Ovulation induction in the ovulatory woman

Controlled ovarian hyperstimulation is frequently employed as empiric therapy for the treatment of unexplained infertility, mild male factor, cervical factor, and treated endometriosis. Prescribed in the form of either clomiphene citrate or gonadotropins, it is often combined with intrauterine insemination and offered to patients as a less expensive and less invasive alternative to the assisted reproductive technologies. Efficacy studies for these regimens are very important, as patients who would appear to be ideal candidates for this empiric therapy frequently do not suffer from absolute infertility; rather they are often subfertile, and may conceive spontaneously given enough time. Although there are few well-designed, controlled trials that assess the effectiveness of this form of therapy, the majority of the published data do suggest an improvement in pregnancy rates when compared to expectant management.