Fertility Problems
Medications
Medication or hormone treatments are often the first steps in infertility treatment. They are also used for in vitro fertilization and other assisted reproductive technologies.
Medication Choices
Medications to stimulate ovulation
- Clomiphene citrate (Clomid) stimulates the release of hormones that trigger ovulation. Clomiphene is typically the first choice of treatment for unexplained lack of ovulation because of its ease of use—it's taken orally rather than injected, doesn't usually cause severe side effects, and doesn't usually require daily monitoring.
- If clomiphene does not work, your doctor might try hormone shots. These shots, called gonadotropins, include Bravelle, Luveris, Pregnyl, Pergonal, Puregon, Gonal F, Repronex, and rFSH. They directly stimulate the ovaries to produce mature eggs.
- If you have polycystic ovary syndrome, your doctor may try a medication called metformin in combination with clomiphene. It can help correct insulin resistance and elevated male hormone levels, often starting egg production and regular menstrual cycles.9
Medications used for in vitro fertilization
- First, a hormone is used to "shut down" the pituitary, which puts the ovaries in a menopause-like state (menopausal symptoms are common). This is generally done using a gonadotropin-releasing hormone (GnRH) analogue.
- Then ovulation-stimulating gonadotropins (such Bravelle, Luveris, Pregnyl, Pergonal, Puregon, Gonal F, Repronex, and rFSH) are used to trigger ovulation on a schedule. This process is also used before some insemination procedures.
Other medications
- Gonadotropin-releasing hormone (GnRH) (for women and men with low levels of naturally produced gonadotropins) increases the body's production of hormones needed for egg and sperm production. A small pump worn by the user injects a tiny amount of this drug into the body. The drug stimulates the pituitary gland to produce hormones that trigger ovulation in women and sperm production in men.
- Bromocriptine and cabergoline (for women and men) reduces high prolactin levels. High prolactin levels can prevent ovulation in women and can prevent the release of testosterone and production of sperm in men.
What To Think About
Ask your doctor questions about medications you are considering, including whether there are long-term effects, how long the treatment lasts, how often you must be tested while taking it, and whether there are any side effects that will affect your daily life.
Multiple pregnancy risk
If you have irregular or no ovulation, using medication or hormones to stimulate ovulation will increase your chances of pregnancy. However, these treatments increase your risk of multiple pregnancy, which poses health risks to both you and your fetuses. When considering an infertility treatment:
- Ask your doctor about your risk for having a multiple pregnancy and how to minimize the chance of conceiving more than one fetus.
- Consider the impact of a high-risk multiple pregnancy, and the possibility of having multiple disabled children, on your life. For more information, see the topics Multiple Pregnancy: Twins or More, Preterm Labour, and Premature Infant.
Other rare complications—such as ovarian hyperstimulation syndrome—can result from hormone shots used to stimulate ovulation, usually for assisted reproductive technology such as IVF.
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| Author: | Shannon Erstad, MBA/MPH Carrie Henley | Last Updated: August 16, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Femi Olatunbosun, MB, FRCSC - Obstetrics, Gynecology and Reproductive Medicine | |
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