Medications are a regular and normal part of infertility treatments andthe in vitro fertilization (IVF) procedure. These medications are used toprepare the body for treatment and to increase the probability that morehealthy eggs are released from the ovaries. A reproductive specialist canevaluate your situation to determine the most appropriate medications foryour situation.
The Following Medications Are Used For Ovarian Stimulation:
Clomiphene citrate (CC): There are two types of medications,Clomid® and Serophene®. These medications work by increasing theamount of FSH the pituitary gland secretes. These are often used to stimulateovulation in women who have absent periods, infrequent periods or long cycles.The dosage is usually started at 50mg a day, for a certain amount of days.Dosage may be increased if ovulation still does not occur, although thechances of side effects increases as the dosage increases. The AmericanSociety for Reproductive Medicine (ASRM) recommends that clomiphene be prescribedfor only 3-6 cycles. Potential side effects include:
- Increased incidence of multiple birth
- Increased incidence of miscarriage
- Hot flashes, nausea, and breast tenderness
- Headaches or blurred vision
- Depression and mood swings
- Ovarian cysts and pelvic discomfort from overstimulation of the ovaries
Synthetic Human Chorionic Gonadotropin (hCG): Intra muscularinjections used to trigger ovulation. Often used when other medicationshave been taken to induce ovulation. Common hCG medications include: Pregnyl®,Profasi® Novarel® and Ovidrel®. There are no known side effectsif ONLY taking hCG.
Follicle Stimulating Hormone (FSH): An injection givenjust below the skin (subcutaneous injection) that bypasses the hypothalamusand pituitary glands to directly stimulate follicle growth in the ovaries.Common FSH medications include: Bravelle®, Follistim®, and Gonal-F®.Potential side effects include:
- Increased incidence of multiple birth
- Increased incidence of miscarriageand premature delivery
- Breast tenderness, swelling, or rash atinjection site
- Mood swings and depression
- Hyper stimulation syndrome which includes enlargedovaries, abdominal pain and bloating
Human Menopausal Gonadotropins (hMG): An injection thatcontains equal parts of FSH and LH (luteinizing hormone), given to stimulatethe ovaries to produce multiple eggs during one cycle. Common hMG medicationsinclude: Menopur® and Repronex®. These are the most potent ovulationmedications currently used today. Potential side effects include the sameas noted above for FSH.
Bromocriptine and Cabergoline: Oral medicationsused to reduce the amount of prolactin released by the pituitary.The brand name for bromocriptine is Parlodel® and the brand namefor cabergoline is Dostinex®. Potential side effects include:
- Nausea, vomiting, nasal congestion
- Headache, dizziness, fainting
- Decreased blood pressure
Gonadotropin-Releasing Hormone (GnRH): An injectionused to stimulate the pituitary gland to secrete LH and FSH. Commonnames for GnRH medications include: Factrel® and Lutrepulse®.Potential side effects include:
- Slight chance of multiple births
- Mild hyper stimulation which includes enlargedovaries, abdominal pain, and bloating
- Headaches and nausea
The Following Medications Are Used to Prevent Premature Ovulation:
GnRH Agonists (Analogs): There are two types ofmedications. Lupron® and Zoladex® are injections given belowthe skin and Synarel® is a nasal spray. These medications areused to enable the body to produce a higher number of quality eggs.These medications are also designed to prevent the mid-cycle hormonalsurge which can result in a cancelled cycle. Potential side effectsinclude:
- Hot flashes
- Mood swings
- Vaginal dryness
- Decreased breast size
- Painful intercourse
- Bone loss
GnRH Antagonists: These medications, Ganirelix Acetate®and Cetrotide®, are injections administered for three to four days.These medications operate as antagonists of the gonadotropin causing thehormone (GnRH) to be released to help prevent premature ovulation. Potentialside effects are the same as GnRH.
Other Medications Used to Enhance Fertility Treatments:
Medrol: A steroid provided daily for four days duringthe cycle to assist with pre-embryo implantation.
Doxycycline: An oral antibiotic provided to themale partner during the female’s stimulation cycle to reducethe levels of bacteria which may be found in semen. This medicationis also given to the female partner to decrease the risk of infectionafter aspiration of the follicles at the time of egg retrieval.
Progesterone: Intra muscular injections provided daily beginningtwo days after retrieval and finishing when the placenta is creating appropriateamounts of Progesterone. Progesterone may be administered through a vaginalgel, suppository or in a pill.
Supplements: Many couples opt for natural, non-prescriptionfertility supplements containing vitamins, minerals, antioxidants and/orherbs to help improve their reproductive health. ShopSupplements Now
Compiled using information from the following sources:
RESOLVE: The National Infertiltiy Association, http://www.resolve.org
The Association of Reproductive Medicine (ASRM), http://www.asrm.org