Drugs That Help You Ovulate

Author: Janefrances Ugochi Ozoilo, MBBS, FMCPH, MSc (PH), PMP

Medical Reviewer: Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights

• Ovulation induction uses medicines to help the ovaries release eggs and improve the chance of pregnancy.
  
  
• A normal cycle depends on hormones from the brain and ovaries working together to grow a follicle, mature an egg, and release it.
  
  
• Doctors often recommend ovulation induction when ovulation is absent or irregular, making it harder to get pregnant.
  
  
• Common causes of irregular ovulation include Polycystic Ovary Syndrome, thyroid problems, high prolactin levels, conditions affecting the brain, and increasing age.
  
  
• Treatment usually starts with baseline tests, followed by tablets or injections, depending on your needs.
  
  
• Some supplements may help ovulation in women with PCOS, but strong scientific evidence for their benefit is still limited.

What is Ovulation Induction?

Each month, most women between the ages of 15 and 45 release one egg from the ovaries. This process is called ovulation. If the egg meets a sperm, it can form an embryo and grow into a pregnancy. If it does not meet a sperm, the egg is shed during the monthly period. Hormones in your body control this process and prepare the uterus for pregnancy.

Sometimes, ovulation does not happen regularly or does not happen at all. Ovulation induction is a treatment that uses medicines to help the ovaries grow and release an egg. Doctors may recommend this treatment if you are having difficulty ovulating. In some cases, these medicines are also used to help the ovaries release more than one egg in a cycle, depending on your fertility plan and your doctor’s advice.

How Ovulation Occurs

Before going further, you need to understand a normal ovulation cycle. 

• Each woman has two ovaries. Each ovary has many small eggs inside sacs filled with fluid, called follicles. 
• Every month, one follicle usually becomes the main one and helps an egg mature.
• Hormone signals from the hypothalamus in the brain send out Gonadotrophin Releasing Hormone (GnRH) in bursts. 
• GnRH then tells the pituitary gland to release two important hormones: Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH). 
• FSH helps the ovary grow follicles, and LH helps release the egg.
• As the follicle grows, it makes a hormone called oestrogen. This hormone helps the body get ready for a possible pregnancy. Then, a sudden sharp increase in LH occurs, and the mature egg is released.
• The released egg travels towards the womb through the fallopian tube. This is when fertilisation occurs if a sperm is present.
• The fertilised egg is now implanted in the uterus. At this point, pregnancy is said to have occurred.

Ovulation can become irregular if the signals between the brain and ovaries are disrupted or if the ovaries have trouble releasing an egg. A common example is Polycystic Ovary Syndrome (PCOS), where ovulation may not happen often. This is why medicines that help induce ovulation are commonly used.

When is Ovulation Induction Needed?

The usual complaint to your doctor will be an inability to get pregnant despite more than a year of trying with your partner. Your doctor would also have made a diagnosis of infertility and suggested you undergo an ovulation induction. What are the reasons to conduct an ovulation induction? 

• You are not releasing an egg 

This is called anovulation. If no egg is released, pregnancy cannot happen naturally.

• You release eggs only in some months 

Some people have irregular ovulation called oligo-ovulation. This means they might have very long cycles or go months without ovulating.

9 Conditions that cause Anovulation and Oligo-ovulation 

• Polycystic Ovary Syndrome (PCOS)

In PCOS, the ovaries look big on ultrasound and have so many follicles, usually arranged like a string of pearls. This condition, which results in irregular or missing ovulation, is often caused by high levels of male hormones and problems with insulin (a type of hormone).

• Functional Hypothalamic Amenorrhea (FHA)
  Functional Hypothalamic Amenorrhoea (FHA) happens when there is major weight loss, not enough nutrition, eating disorders, too much exercise, or high stress. This affects the function of the hypothalamus (an organ in the brain) Other causes include tumours in the pituitary or hypothalamus, radiation effects and severe bleeding during childbirth. All these can cause low or irregular ovulation.

• High Prolactin

Hyperprolactinemia is a condition in which there is too much prolactin (a hormone) in the blood. High prolactin can stop the brain from sending signals needed for ovulation. This can happen because of growths in the pituitary gland ( an organ in the brain) or some medicines. 

• Thyroid Problems

The thyroid is a gland located in the neck that releases a hormone called the thyroid hormone. Having too much or too little thyroid hormone can affect hormones that control menstruation. This can make it hard for the ovaries to release eggs.

• Primary Ovarian Insufficiency (POI)
  In Primary Ovarian Insufficiency (POI), the ovaries stop working properly before age 40. This means follicles do not mature properly, leading to irregular or no ovulation.

• Age-related ovarian decline

During perimenopause and menopause, the number of eggs in the ovaries decreases. This can cause ovulation to become irregular and eventually stop. 

• Medications

Medicines can interfere with hormone signals and ovarian function. Mental health medicines like antipsychotics can raise prolactin and disrupt ovulation, while some anti-seizure medicines affect hormones and menstruation. Cancer treatments can damage the ovaries and reduce eggs. Hormone-based medicines, including progestins, androgens, estrogens, and GnRH analogues, can directly alter ovulation-controlling hormones.

• Breastfeeding

Breastfeeding, especially when done often or exclusively, can delay ovulation after childbirth. This is because suckling can reduce certain hormone pulses. 

• No known Cause

After medical examinations and tests, the exact reason for ovulation disorder may remain unknown in some people [1,2]. 

What Drugs are used for Ovulation Induction?

Certain medicines are used to enhance and enable the process of ovulation for women in the reproductive age group (15-45 years). This intervention becomes necessary when it is confirmed that you have anovulation or oligo-ovulation. It is important to know that as you approach menopause, the chances of a successful ovulation induction decrease. These medicines include;

• Letrozole

Letrozole tablets lower oestrogen levels. This makes the brain think there is not enough oestrogen, so it increases FSH to help eggs grow and mature. You may experience side effects such as headaches, hot flashes, tiredness, dizziness, feeling sick, and mild pelvic pain or bloating.

• Clomiphene Citrate 

Clomid tablets stop oestrogen from sending signals to the brain. This makes the brain release FSH and LH, which help the ovaries grow a follicle and release an egg. Side effects can include hot flashes, mood changes, painful breasts, and feeling sick. You may sometimes get headaches. Vision problems are rare. If you have them, see a doctor right away.

• FSH 

Follicle Stimulating Hormone (FSH) injections are used to help one (or sometimes multiple) follicles develop so that an egg can be released. FSH injections may cause mild reactions at the injection is given. Other side effects include bloating, pelvic pain, headaches, nausea, tiredness, mood swings, and sore breasts. 

• HMG Injections

Human Menopausal Gonadotrophin (HMG) Injections contain FSH and LH and help the ovaries grow one or more follicles. Side effects can include swelling or redness where the injection is given, painful breasts, feeling bloated, mood changes, and pelvic pain. These injections can increase the chance of having twins or more. They may also cause Ovarian Hyperstimulation Syndrome (OHSS), especially in people with PCOS.

• Metformin

Metformin helps the body use insulin better. For some women with PCOS, lowering insulin resistance can make menstruation regular and help with ovulation. It can be used with letrozole and clomid. Possible side effects include stomach pain, nausea and diarrhoea, which usually get better over time.

• Cabergoline and Bromocriptine 

High prolactin levels, also called Hyperprolactinemia, inhibit ovulation. Medicines like Cabergoline and Bromocriptine reduce prolactin levels, enabling brain and ovarian hormones to resume function and restore ovulation. Side effects include nausea, dizziness, headaches, fatigue, and low blood pressure upon standing (postural hypotension) [2].

 What to expect during Ovulation Induction

The ovulation induction process is guided and supervised by your doctor. Here is what you can expect during ovulation induction.

1. Your doctor will first check if ovulation is the main problem.
 You may have blood tests to check your hormone levels and your ovarian reserve. Your doctor may also arrange a pelvic ultrasound to look at your ovaries and uterus and check for cysts or other problems. Tests may also be done to be sure there are no sperm problems or blocked fallopian tubes.

2. Tell your clinic when your period starts.
 Day 1 is the first day of menstrual bleeding. Many clinics ask you to call or send a message on that day. This helps them plan your scans and medicines at the right time.

3. You will take medicines based on your needs.
 Your doctor may give tablets such as letrozole or clomiphene to take for five days at the start of your cycle. Some women need hormone injections such as FSH or hMG. These usually start around Day 2 or Day 3 of your cycle and are taken daily for about 7 to 12 days, or longer if needed.

4. Your doctor will monitor your progress.
 You may have scans to check how your eggs are growing. This is called follicle tracking. It helps your doctor choose the safest and best time for ovulation.

5. You may get a trigger shot.
 When an egg is ready, your doctor may give an hCG injection. This helps the ovary release the egg at a planned time.

6. You will be told when to try for pregnancy.
 Your doctor will guide you on the best time to have intercourse, often after the trigger shot or when the egg is ready. If you are having intra-uterine insemination (IUI), the clinic will schedule it at the right time.

7. You may receive progesterone support.
 After ovulation, your body makes progesterone to prepare the uterus for pregnancy. Sometimes your doctor will give extra progesterone to support this phase. You will usually do a pregnancy test about two weeks after ovulation or after the trigger shot.

8. Be aware of possible side effects.
 You may notice bloating, mild pelvic pain, mood changes, or hot flashes. Multiple pregnancy can happen, especially with injections. A rare but serious problem called ovarian hyperstimulation syndrome can also occur with injections. Call your doctor quickly if you notice severe stomach pain, fast swelling, sudden weight gain, trouble breathing, or reduced urination.

Are there supplements that help with ovulation?

Researchers have looked into dietary supplements that might help with ovulation. So far, the results are unclear, and more studies are needed. Experts have different opinions on this. 

These supplements are sometimes suggested to support ovulation, especially for people with Polycystic Ovary Syndrome. They may help with hormone balance, egg development, or insulin control. However, studies show they work best when used alongside medical treatment, not as a replacement.

• Inositols

Inositols, like myo-inositol and D-chiro-inositol, may help with ovulation, menstrual cycles, and hormone and metabolism issues in people with PCOS [3]. These compounds are found in fruits, beans, legumes, whole grains, nuts, and seeds. 

• Vitamin D

There is some evidence that Vitamin D may help women with PCOS ovulate more often [4]. You can get Vitamin D from foods like salmon, tuna, and mackerel, or from fortified foods like milk, cereals, and juices. Sunlight also provides Vitamin D. 

• N-acetylcysteine (NAC)

Evidence  show N-Acetylcysteine (NAC) might help improve reproductive health in PCOS patients, often when used with ovulation medicines. The results are promising but vary across studies [5]. NAC is a supplement, and its building block, cysteine, is in protein-rich foods like meat, fish, beans, and grains.

• L-Carnitine

How L-carnitine affects ovulation in women with PCOS has been studied recently. The results were mixed; some studies found benefits, while others did not [6]. This shows that more research is needed. The highest levels of this nutrient are found in animal foods like meat, fish, poultry, and dairy. 

• Chromium Picolinate

Research shows that Chromium (a mineral) supplementation might help with PCOS by improving ovulation and pregnancy rates [7]. However, more studies are needed to be sure. It is found in many foods.

Conclusion

Ovulation induction helps improve hormone signals for egg release. This gives people with irregular ovulation a better chance of conceiving. With the right medicine, careful monitoring, and a plan that suits your body and goals, treatment can be safe and empowering. 

Support your progress with healthy habits and supplements if needed. Remember, you are not alone, and there are many effective options to help you.

References

1. Katsikis I, Kita M, Karkanaki A, et al. Anovulation and ovulation induction. Hippokratia 2006; 10: 120–127. Available from: https://pubmed.ncbi.nlm.nih.gov/20351807/
2. Mousa A, Tay CT, Teede H. Technical Report for the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Monash University. Available from: https://bridges.monash.edu/articles/report/Technical_Report_for_the_2023_International_Evidence-based_Guideline_for_the_Assessment_and_Management_of_Polycystic_Ovary_Syndrome/23625288?file=41455206
3. Nordio M, Basciani S, Camajani E. The 40:1 myo-inositol/D-chiro-inositol plasma ratio is able to restore ovulation in PCOS patients: comparison with other ratios. European Review for Medical and Pharmacological Sciences 2019; 23: 5512–5521. Available from: https://pubmed.ncbi.nlm.nih.gov/31298405/
4. Yang M, Shen X, Lu D, et al. Effects of vitamin D supplementation on ovulation and pregnancy in women with polycystic ovary syndrome: a systematic review and meta-analysis. Front Endocrinol 2023; 14: 1148556. Available from: https://pubmed.ncbi.nlm.nih.gov/37593349/
5. Thakker D, Raval A, Patel I, et al. N-acetylcysteine for polycystic ovary syndrome: A systematic review and meta-analysis of randomised controlled clinical trials. Value in Health 2013; 16: A156–A157. Available from: https://pubmed.ncbi.nlm.nih.gov/25653680/
6. Abu-Zaid A, Alghamdi GA, Alharbi AS, et al. Effect of L-carnitine supplementation on fertility outcomes among patients with polycystic ovary syndrome: a systematic review and dose-response meta-analysis of randomized clinical trials. Obstet Gynecol Sci 2025; 68: 260–272. Available from: https://pubmed.ncbi.nlm.nih.gov/40436023/
7. Hamsho M, Ranneh Y, Fadel A. Therapeutic effects of chromium supplementation on women with polycystic ovarian syndrome: A systematic review and meta-analysis. Endocrinología, Diabetes y Nutrición (English ed) 2025; 72: 501578. Available from: https://pubmed.ncbi.nlm.nih.gov/41067797/

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published February 24, 2026