What is Controlled Ovarian Hyperstimulation?
Controlled ovarian hyperstimulation (COH) is a process designed to stimulate the ovaries through fertility medication to produce ovulatory follicle(s). We generally use a combination of oral medication (clomiphine citrate) and injectible hormones (follicle stimulation hormone) to stimulate the ovaries to produce 2 mature follicles.
Each mature follicle contains 1 egg that is capable of being fertilized. For a woman who has irregular periods and does not normally ovulate, the goal of COH is to produce 1 mature follicle and restore normal ovulatory function. For women who menstruate and ovulate normally each month, COH is used to “superovulate” women with the hope of increasing the likelihood of pregnancy by producing 2-3 mature follicles per month. Controlled ovarian hyperstimulation is meant to boost monthly fertility rates back to that of a 20 year old woman, or somewhere near 20% per month. Ultimately, COH is designed to help couples achieve a healthy singleton pregnancy.
COH and Intrauterine Insemination
Intrauterine insemination (IUI) may also be use in conjunction with controlled ovarian hyperstimulation (COH) for couples affected by mild/moderate endometriosis or other unexplained fertility issues. The success rates of COH and IUI, when combined, resemble the 20% a month rate that is seen in fertile couples.
The woman’s age and the nature or your fertility diagnosis can affect the success rate, however. If couples are not successful after 3-6 cycles of COH/IUI, we recommend a consultation to review any potential complications and to reevaluate your treatment plan.