For women who are infertile because they do not ovulate regularly, medications are often used in the treatment of infertility. Fertility medications may be used with IUI, IVF, or timed sex. The two most common fertility medications are Clomid and injectable gonadotropins.
Clomid is an oral medication that stimulates the hypothalamus and pituitary glands to release hormones associated with ovulation: gonadotropin releasing hormone (GnRH), follicle stimulating hormone (FSH), and luteinizing hormone (LH).
Usually, Clomid is initially given at 50 milligrams per day for five days starting on the 3rd or 5th day of the menstrual
cycle. Ovulation usually occurs approximately 7 days after the last dose is taken. If ovulation does not occur, the dose of the drug will be titrated over the next several months.
Pregnancy is most likely to occur in the first 3 to 4 months of taking Clomid, and the drug should usuaully not be taken for longer than that. Up to 80% of women ovulate when taking Clomid, and about 50% get pregnant with the drug.
As is the case with any drug, there are some side effects associated with taking Clomid. The side effects are usually lower than those associated with injectable gonadotropins, and include headaches, bloating, hot flashes, and multiple births.
In cases where Clomid is not effective, injectable gonadotropins may be used. Gonadotropins are bioidentical to the hormones that the body makes, and directly stimulate the body to produce and release eggs. In addition to the gonadotropin preparations – FSH, LH, and human chorionic gonadotropin (hCG) – other medications such as GnRH agonist or GnRH antagonist may be used alongside the gonadotropins to prevent early ovulation. These drugs come under a number of brand names, and may be collected either from sterile urine or through genetic engineering.
Gonadotropins cannot be given orally, and instead must be injected. Most are injected subcutaneously, beneath the skin, but some are injected intramuscularly, in the muscle. Injections begin on the 2nd or 3rd day of the cycle and continue for 10-12 days. In some cases, gonadotropins may be used along with Clomid.
Up to 50% of women who are treated with gonadotropins are able to get pregnant, and many women treated with these drugs do ovulate.
In most cases, the side effects associated with the most common fertility medications are mild, and may include issues such as tenderness and moodiness. There is a risk of ovarian hyperstimulation, a condition in which the ovaries become enlarged. OHSS is usually relatively mild and will resolve once the medication is withdrawn, but can sometimes be serious. As with Clomid, there is an increased risk of multiple gestation with gonadotropins.
Weighing the Risks and Benefits of the Most Common Fertility Medications
There are both risks and benefits to being treated with the most common fertility medications, just as there are risks and benefits to any fertility treatment. Some women are at a higher risk of certain complications. For example, women who have had OHSS in the past are more likely to have OHSS again. Deciding whether or not the risks are worth the benefits of treatment is a highly personal decision that every couple must make for themselves. Many women feel that the opportunity to start a family is worth the risk of side effects, and these medications have helped millions of women to get pregnant and have children over the past several decades. Your doctor will go over the risks and benefits in more detail at your consultation.
Dr. Randy Morris would be happy to meet with you about treatment for your infertility. To schedule your consultation today, please click below and enter your information or call (630) 357-6540.