Timed intercourse
The timed intercourse is the simplest form of assisted reproduction treatments.
It can be performed either during a natural cycle or using a simple ovarian stimulation protocol to induce multiple follicular development and ovulation.
It entails minimal risks and inconvenience to the patient while being relatively inexpensive.
Monitoring of the cycle and hormone tests are necessary, so that sexual intercourse can be "programmed" as close as possible to the ovulation day. Two or three ultrasounds and two or three measurements of E2 and LH levels are required.
Prerequisite for the success of this method is to have open fallopian tubes, normal ovulation and normal sperm parameters.
Ovulation is either achieved naturally or is scheduled 36 hours after administering chorionic gonadotropin (HCG). It can be indentified by ultrasound and hormonal testing. Alternatively, ready kits are available to determine the fertile day. The old method of the thermometric chart is now used by very few women.
Natural Cycle or medicated
The main advantage of the natural cycle is that the procedure is simple: there are no drugs, the duration is shor, and the cost is limited.
The disadvantage is the possibility that no follicle will be developed. This occurs in cases of anovulated cycles, most commonly associated with polycystic ovarian syndrome. In this case it is preferable to cause ovarian stimulation. This is achieved by administering drugs which contain hormones. The most common drug is clomiphene citrate, used to stimulate the growth of follicles. This drug has an anti-estrogenic effect given on the first days of the menstrual cycle (typically a pill from day 2 to day 6).
Alternatively, gonadotropins (FSH, in small doses can be given subcutaneously or intramuscularly.
Disadvantages or side effects of timed intercourses
The main disadvantage is that this method does not allow any control of what actually happens within the body. Ovulation occurs naturally and fertilization takes place in the fallopian tubes, so it is impossible to check.
Furthermore, the success rates do not exceed the normal rates of conception (i.e. 20% per cycle) in young, fertile couples.
A major drawback is also that sexual intercourse must take place in a specific time. This can be inconvenient and stressful for several couples.
Clomiphene citrate treatment has minor side effects, while gonadotropin doses, if administered, are low and their side effects are also negligible. However, gonadotropin treatment actually induces ovarian stimulation. The risk of ovarian hyperstimulation is negligible. The method also involves a small risk of multiple pregnancy, if there are multiple follicles.
