Ovulation Induction (OI)
Why some patients benefit from OI
Women of reproductive age have varying ovarian reserve. When FSH, the hormone controlling the ovaries is high and the ovarian hormone (AMH) is low, success with IVF treatment may be reduced because fewer eggs can be obtained.
Such patients may be referred to as ‘poor responders’. Hormone tests are used to measure ovarian response and to design the best treatment pathway for each patient.
At Midland Fertility, treatment pathways are designed and tailor-made for each patient depending on her individual hormone test results and any previous treatment outcomes. This helps optimise success rates and reduce the risk of cycles being cancelled.
The ovulation induction process
Response to the stimulating hormone injection used in IVF can vary from month to month in ‘poor responders’ so Midland Fertility developed ovulation induction as a dynamic test of ovarian response.
Clomid (clomiphene citrate) is an established fertility medicine in tablet form. It is an anti-oestrogen drug and works by making the woman produce more FSH. In many women this will result in the production of more than one follicle each month. ‘Poor responders’ may achieve a similar number of follicles to that which they would get with six days of high-dose injections.
If a treatment cycle is not successful, OI can be tried again the following month. As with any medical procedure, there is no guarantee of success. The clinical team will discuss with each patient how many times OI may be attempted – this is also assessed on each patient’s individual circumstances and responses.
If a treatment cycle is cancelled, the patient will receive a refund of any unused medication which is stored at Midland Fertility. If she wishes to continue with a new OI, any unused medication stored at Midland Fertility can be used for the following treatment cycle. There would be a charge for the new monitoring cycle.
For whom is this protocol not suitable?
- a patient with a known allergy to clomiphene citrate
- a patient with a history of recurring ovarian cysts
OI for private patients
If a private patient were to go straight to a cycle of IVF or ICSI she would have to pay the full-cost of the treatment cycle and all medication before the cycle begins. If she does not respond to the injectable stimulation drugs her cycle would be cancelled and she would potentially be left with hundreds of pounds worth of unrequired medication, as it will have been delivered to her home address.
Instead, if there is evidence that she may be a ‘poor responder’ her Midland Fertility clinician will suggest an OI cycle – the cost of which includes the monitoring scans. Any medication is charged in addition and stored at Midland Fertility. If she does not recruit follicles the OI treatment cost is non-refundable, but conversion to IVF or ICSI does not happen and so the associated costs are avoided.
If follicles are recruited then she will convert to a cycle of IVF or ICSI. The cost of the IVF or ICSI treatment will be invoiced, less the cost of the OI (excluding the OI medication). The scans performed throughout the OI will form the basis of monitoring for the IVF or ICSI cycle.
OI for NHS patients
NHS funding starts at the beginning of treatment. If a poor response leads to the cancellation of IVF or ICSI in the early stages, the NHS funding will be lost for that cycle. If a patient is possibly a ‘poor responder’ she can choose to preserve that NHS funding by having a OI cycle at her own cost.
If she does not recruit follicles from the OI, and so doesn’t convert to IVF or ICSI treatment, the OI fee is non-refundable. But NHS funding for at least a full single IVF or ICSI treatment cycle is still available – the private cost of which would potentially be more than 10x the cost of OI.
If the patient then has another cycle of OI, a further charge for OI would apply.
What is included in the cost?
- a treatment planning appointment and scan
- two monitoring scans to check the ovarian response
If an OI cycle is cancelled or does not convert to treatment within that cycle, the charge is due in full, plus any medication charges, regardless of how many scans have been performed.
If an OI cycle is successful and the patient converts to treatment within that cycle, the OI fee will be credited and the patient would then be invoiced for whichever treatment she converts to. She would pay the difference between this credit and invoice plus any extra drugs if applicable.
What is not included in the cost?
- charges for the OI medication
- any other fertility investigations, treatments or preservation services for either partner
How long does OI treatment take?
A single cycle of OI can be completed in up to four weeks.
Cost of ovulation induction at Midland Fertility: £525.00
Also, go to the Midland Fertility Patient Treatment Information page and download:
- Fertility Check-up for Women infosheet
- IVF infosheet
- ICSI infosheet
- Embryo Transfer Policy and SET infosheet