Infertility Drugs
Guide To Fertility Medications For Women

Fertility Drugs

Contents

• What Are Infertility Drugs?
• Who Needs Fertility Medications?
• What Are The Most Popular Fertility Drugs?
• Clomiphene
• Gonadotropins
• Bromocriptine
• What Are The Side Effects?

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Infertility Guide

What Are Infertility Drugs?

Fertility drugs are medications which are taken to stimulate ovulation (also known as ovarian stimulation). These drugs can be taken as an oral pill or in stronger doses by injection. While some of the medications can also be used to treat male infertility, they are much more commonly prescribed to women. In fact fertility medications are often the first line of treatment for female infertility. They work by increasing the level of certain hormones in your body so that you release one or more eggs a month (ovulation). While most medications have been around for years, they still carry some side effects; primarily they increase your chance of having twins or even triplets. Have you noticed more women pushing twin strollers around the shopping mall in recent years? According to statistics by the Centers for Disease Control and Prevention (CDC) ovulation treatments account for nearly 25 percent of all multiple births in the United States. As the number of women turning to fertility treatment increases, so too are the number of twins and triplets being born. It is estimated that about 190,000 children are born every year in the US by OI.

Who Needs Fertility Medications?

OI is usually recommended to women with:

1. Irregular periods due to a hormone imbalance, usually they have low levels of LH (luteinizing hormone) or FSH (follicle stimulating hormone). Fertility tests will reveal if there is an imbalance.
2. Polycystic ovarian syndrome (PCOS).
3. A luteal phase defect (LPD), where the luteal phase of the menstrual cycle is shorter than normal.
4. Fertility drugs are also used in combination with more powerful fertility treatments called assisted reproductive technology (ART), including In Vitro Fertilization (IVF) and egg donation.

What Are The Most Popular Fertility Drugs?

The most popular are:

1. Clomiphene citrate (brand names Clomid and Serophene).
2. Gonadotropins (brand names Pergonal, Repronex, Menogon, Fertinex, Follistim, Gonal F, Purego, Pregnyl, Novarel, Profasi and Ovidrel).
3. Bromocriptine (Parlodel).

As there are many different causes of infertility, there are many different medications to deal with the various possible conditions. Which one is right for you will depend on the reason why you are having difficulties falling pregnant.

Clomiphene

Clomiphene (usually Clomid) is usually taken as a pill 5 or more days a month. It is supposed to induce ovulation on day 13 or 14 of your menstrual cycle, if you have a regular 28 day menstrual cycle. For more information, read about your most fertile days. The initial dosage is usually 50mg. It may be increased to 100mg the following month if you don't ovulate. Doses higher than 150mg are generally not recommended, but protocols vary from one fertility clinic to another. About 10 percent of women who take clomiphene go on to give birth to multiples (usually twins). 80 percent of pregnancies occur within the first 3 months of taking clomiphene; very few occur after 6 months. If you have not fallen pregnant within the first 3 months, you may be prescribed stronger fertility drugs which need to be injected. Women over the age of 40 tend not to respond well to clomiphene, so they may be advised to head straight for gonadotropins.

Gonadotropins

Gonadotropins are often prescribed to women:

1. Who fail to become pregnant with clomiphene.
2. Who have PCOS.
3. Luteal phase defects.
4. Unexplained infertility.
5. Undergoing ART procedures like IVF treatment.

There are 3 main types of gonadotropins injections. The first is a mixture of LH and FSH and is called HMG (human menopausal gonadotropins). The next is an injection of pure FSH and the final one is HCG (Human chorionic gonadotropins). Normally a woman starts by taking shots of either HMG or FSH 3 days into her menstrual cycle and will continue to take them for 7 to 12 days until her eggs mature. The doctor will train her how to self-inject. She will also undergo regular blood tests and ultrasound scans to see if she is responding correctly. Once her eggs mature she will be given one shot of HCG to encourage the release of the egg(s). Sexual intercourse or ART procedures will be timed to take place 36 to 40 hours after the final injection. As injections are much more potent than pills, the risk of twins is 10 to 40 percent with gonadotropins. Most women will become pregnant within 3 to 6 cycles (a cycle is one month of treatment). If you don't fall pregnant within this timeframe you will probably be recommended an alternative treatment (like IVF).

Bromocriptine

Women with a rare cause of infertility called hyperprolactinemic amenorrhea are usually prescribed this medication. Taken as an oral pill or a vaginal pill bromocriptine is usually taken for several months, 2 or 3 times a day. Between 65 and 85 percent of patients become pregnant with this treatment.

What Are The Side Effects?

As you are boosting your hormone levels, many of the side effects are like a severe form of premenstrual syndrome (PMS). This includes:

• Breast tenderness.
• Headaches.
• Bloated stomach.
• Weight gain.
• Mood swings.
• Ovarian cancer: There was some controversy for years about fertility drugs increasing the risks of ovarian cancer. However recent studies found no such link, even if the woman takes them for more than 12 months. Do check our list of books on infertility for some published personal stories and experiences.

Related Articles on Infertility Medications

For more information, see the following:

• Infertility Resources: List of support and information websites.
• How Common Are Twins? Naturally and with IVF.
• Male Fertility Testing: The boys need to be tested too!

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