Types of Medications used during Fertility Treatment
Medications are a usual part of infertility treatment and the in vitro fertilization (IVF) procedure. These medications prepare the body for therapy and increase the probability of ovaries releasing healthy eggs. The reproductive specialist evaluates the situation to determine which medications are best for you.
Clomiphene citrate (Clomid and Serophene) work by increasing the amount of follicle-stimulating hormone (FSH) by the pituitary gland. This drug stimulates ovulation in women who do not have periods, or those who have long or infrequent cycles. The starting dose is 50 mg per day, and dosage can be increased when ovulation does not occur. Chances of side effects increase when dosage increases. Potential side effects include hot flashes, mood swings, breast tenderness, and nausea.
Synthetic Human Chorionic Gonadotropin (hCG)
Synthetic hCG is used to trigger ovulation. This injectable medication is known as Profasil, Pregnyl, and Novarel. This fertility drug initiates ovulation in cycles.
Follicle-Stimulating Hormone (FSH)
An injection of FSH is used to directly stimulate follicle growth in the ovaries. FSH is secreted by the pituitary gland and hypothalamus of the brain. Synthetic forms include Folistim, Bravelle, and Gonal-F.
Luteinizing Hormone (LH)
Luveris is the name brand of pure luteinizing hormone. This medication is indicated for women who have LH deficiency secondary to gland dysfunction. Luveris can trigger ovulation.
Human Menopausal Gonadotropins (hMG)
An injection of hMG contains equal parts of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This is given to stimulate the ovaries so they will produce multiple eggs during one cycle. Common hMG drugs include Repronex and Menopur.
Bromocriptine and Cabergoline
Both bromocriptine (Parlodel) and cabergoline (Dostinex) are used to reduce the amount of prolactin secreted by the pituitary gland. Hyperprolactenemia (increased prolactin levels) can lead to irregular menses or no ovulation. Side effects of these medicines include nausea, vomiting, dizziness, headache, and low blood pressure.
Gonadotropin-Releasing Hormone (GnRH)
GnRH is an injection that stimulates the pituitary gland to secrete FSH and LH. Name brand GnRH include Lutrepulse and Factrel. Side effects include headaches, nausea, multiple births, abdominal pain, and bloating.
Lupron and Zoladex are two GnRH agonist given as injections, as well as Synarel given as a nasal spray. These medications allow the body to produce more high-quality eggs. GnRH agonists are given in the mid-cycle, where a hormone surge can cancel the cycle. These medicines are used in conjunction with IVF cycles because they prevent ovulation from occurring before the egg retrieval procedure. Side effects include headache, hot flashes, mood swings, vaginal dryness, and insomnia.
Injections of GnRH antagonists include Cetrotide and Ganirelix. These medications are antagonists of the gonadotropin, and prevent premature ovulation. Side effects are hot flashes, changes in mood, and irritability.
Administered as a pill, injection, vaginal gel, or suppository, progesterone is given to prepare the uterus for the embryo implantation. This drug is always used in IVF cycles to control ovarian stimulation. In addition, it is used to stimulate intrauterine implantation cycles.
Metformin is used to treat women with polycystic ovarian syndrome (PCOS). Also called Glucophage, this drug controls elevated insulin levels, which can lead to overproduction of androgens that cause ovulatory irregularities.
Also called letrozole, Femara helps women who have irregular periods or no ovulation. Femara is an aromatase inhibitor that lowers the body’s levels of estrogen. With lower estrogen levels, the eggs mature in the ovaries.