Controlled Ovarian Hyperstimulation (COH)


Controlled ovarian hyperstimulation

  • Controlled ovarian hyperstimulation (COH) is a process of inducing ovulation and egg release by injecting several different fertility medications.
  • At the Fertility Institute, our doctors provide this service in conjunction with fertility treatments like in vitro fertilization, artificial insemination and intrauterine insemination.
  • Our fertility specialists will work closely with you to determine what medications are best for your unique needs.
  • To learn more about controlled ovarian hyperstimulation, contact any of our centers today.

Why COH is necessary

COH injection | The Fertility Institute of New Orleans | Baton Rouge & Mandeville, LACOH is specifically designed to help control when ovulation occurs, and increase the number of eggs released. These two factors can ultimately increase the chances of fertility when combined with other treatments. COH is not designed to treat or correct a condition that is hindering fertility. Rather, it is a way to increase the chances that other treatments will be successful.

In basic terms, it is designed to enhance and more precisely time the natural process of ovulation in the hopes that an introduced sperm will fertilize one or more eggs.

For IVF patients, COH greatly increases the likelihood that more than one healthy egg can be harvested at once. This ultimately increases the opportunities for a successful fertilization in the laboratory, and successful introduction of an embryo into a patient’s uterus. COH medications also allow our fertility specialists to control when a patient ovulates, and to harvest eggs or introduce sperm at the proper time.

This type of treatment is only for patients who are naturally producing healthy eggs and have a healthy uterus and fallopian tubes. COH can be used to help couples affected by male factor and female factor infertility.

COH overview

In the first stage of COH, our specialists will inject patients with a follicle stimulating hormone, or FSH. The ovarian follicles are groups of cells that are responsible for producing a single oocyte, or female egg, at a time. FSH injections stimulate multiple follicular groups to produce multiple eggs, rather than the single egg that is produced during natural ovulation. In addition to FSH injections, our fertility specialists may also provide injections of the luteinizing hormone, which stimulates the follicle to produce estrogen and makes the uterus more hospitable to sperm and egg alike.

Once a patient’s ovarian follicles have fully matured, our specialists will provide human chorionic gonadotropin (hCG). hCG helps the ovarian follicles to release their eggs so that they can be harvested or inseminated. This usually occurs 36 to 48 hours following the injection. During follicle stimulation and egg retrieval, we will utilize ultrasound monitoring to determine the optimal time to harvest eggs or introduce sperm through IUI or artificial insemination.

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Evaluating COH/AI candidates

For many patients who have had difficulty conceiving on their own, controlled ovarian hyperstimulation (COH) and artificial insemination (AI) can provide an improved chance of becoming pregnant. COH refers to the process of using fertility medications to stimulate the development of ovarian follicles and promote the release of healthy eggs. AI involves inserting sperm, either from a partner or a donor, directly into the woman’s uterus, cervix, or fallopian tube.

Our doctors have helped many women and couples conceive healthy babies through the use of different fertility treatments, and we can help you determine if you may be COH/AI candidates.

Our fertility centers are dedicated to helping our patients overcome infertility issues. If you have had difficulty conceiving and would like more information about COH/AI, please contact our office to make an appointment with one of our caring fertility specialists.

The COH process

The COH process involves the use of specific fertility medications that are designed to induce ovulation. COH is also the first step in a cycle of in vitro fertilization, and uses the same types of medications. Follicle stimulating hormone (FSH) is administered, often in conjunction with luteinizing hormone (LH), to stimulate the development of ovarian follicles. When the follicles begin maturing, human chorionic gonadotropin (hCG) is administered to encourage the release of a healthy egg or eggs.

Artificial insemination

Sperm from your partner or a donor will be washed in our laboratory to remove any impurities and enhance the chance of fertilization. After fertility medications are administered and ovulation has occurred, our doctors will introduce the sperm into the uterus (intrauterine insemination) or the cervix (intracervical insemination) through a thin catheter.

The procedure is relatively quick and painless, and you can typically return to your daily routine after about 45 minutes.

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Determining your candidacy

COH and AI treatments are indicated for a number of different causes of infertility. These procedures are commonly recommended for severe male fertility factors because the sperm is introduced directly into the uterus or cervix. This provides a minimally invasive solution for low sperm count and poor sperm motility. COH and AI are also commonly indicated for women who suffer from endometriosis and abnormalities of the reproductive organs. This treatment is effective in these cases because it has the ability to bypass any areas of the reproductive tract that may be causing difficulty with conceiving.

COH and AI procedures are also commonly recommended in cases of “unreceptive cervical mucus.” This condition causes the mucus that surrounds the cervix to inhibit sperm from entering the uterus. As a result, the sperm are unable to reach the egg and achieve natural fertilization. AI allows the sperm to pass by the cervix altogether and reach the egg in the uterus or fallopian tube.

Doctors may also suggest COH/AI treatments when the cause of infertility is unknown and other treatments have been unsuccessful.