Medications for Infertility in Women
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The information provided here is meant to give you a general idea of what to expect from each of these medications. Only the most common side effects are included, so ask your healthcare provider if there are any precautions specific for you. Use each of these medications as recommended by your healthcare provider and according to the instructions provided with the medication. If you have further questions about usage or side effects, contact your healthcare provider.
You may be given medications that stimulate your ovaries to produce more eggs. The likelihood of multiple births is increased with these medications
Prescription Medications
Drugs That Stimulate Ovulation
- Clomiphene citrate (Clomid, Serophene)
- Metformin
- Progesterone (Provera)
- Human chorionic gonadotropin or hCG (Profasi, Pregnyl, Ovidrel)
- Human menopausal gonadatropin or hMG (Pergonal, Humegon)
- Follicle-stimulating hormone, or FSH (Follistim, Gonal F)
Drugs That Help Modify Hormone Levels
- Gonadotropin releasing hormone, or GnRH agonists (Lupron, Synarel)
- GnRH antagonists (Antagon, Cetrotide)
- Bromocriptine mesylate (Parlodel, Ergoset)
Prescription Medications
Drugs That Stimulate Ovulation
Clomiphene Citrate
Common names include:
- Clomid
- Serophene
This drug can help when infertility is caused by ovulatory problems, such as inadequate secretion of luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Clomiphene citrate causes a surge in LH and FSH release by the brain that ultimately stimulates ovulation. The drug is taken orally as a tablet, usually for five days. If no ovulation occurs, the regimen may be repeated, usually with a higher dose. Timing of the dose is important, so you’ll probably be advised to take the tablet at the same time every day. If you miss a dose, contact your healthcare provider to determine when to take the next dose.
Possible side effects include:
- Hot flashes
- Migraines
- Breast discomfort
- Vaginal dryness
Metformin
This drug is sometimes used in combination with clomiphene in patients diagnosed with a cause of infertility known as polycystic ovarian syndrome .
Progesterone (Provera)
This drug is sometimes used in combination with clomiphene to trigger a withdrawal period prior to a cycle with clomipene.
hCG, hMG and FSH
Common names include:
- Profasi, Pregnyl, Ovidrel
- Pergonal, Humegon
- Follistim, Gonal F
Both hCG and hMG are naturally occurring hormones that work by inducing maturation of the ovarian follicle and release of a mature egg. hCG works like LH, and hMG has activities of both LH and FSH. Both drugs are provided as intramuscular injections, although more purified forms of hMG may be injected under the skin. hCG is usually provided as a single injection following a fertility treatment cycle. hMG, on the other hand, may be given for 10 days or more. Blood levels of estrogen and other reproductive hormones may be monitored throughout treatment, and dosages of the drugs may be adjusted accordingly. FSH may also be provided directly as an injection usually for five days. Women whose infertility is related to polycystic ovarian syndrome (PCOS) may be treated with FSH for longer periods of time.
Possible side effects include:
- Injection site pain
- Lower abdomen tenderness
- Fluid retention, breast tenderness
- Headache
- Emotional irritability
- Multiple births
Drugs That Help Correct Hormonal Imbalances
Gonadotropin-Releasing Hormone (GnRH) Analogs
Common names include:
- Lupron
- Synarel
GnRH analogs are synthetic versions of naturally occurring hormones. These drugs suppress secretion of pituitary hormones, which prevents premature ovulation, and help to control ovulatory cycles during fertility treatment. They may be given by injection, nasal spray, or implants.
Possible side effects include:
- Hot flashes, night sweats, headaches
- Emotional irritability
- Lower abdomen tenderness
- Long-term use can lead to bone loss
Gonadotropin-Releasing Hormone (GnRH) Antagonists
Common names include:
- Antagon
- Cetrotide
Like the GnRH analogs, they also suppress release of LH and, to a lesser extent, FSH. This activity delays the LH surge and ovulation, which is useful in synchronizing ovulatory cycles during fertility treatment.
Possible side effects include:
- Abdominal pain
- Headache
Bromocriptine Mesylate
Common names include:
- Parlodel
- Ergoset
This drug is prescribed for women who have elevated levels of the pituitary hormone prolactin. Although prolactin is important during lactation, high levels can cause irregular menstrual cycles, suppress ovulation, and interfere with fertility. The drug is provided as a tablet, which is taken with food 1-3 times daily. Once prolactin levels are normalized, regular periods usually begin within 6-8 weeks.
Possible side effects include:
- Nausea
- Headache
- Tingling in hands and feet
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
- Take them as directed—not more, not less, not at a different time.
- Do not stop taking them without consulting your healthcare provider.
- Don’t share them with anyone else.
- Know what effects and side effects to expect, and report them to your healthcare provider.
- If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
- Plan ahead for refills so you don’t run out.
References:
The InterNational Council on Infertility Information Dissemination website. Available at: http://www.inciid.org/ .
RESOLVE: The National Infertility Association website. Available at: http://www.resolve.org/site/PageServer .
Update on the management of the pregnant patient with antiphospholipid antibody. Current Rheumatology Reports. June 2001.
US Food and Drug Administration website. Available at: http://www.fda.gov/ .
USP DI. 21st ed. Micromedex; 2001.
Last reviewed November 2008 by Jeff Andrews, MD, FRCSC, FACOG
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.