If a woman has an irregular menstrual cycle, monitoring with ultrasound scans and hormone assessments may help to identify the fertile time of the month and so improve the chances of natural conception.

Monitoring is done through Folliculometry with ultrasonography, Measurement of E2 (Estradiol) level methods.

If ovulation is not occurring, then drugs may be administered after the onset of menstruation to stimulate egg production.

The simplest treatment is with tablets given within the first few days of the cycle. The response is monitored by ultrasound scans. These are not always effective and more powerful fertility injections may be necessary to stimulate egg production in the ovaries. With these more potent drugs there is a greater risk of increased egg production and, therefore, the risks of multiple pregnancy are greater. Women receiving fertility injections are monitored by ultrasound scans and hormone assessment.

The drugs used are

Clomifene Citrate

The first line of the treatment is usually with   Clomifene . it includes the ovulation in 80% of cases. Usually is started after menstruation day 2 to day 5. If needed, the dose & duration of treatment is increased.

Gonadotrophins

If   Clomifene Citrate fails to induce ovulation , gonadotrophins are added. Different dosasges and combination are available. The gonadotrophin HCG is given after the follicles are found to be 18mm or more to induce  ovulation.