Pioneer of infertility treatment. Covering the needs of infertility from various tests 
to IVF/ICSI’s Advanced Reproductive Technologies.

How We Think about Ovulation Induction at Our Clinic

First of all in principle, we think that it should be something tailor-made and suited to each individual’s situation.  However, there is a great value on the points of safety and success rate of going though the long years of protocol.  But, we believe that the success rates will be heightened additionally by responding to and arranging various situations on top of that.



Stimulation Method, Natural Cycle or Low Stimulation


In regards to the ovulation induction of in vitro fertilization, the data that we can trust is the data coming from western countries and centering out of America.  In western countries, they prospectively consider and analyze the many cases at large-scale IVF centers.  Therefore, when it comes to the patients coming in, “You will have the long method” and “You will have the short method” are at random, and the one equal method that is chosen by everyone will be the way to take IVF.  Additionally, we generally don’t use Low stimulation method.  First, that is a situation based on protocol.


Japanese IVF is becoming quite a thing of considerable features.  There are many cases of  low stimulation and moderate degree stimulation when compared to western countries, and we have the style of doing it like that, while checking on the follicle development we moderate.  In addition to the inside, it is also seen as an extreme way that we only use the ways devised by our own clinic.


At our clinic, from long years of experience, the basics of ovulation induction are tailor-made, and therefore, we feel that it is something that ought to be considered accordingly to each individual case.  That’s why before the egg retrieval period we build a plan geared to the patients.


However, the first selection is the Short Method, or in other words, the Stimulus Method.
The reasons are as follows:

  1. In the case of a low stimulation or natural cycle egg retrieval, there are many cases where the potential of egg retrieval cancellation from ovulation and vacuolation, and fertilization and splitting not occurring in the cases where a transplant can not take place when compared to the stimulus method.
  2. In the case of low (mild) stimulation, because the number of retrieved eggs is few there is no surplus freezing and it will be necessary for continuous cycle egg retrieval.  The burden to the body, and in terms of the results, the financial burden is more of an increasing thing.
  3. In the case where one is thinking about a second child, if one is in the upper 30’s, it would be advantageous to have surplus embryos frozen.



Agonist or Antagonist (Cetrotide®)?


Although the use of Agonist (Mainly nasal medicine, used for Short Method and Long Method) was a conventional method to retrieve eggs by inhibiting ovulation, the story of the use of Antagonist, which can inhibit ovulation for a brief time, came around about 10 years ago.  Until the development of the formulations we have today, the side effects were very strong and were hardly used.


From the 6th day of menstruation in the stimulation cycle, it will start being used.  At the time when early on formulations came out, there were reports that the quality of the oocytes were better with the use of Antagonist more so than with Agonist, but nowadays, it is said in regards to the quality of the oocytes that there is no change.  We, at Oak Ladies Clinic, are feeling the same way.


The good points of Antagonist are that the pituitary suppression is weak; it is temporary and will not prolong. 
On the other hand, because there is a risk of ovulation, for example, such as when there are various follicle sizes and are numerous follicles with slow development, because there is a suffice pituitary suppression with the Agonist Method, even if there is a good enough size of follicles, we can still wait for the development of the small follicles.  However, with the Antagonist Method, it will be trouble if large follicles are ovulated, so we can’t really wait.  Consequently although the suppression is strong, we can get more oocytes by means of the Agonist Method.


At our clinic, we first try the Short Method, and in the case of 3 or fewer oocytes are collected, then from the next time in order to increase the number of oocytes collected we will weaken the suppression and change to the HMG Cetro Method of the Antagonist Method.



Summary of Ovulation Induction


Method Development Control Ovulation Risk ET Cancel Cryopreservation Cancel OHSS Preliminary functional decline example Cost❈1 Cost until pregnancy ospital Visit❈2
Short method
Long method
HMG Cetro Method
(Breast cancer ex. Is ○)
Complete Natural Cycle

❈1)The cost is only for that egg retrieval cycle.  In the case of low stimulation, because it may take several cycles until pregnancy, the total cost tends to be slightly lower with the stimulation cycle

❈2)As for the number of visits, that can be adjusted by means of self-injections.




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Oak Medical Group has been from the time we opened, supporting the many issues of women's health, building performance and trust, and not only here in Osaka, but centering in Kansai we are receiving patients from across Japan.
Especially with our infertility treatment, we are widely covering the various tests to IVF/ICSI's Advanced Reproductive Technologies.  Depending on the cause of the infertility, we are handling the treatment of each patient one by one.  If you have some concerns, please don't hesitate to consult with us.