Ovulation management includes monitoring of both unstimulated and stimulated cycles. Unstimulated monitoring is done as part of the basic fertility evaluation for many patients.
Controlled ovarian stimulation (COS), is the use of ovarian-stimulating medications which are used to increase the number of ovulated eggs in any given month. COS can be done conservatively with oral medications such as Clomiphene Citrate or Letrozole, or more aggressively with injectable drugs known as Gonadotrophins. These can correct ovulatory problems for women with irregular menstrual cycles, or can boost ovulation in women who ovulate normally. In general, the more aggressive the approach, the higher the success rate, but also the higher the multiple pregnancy rate (chance of having twins, or triplets).
Most pregnancies occur within three to four courses of therapy. Success rates decline with age and depend on the diagnosis.