Women who have ovulation disorders (meaning the ovary does not release an egg regularly) often present with an absence of periods (amenorrhoea) or infrequent periods (oligomenorrhoea). Rarely, women with regular cycles may also not be ovulating regularly.

Drug treatment is effective in most of these cases without having to resort to IVF. Treatment with a fertility drug - called clomiphene citrate (Clomid and Serophene) - in low to increasing doses is effective in most cases.

Because 80% of all pregnancies on this treatment occur within the first 3 months of ovulating, the treatment should be reviewed if it has not worked after 6 months. It is not usual to give treatment with clomiphene citrate for more than six months.

A more involved treatment course of daily injections with Follicle Stimulating Hormones (eg Gonal-F, Puregon) is used in women who do not respond to treatment with clomiphene citrate.   This is highly successful with up to 90% of women conceiving within 9 months of treatment.

Multiple pregnancy with the use of gonadotrophin hormones is an ever-present risk, with 20% of pregnancies resulting in twins, 5% in triplets and 2% in quads or more. The treatment requires careful monitoring.   With ultrasound assessment of the ovary's response if more than 2 follicles (eggs) are developing we will advise women not to try to conceive in that cycle.