necessary, ovulation monitoring treatment is decided. In this way, it can be determined exactly whether the patient’s egg is developing and when the egg will hatch. Ovulation induction Various medicines are used for this purpose. HMG and FSH can be given for this purpose. These two drugs stimulate ovulation. Among these drugs that stimulate ovulation, the appropriate one for the patient is determined and the patient is given the appropriate dose of the drug. The physician determines which drug is suitable for the patient, the dose of the drug and when it will be given. Medication should be continued for a while. The follicles containing the eggs must reach a certain size. The medication is continued until the follicles reach a certain size. During the medication period, the patient is monitored by ultrasonography. The patient is followed up regularly by the physician. When the vesicles reach the desired size, the next stage can be started. The desired size for vesicles is around 18 to 20 mm. When the vesicles reach a size of around 18 to 20 mm, a ligation injection can be performed. The hCG is used for the hatching needle. Sexual intercourse is recommended for couples after the injection. The time and frequency of sexual intercourse is determined by the physician and couples are informed. If a pregnancy does not occur with the treatment method applied, the same procedures can be repeated for 3 or 4 months. If there is still no pregnancy, the physician proceeds to the next stage. The next stage is usually vaccination. How to Detect Ovulation Day? The day of ovulation is easier to detect in women who do not experience menstrual irregularities. Because women who do not experience menstrual irregularities menstruate at regular intervals. In women with regular menstruation, ovulation occurs 14 days before menstruation begins. This is the most practical way to determine the day of ovulation. According to this calculation, the ovulation day of a woman whose menstrual period lasts 28 days is the 14th day of menstruation. You start counting from the first day of menstruation and when you reach the 14th day, this is the day of ovulation. Women who want to increase their chances of getting pregnant should start sexual intercourse 2 or 3 days before this day and continue for 1 week. In this process, having sexual intercourse every 2-3 days increases the chance of getting pregnant. A woman whose menstrual period lasts regularly for 30 days should start from the first day of menstruation and reach the 16th day. On the 16th day, ovulation can be calculated. For a woman whose menstrual period regularly lasts 35 days, it can be said that the 21st day is the day of ovulation. Women can calculate their ovulation periods for themselves by looking at these dates. It will be convenient to follow the calendar or use some developed applications to calculate the day of ovulation. Drugs Used for Ovulation Induction Ovulation induction There are some main medicines used for Which of these medicines to use and how much dose to use varies from patient to patient. Because every woman’s body has different characteristics. It is important to adjust the right medication and dose for the patient. For the arrangements made under the control of a specialist physician, some tests are first performed on the patient. After the examination, the appropriate treatment process is determined for the patient. The drugs to be applied in this process are determined by the physician. The main purpose of the treatment method applied to the patient is to detect the previously problematic ovulation and to regulate ovulation. With the treatment method applied, the number of eggs is increased numerically. Thus, the chance of pregnancy is increased. Ovulation induction The medicines used for this varies from patient to patient. Medicines can be administered in different doses. The applied medicines are used for different periods of time. The drugs used as ovulation stimulants are hormonal drugs. These drugs are used in tablet form and as injections. Drugs in tablet form include clomiphene, bromocriptine, tamoxifen. Drugs used as injections include HMG and FSH. What is Clomid Therapy? Clomid is a type of medicine used in patients with ovulation problems. This medicine is used to stimulate egg production in women. Clomiphene ovulation induction is a type of medicine used in the treatment of This type of medicine used in the treatment of various disorders ovulation induction is also used in its treatment. A healthy female body menstruates regularly every month. New egg cells are produced with the menstrual cycle. However, some women do not ovulate regularly due to health problems in their bodies. In the absence of regular ovulation, treatment is applied for a healthy fertility. Clomid ovulation induction As a medication used in the treatment of the disease, it is usually recommended to use it for 5 days. The drug, which is used once a day, may be recommended to be used in different doses from patient to patient. The dose of the drug is adjusted under the control of a specialist physician. Clomid, which is among the drugs used for ovulation monitoring, is a drug that has been recommended for a long time. This drug used in the treatment process can be considered reliable by physicians. The body structures of patients are different from each other. For this reason, while the effect of the drug becomes apparent in a short time in some patients using clomid, the effect may be seen late in some patients. When drugs such as clomiphene are used during treatment, it is more common for the patient to have twins or multiple pregnancies. Multiple pregnancies occur in %6 of patients using clomiphene. This is because the ovaries are stimulated more than normal. Women who conceive using clomiphene do not experience a process different from a normal pregnancy. The effect of the drug used ends with pregnancy. The process after pregnancy proceeds as it should. Ovulation Calculation Methods Ovulation induction patients should consult a specialist physician. Ovulation in women is also known as ovulation. Ovulation, that is, ovulation calculation can be done in several ways. Ovulation calculation methods may differ in women. Ovulation calculation methods used for women among different methods:

• Use of calendar
• Use of transvaginal ultrasonography
• Urine LH detection
• Detection of progesterone in the blood
• Basal body temperature monitoring
• Examination of cervical mucus
• Analysis of saliva fern

For women, ovulation day can be calculated in different ways. Women can also calculate the day of ovulation themselves. They can also consult a physician to calculate the day of ovulation. Ovulation calculation is easier for women who do not have menstrual irregularities. However, it can be difficult to calculate ovulation in women with menstrual irregularities. For this reason, especially women with menstrual irregularities can get physician support for ovulation calculation. Ovulation period is one of the important periods that affect the conception rate of women. Known as egg tracking ovulation induction is important for women who want to conceive. Getting Pregnant with Ovulation Induction Women who want to become pregnant but cannot conceive in a healthy way should seek medical support. The reasons why the woman cannot conceive should be determined. Ovulation induction with an increased rate of conception in women. The development of follicles during the egg tracking process may vary depending on the drug treatment. Depending on the development in the process, transition to vaccination or IVF procedures is provided. Egg monitoring is very important for IVF and vaccination procedures. The lifespan of the egg used for pregnancy is 24 hours. Within 24 hours, the sperm must find and fertilize the egg. Otherwise there is no pregnancy. The next month must be waited for pregnancy to occur. Chocolate cysts are frequently seen in women. Conditions such as chocolate cysts negatively affect pregnancy in women. Egg monitoring is important in vaccination and IVF procedures. There are certain conditions that are necessary for pregnancy to occur in women. When these conditions are met, women have a healthy pregnancy. Conditions necessary for pregnancy to occur in women:

• Motile sperm from the man
• The woman’s egg is mature
• Open tubes
• Having a uterine lining

For pregnancy, the egg and sperm must be fertilized. It is important that the sperm from the man is motile. Sperm motility alone is not enough. The woman’s egg must also be mature. It is also important that the tubes are open and the uterine lining is present. In this way, pregnancy occurs in women. Sperm samples are first analyzed for pregnancy. Sperm motility and sperm count are determined. If the sperm is considered to be sufficient, it is taken into evaluation. In women undergoing cancer treatment, ovarian reserves begin to decrease. At the same time, the ovarian reserve of women with chocolate cysts also starts to decrease. Ovulation induction used in women who want to get pregnant. Situations in which ovulation monitoring is used:

• Irregular menstruation in women
• Failure to detect the time of ovulation
• Lack of regular intercourse
• Infertility treatment

Ovulation induction It is generally used in women who experience menstrual irregularities and cannot calculate the day of ovulation. Women should monitor ovulation to increase their chances of getting pregnant. Ovulation tracking cannot always be done easily. Because some women do not menstruate regularly. Ovulation monitoring is most easily done in women with regular menstruation. In women with irregular menstruation, follow-up is usually done under the supervision of a physician. Some women have egg dysfunction. Egg dysfunction may be due to different health problems. It is usually seen due to stress and some unknown diseases. Egg dysfunction due to stress can be corrected by eliminating stress. In egg dysfunction due to unknown diseases, the disease should be detected. Then the disease can be treated with the appropriate treatment method. Women with egg dysfunction usually have polycystic ovary disease. In women with this disease, menstrual bleeding is infrequent and hair growth increases on the woman’s body. Women with polycystic ovary disease also have ovulation uncertainty. Which Drugs Are Used During Ovulation Induction? Ovulation induction In the process, patients are treated with different medications. The treatment process of each patient differs. The physician’s decision is effective in determining the appropriate treatment process for the patient. The physician first examines the patient and performs some tests. Depending on the results, the physician determines the appropriate treatment process for the patient. Ovulation induction There are certain medicines used for Which of these medicines, how often and in what dosage is used depends on the individual patient. Medicines used in the treatment process:

• Clomiphene citrate
• Tamoxifen
• Letrozole
• HMG
• FSH
• LH
• HCG
• Bromocriptine
• GnRH analogs
• Natural progesterones

Klomifen sitrat (Clomiphene), tablet formda bir ilaçtır. Bu ilaç kadında mevcut yumurtlama sorununun giderilmesi amacıyla kullanılmaktadır. İlaç vücutta östrojen hormonu yokmuş gibi bir durum oluşturarak bu durumu telafi etmek amacıyla FSH ve LH hormonlarının fazla salgılanmasına neden olur. Böylelikle folikül adındaki yumurtalar gelişmeye başlar. İlaç ile ovulasyon uyarılmasında adetin 2 ile 5. günlerinde günde 1 tabletle başlanır. Genellikle ilaca 5 gün boyunca devam edilmesi önerilir. Folikül gelişiminin olmadığı durumlarda ilaç dozu arttırılır ve günde 3 tablete kadar kullanılabilir. İlaç dozu hekim tarafından belirlenmelidir. Kullanılan ilaçla ovulasyon gerçekleşmesi %80 civarındadır. 6 ayın sonunda gebelik oranı %30 ile %50 arasındadır. Gebeliklerde ikiz gebeliğin görülmesi ise %10’dur. Tamoxifen works by a similar mechanism as Clomiphene. The use of both medicines is the same. Another medicine used in treatment is Letrozole. This medicine blocks the production of estrogen in the ovaries. To compensate for this, it causes the brain’s pituitary gland to secrete more follicle growth stimulating hormones. This stimulates follicle development in the ovaries. Ovulation induction The use of the drug in the process is usually started on the 3rd day of menstruation and the drug is used for 5 days. The dose is 1 or 2 tablets per day. In a significant part of the patients who use Clomiphene and do not get results, results can be obtained with the drug Letrozole. HMG, tedavi sürecinde kullanılan ve iğne formda olan bir ilaçtır. İğne, FSH ve LH hormonlarını içerir. Clomiphene ve Letrozole ilaçlarının etkili olmadığı durumlarda, kendi FSH ve LH hormonlarının üretilmediği kadınlarda bu ilaç kullanılmaktadır. İlacın dozu kişiden kişiye değiştiği gibi aynı kişide farklı zamanlarda ve farklı dozlarda kullanılabilir. Çoğul gebelik ise %20 civarıdır. FSH ile HMG ilaçları birbirine benzer özelliktedir. FSH ilacı sadece FSH içerir. FSH ilacıyla yumurtalıklar aşırı uyarılmaktadır. Bu nedenle hastalarda sık sık ultrason takibi yapılmalıdır. İlacı kullanan hastalarda çoğul gebelik %20 civarıdır. Gebeliklerin üçte biri ise üçüz ve üzeri olabilmektedir. Özel kalemleri ve ince iğneleri olan ilacın kullanımı kolaydır. Ovulation induction Another drug used in the process is the LH drug. This medicine is a hormone medicine, just like FSH and HMG. In some cases it is recommended to be used together with FSH. The HMG drug administered to patients also contains LH. During the treatment process, HCG is given to the patient after egg development is achieved. Giving HCG to the patient is the last step. HCG is a medicine in injection form. The dose of the medicine is adjusted;

• The size of the eggs,
• The thickness of the lining of the uterus,
• It is based on blood estrogen levels.

The eggs hatch 36 to 48 hours after the patient has been given the HCG drug. Bromocriptine, Cabergoline are drugs that do not directly stimulate follicle development but lower prolactin levels. In patients with ovulation problems and high prolactin levels, the prolactin level returns to normal with the use of this drug. Thus, ovulation can start and pregnancy can occur. GnRH analogs are used during ovarian stimulation using FSH and HMG. These medications can be used according to different treatment protocols. The medicine is used in two forms. One form can be administered under the skin and the other is used as a nasal spray. The use of the drug is recommended on the 3rd or 21st day of menstruation. The use of the drug is determined by the physician and the patient is informed. It is among the most commonly used medicines today. Finally, another drug used in the treatment process is natural progesterones. These are drugs such as progestan and Crinone gel. The drug is administered to the patient after egg collection. Natural progesterones have a common purpose. They all aim to prepare the inner wall of the uterus for the implantation of embryos. In some cases, HCG injections may be used in addition. Do Ovulation Induction Drugs Cause Early Menopause? Ovulation induction medicines are administered to patients under the supervision of a physician. Under the supervision of a physician, the frequency and dosage of the medication is determined. Patients are under the control of a physician throughout the treatment process. In this way, the physician intervenes in case of a possible mishap. Patients ovulation induction wonder whether their medication can cause premature menopause. Medicines do not cause early menopause. In women, 40 – 60 eggs grow and mature every month. Only one of these eggs becomes mature. The other eggs regress. In ovulation treatment, some of the regressed eggs are stimulated. After stimulation, the eggs continue to grow and develop. Ovulation induction The medicines used in the process do not cause early menopause in women. Women can safely choose the treatment process.