Ovulation Induction & Timed Sexual Intercourse (TSI)
Timed Sexual Intercourse (TSI)
Ovulation is a part of menstrual cycle. It occurs when an egg is released from the ovary. It typically happens around day 14 of a 28 day menstrual cycle. However, not every woman has 28 days cycle, so the time of ovulation can vary depending upon the length of cycle. The cyclic behaviour of the hormones and ovulation is what gives ovulating women regular menses (defined as a variation of not more than 8 days between cycles).
When this ovulation process fails, patients present with irregular menses. Its is known from various studies that the majority of women with regular menses are ovulating.
Ovulatory dysfunction can be the cause of infertility in about 25% of couples, trying to achieve a pregnancy and the most common cause is polycystic ovarian syndrome (PCOS). When a couple is trying to conceive but ovulation is not happening, it is extremely unlikely that a pregnancy can be achieved. The treatment of Ovulation Induction with Timed Sexual Intercourse (TSI) is indicated as the initial approach for these couples as it will support the female to ovulate. Those who most benefit from Timed Sexual Intercourse (TSI) are: -Patients trying less than 2 years with no apparent cause of subfertility
When this ovulation process fails, patients present with irregular menses. Its is known from various studies that the majority of women with regular menses are ovulating.
Ovulatory dysfunction can be the cause of infertility in about 25% of couples, trying to achieve a pregnancy and the most common cause is polycystic ovarian syndrome (PCOS). When a couple is trying to conceive but ovulation is not happening, it is extremely unlikely that a pregnancy can be achieved. The treatment of Ovulation Induction with Timed Sexual Intercourse (TSI) is indicated as the initial approach for these couples as it will support the female to ovulate. Those who most benefit from Timed Sexual Intercourse (TSI) are: -Patients trying less than 2 years with no apparent cause of subfertility
- -Women younger than 35
- -Anovulatory patients
- -Oligomenorrhoeic patients (with very long menstrual cycles)
- -Patients with inadequate luteal phase (insufficient progesterone production during the latter phase of the menstrual cycle)
- -Patients with no alterations in sperm
- A typical TSI cycle takes place as follows:
- The woman starts daily injection for 5 days, starting on cycle day 2-5 of her period)
- She attends for a follicle tracking trans-vaginal scan 5-6 days after the start of the injections
- One or more further follicle tracking scans may be necessary, depending on how quickly the follicles start growing
- Once the follicle has reached a size of higher than 17mm a hCG injection is given and the couple are advised to have intercourse 24 and 48 hours later.
- The female is advised to take progesterone support in the form of vaginal gel or suppositories
- A pregnancy test is carried out two weeks later