Ovulation induction

⚕ Medically reviewed by Prof. Stratis Kolibianakis, MD, MSc, PhD · Thessaloniki Medical Chamber Reg. No. 16340 · Last reviewed 6 July 2026

Ovulation induction is for women with menstrual-cycle disorders (such as polycystic ovary syndrome) or unexplained infertility. We administer letrozole or low-dose gonadotrophins, with ultrasound monitoring every 2–3 days. When a mature follicle develops (≥17 mm), we schedule timed intercourse or insemination. The goal is one mature follicle per cycle to minimise the risk of multiple pregnancy.

Why letrozole is preferred in PCOS. In polycystic ovary syndrome (PCOS), letrozole is now the first-line medication for ovulation induction, as it leads to higher live-birth rates than clomiphene, according to the 2023 International PCOS Guideline. It is taken by mouth for 5 days early in the cycle. Before drug-based induction starts, factors such as body weight and thyroid function — which directly affect the response — are addressed.

Why monitoring is essential. Ultrasound every 2–3 days is not a formality: it lets us see how many follicles are developing and cancel or adjust the cycle if several grow, reducing the risk of twin or higher-order pregnancy. The goal is one, at most two, mature follicles. Without monitoring, ovulation induction is less safe.

How many cycles, and then what. Most pregnancies from ovulation induction occur within the first 3–6 cycles. If there is no pregnancy in that window, or if other factors coexist (age, male factor, tubal problem), we reassess the plan and discuss moving to IVF. The aim is not to stay on a treatment that is no longer delivering longer than necessary.

→ back to Services · related: IUI, Fertility investigation, IVF & ICSI · → Book an appointment