Photo By: Sarah Neff/ CC BY
Are you facing infertility issues? Well, thereâs a solution to this and itâs called a fertility drug. The doctor may offer a prescription to help in pregnancy. Meds known as fertility drugs cause the body to trigger and/or regulate ovulation to release the hormoneâ the release of the egg from the ovaries. If another method is being used to boost the chances of increasing pregnancy, such as in vitro fertilization, drugs are a critical part of the treatment. For couples that have difficulty in conception, fertility drugs are a critical step forward for the treatment.
How Do These Drugs Work?
Table of Contents
Fertility drugs work by enhancing certain hormonal level in the body, helping in maturing or releasing one or higher eggs each month, if one ovulates on a regular basis. For those with irregular. rare ovulation, fertility drugs can be the right answer. They can also help in assisted conception. Certain drugs are used in IVF too as controlling how the eggs develop and are released from the ovaries can enhance a chance of success.
Certain fertility drugs have been successfully and effectively used across decades. Some can even cause a severe side effect. such as ovHow to Reduce Side Effectsarian hyper simulations or greater chance of multiple pregnancies. The desire to have a baby should be counterbalanced by a healthy respect for possible side effects, and the possibility of carrying twins/more. Commonly used fertility drug is as follows:
- Clomifene citrate
- Gonadotrophins
- Metformin hydrochloride
- Dopamine agonists
All these meds are helpful, but which one is the right one? Difficulty in ovulation and conception can be for a wide number of reasons and if drugs are being used as part of the IVF treatment, this can also influence how the medicines will be used.
Types of Fertility Drug
Clomid
Clomifene citrate is essential for blocking estrogen, This blocking effect causes the body to bump up levels of other hormones critical for ovulation. The other hormones are FSH and LH. While eggs in the ovary ripen and become ready for release due to FSH release, LH triggers mature eggs from the specific ovary. Eggs move down into one of the fallopian tube, where they can be fertilized with sperm.
Clomifene is taken as a pill for 5 days earlier in the cycle, for up to half a year. Brand names for this drug include Clomid and Clomifene.
Metformin hydrochloride
Metformin hydrochloride is a drug that ensures sensitivity to the hormone called insulin. It is licensed as a treatment for diabetes. It can also be used for ovulation issues in women including PCOS.
This drug is useful for women with weight problems and is more likely to have issues with insulin level. It also serves an important function when added to clomifene for women who can withstand the effects of clomifene on its own.
This drug is taken daily in numerous doses. This works by reducing insulin levels circulating in the blood and can restore the balance between estrogen and testosterone, helping the body to undergo normal ovulation. Metformin will be tried under the brand Glucophage.
Gonadotropins
Luteinizing hormone and follicle-stimulating hormones are the natural gonadotropins. LH and FSH stimulate the ovary to ripen and produce eggs, These work for women with PCOS and those not responding to other medicines while facing IVF.
LH and FSH have been used as a course of injections over a few days. The injections ensure that ovaries start developing and maturing egg follicles. The injections are followed by HCG injections. HCG stands for human chorionic gonadotropin.
HCG instructed ovaries to mature eggs that have just formed. The mature eggs will be released within the body or taken from the ovary through a minor procedure if one is undergoing IVF. HCG ensures that follicles are in optimal conditions and pregnancy results.
Several different brand names are there for gonadotropins. The medicines include Merional, Menopur, Bemfola, Fostimon, Choragon, Ovitrelle and Pregnyl.
Dopamine Agonists
These block the hormonal imbalance caused by high hormonal levels known as prolactin. Examples of dopamine agonists include cabergoline and bromocriptine. High levels of prolactin prevent the ovary from producing estrogen and releasing an egg each month. These drugs intimate dopamine receptors in the brain and prevent the release of prolactin from the pituitary glands.
You can take the dopamine agonists if there is too much hormone prolactin. Too much of this hormone lowers the level of the hormone estrogen and causes a problem in conception. When used during IVF, cabergoline reduces the risk of OHSS without increasing the likelihood of pregnancy or increase the risk of multiple pregnancies.
Which Infertility Treatment is Right For You?
Photo by: Sarah Nef/ CC BYSome treatments are given beneath the skin, while others are injected into the muscle. Different types of injections are administered within different parts of the body. The injection is taken during the cycle on the second or third day after bleeding. This has to then be taken for 7-12 days and sometimes injections with Clomid can be orally taken.
Along with clomiphene, injected hormones have high chances of success in ovulating. Among women who start ovulation, as many as half are able to get pregnant. Most are mild and include issues like tenderness, blood blisters, infection, swelling or bruising at the site where the medicine has been injected. Ovarian hyperstimulation can also result. Drugs also increase the possibility of giving birth to twins or a higher number of children.
Medicine or hormonal treatments are first used in fertility treatments, used for IVF and assisted reproductive technology. If you lack valuation, these medicines and hormones can facilitate conception and at the same time, treatments increase the chance of health risk too.
Fertility drugs are effective in offering the first treatment of choice for women facing infertility, Couples rely on fertility pills to become pregnant using fertility drugs without procedures like IVF. How these fertility drugs can enable you to conceive is as follows.
Fertility drug provides additional benefits for the development of follicle to help in ovulation. Clomid is a fertility pill increasing FSH, improving ovulation and injecting gonadotropins, stimulating the ovary directly. Fertility drugs also enhance hormone levels raising the chance of embryo implantation and a pregnancy that is regular.
How Fertility Drugs Can Lead to Pregnancy?
Serophene/Clomid
CLomiphene citrate or Clomid has been used for more than forty years. It may be prescribed if one is not ovulating correctly. The brand names of clomiphene are Clomid and Serophene. It is known as a drug for blocking estrogen. This leads to the pituitary gland and hypothalamus in the brain serve to release hormones called GnRH/gonadotropin-releasing hormone, LH/luteinizing hormone and FSH or follicle stimulating hormones. These hormones serve to trigger the ovaries to make the eggs. These drugs are used along with other fertility techniques like assisted reproductive methods and artificial insemination.
How It is Used
The starting dosage of clomiphene is 50mg per day for five days. It is essential to take the first pill on the 3rd, 4th or 5th day after starting the periods. Ovulation commences 7 days after taking the last dose. If this does not take place right away, doctors may increase dosage by another 50mg per day each month. The maximum dosage to be prescribed is 150 mg.
Once women start ovulating, most doctors suggest using clomiphene for not more than six months. If one does not become pregnant after 6 months, a different medication can be prescribed or suggested than when one sees an infertility specialist.
Close to 60 to 80 percent of ladies take clomiphene and ovulate. Around 50 percent will also be able to get pregnant. Most pregnancies take place within 3 cycles.
Side Effects
These are milder and include hot flashes, blurred vision, bloating and nausea as well as headaches. Clomid can also lead to changes in cervical mucus, making it harder to gauge when one is fertile. This may also stop sperms from getting into the uterus. Like different fertility medications, Clomid raises the chance of multiple births.
Injectable Hormones
When Clomid does not work on its own, doctors may recommend hormones for triggering ovulation. The different types of injectable hormones are:
hCG/Human Chorionic Gonadotropin: This includes Profasi, Pregnyl, Novarel, and Ovidrel. This medication can be deployed along with different fertility drugs to trigger ovaries and release the eggs.
FSH/Follicle Stimulating Hormone: This comprises hormones like Fertinex, Gonal-F, Bravelle, and Follistim. These drugs trigger egg growth in the ovaries.
hMG/Human Menopausal Gonadotropin: This covers a range of medicines like Metrodin, Menopur, Repronex, and Pergonal. This drug is a combination of FSH and luteinizing hormones.
GnRH/Gonadotropin-Releasing Hormone: This covers medicines like Lutrepulse and Factrel. This is a hormone which triggers the release of LH and FSH from the pituitary gland. It is, however, rarely prescribed by doctors in the US.
GnRH Agonists/Gonadotropin-Releasing Hormone Agonist: This includes Synarel, Lupron, and Zoladex.
GnRH Antagonist/Gonadotropin Releasing Hormone Antagonist: This includes Cetrotide and Antagon.
These are drugs which are not like pills. You take these injectable hormones as shots. There is variation in the dosage, depending on how it is being used. Some are injected within the skin, while others are given into the muscle. Injections are received on glutes, upper thighs, upper arms or stomachs.
These medicines are usually taken during the cycle, specifically the 2nd or 3rd day after seeing bright blood and taken for 7-12 days straight after that. Injections may be needed along with oral Clomid.
How It is Used
Just like clomiphene, injected hormones have a higher rate of success in helping women to undergo ovulation. Among women starting to ovulate, as many as 50 percent are able to become pregnant.
Side Effects
Most side effects of injectable hormones are milder. These include issues like infection, tenderness and blood blisters, swelling or bruising at injection sites. There’s also a chance of a condition called ovarian hyperstimulation. This makes ovaries become larger and tender. This drug also raises the chances of multiple or twin pregnancies.
Other Fertility Drugs
Aspirin
Research shows that aspirin can cut the chance of miscarriage in specific cases, though one should talk to the doctor about if it makes sense.
Heparin
This drug reduces the chances of miscarriage in certain cases.
Antangon
Also known as ganirelix acetate, this injected drug prevents early ovulation in those women undergoing fertility processes. Side effects range across stomach ache, headache, and a possibility of miscarriage.
Dostinex and Parlodel
Dostinex or cabergoline and Parlodel or bromocriptine are medicines used to lower specific hormone levels and reduce pituitary tumor size, in case this is the reason for ovulation issues. The medicines are usually taken by mouth in specific doses, but the amount can also be raised if the doctor recommends it. Side effects also range across upset stomach, and dizziness.
Benefits of Fertility Drugs
For a large number of couples facing fertility issues in conception, fertility drugs are the first key to treatment. Fertility drugs work by raising certain hormone levels in the body, causing eggs to mature and one or more eggs to be released each month by ovulating. If the ovulation is rare or irregular, fertility drugs could well be the way out. These are essential for assisted conception treatments such as IVF.
Certain fertility drugs are used in IVF treatment, apart from controlling the formation and egg release from the ovary to enhance the chances of becoming pregnant. A lot of fertility drugs have been used successfully and safely for years. But this can result in severe side effects like ovarian hyper stimulation syndrome or more chances of multiple pregnancies. Weighing up the desire to have a baby against the possibility of side effects or multiple births. Monitoring by a fertility specialist using ultrasound scans reduces risks.
There are numerous fertility drugs on the market, and while none of these guarantee a pregnancy, they make it a wonderful job of making it as likely as possible. The drugs may be used to induce a pregnancy or make it as likely as possible. These drugs can also be used to encourage ovaries into producing additional eggs and these are taken via suppositories, injection, pills or gels. In case egg production is not a problem, fertility drugs can be given to boost specific hormones and prepare the body to effectively carry a pregnancy to term. It may even cause the cycle to cease completely. The fertility drug can be arduous and complex, as there are different prescriptions of different medicines based on the cycle one is in.
Which Drugs Work Best For Fertility?
While most medicines work well for boosting fertility, there are varying factors determining which fertility drug is required. Variables like the age, the doctor selected, the partner’s fertility and what specific fertility concerns are there can influence the degree of success of fertility drugs. It is important to note fertility drugs are not fail-safe and while there is a high success rate, they cannot guarantee a pregnancy.
Side Effects of Fertility Drugs
Many fertility drugs are associated with symptoms similar to those experienced at the time of the period. This includes breast tenderness and enlargement, headache, nausea, and fatigue. As you are being exposed to a blend of hormones, this can combine with natural anxiety during the fertility treatment to exert a severe toll on the woman and her partner. Many doctors prescribe fertility drugs to women facing issues in getting pregnant. Based on the specific or certain fertility problem, fertility drugs can be useful for overcoming challenges and helping one to get pregnant.
There are different types of fertility drugs available. Some of the common ones work for women by stimulating ovaries to yield multiple eggs. This can help women to conceive. Other drugs can be used to prevent premature ovulation at the time of assisted reproductive technology/ART procedures. Fertility drugs may also be prescribed to lead to the release of more than one egg per cycle. This is a process known as superovulation and is used along with artificial insemination, IVF/in vitro fertilization. With the aid of fertility medications, one or more eggs can be produced with the aim of fertilizing the eggs.
When Are Fertility Drugs Prescribed?
Fertility drugs can help if one suffers from different health conditions, such as ovulation issues, PCOS/polycystic ovary syndrome, eating disorders, thyroid disorders, weight issues or excess prolactin or problem with LH or FSH levels. Most women need to take the fertility drug regularly before pregnancy takes place.
Clomiphene citrate or Clomid/Serophene is the most popular fertility drug for women. This is prescribed for women ovulating irregularly or not at all. Clomid enables the pituitary gland for secreting FSH or follicle stimulating hormone. This starts the development of ovarian follicles rich in eggs. In case of this drug works, the ovary releases the eggs and ovulation takes place. Clomiphene induces ovulation in over 80 percent of women. Less than 50 percent of women become pregnant through 6 cycles.
Human menopausal gonadotropins are prescribed if clomiphene does not function, or if there are issues with LH and FSH levels or one is undergoing IVF or IUI. FSH or Follicle Stimulating Hormones like Gonal-F, Bravelle and Follistim are another common drugs. Through injection, FSH works by stimulating the ovaries to produce more eggs and follicles.
Human chorionic gonadotropin/hCG such as Profasi and Pregnyl helps in the follicle maturation and triggers egg release. This drug triggers ovulation. This usually takes place about 36 to 48 hours post the administration of hCG.
Doctors can prescribe other drugs such as Parlodel or Bromocriptine and Cabergoline or Dostinex. These are used in case ovulation problems are the consequence of excessive prolactin levels. This reduces the amount of prolactin produced by the pituitary, thereby inducing ovulation.
Gonadotropin Releasing Hormone/GnRH ranges across Factrel and Lutrepulse. This is a natural hormone in the body released via the bloodstream in a manner that is rhythmic. This stimulates the pituitary gland to produce LH and FSH. A special pump is also used along with GnRH that administers hormones into the bloodstream through a small needle in the body within 60 to 90 seconds.
If one opts for the in vitro fertilization route, doctors may prescribe GnRH analogs along with other fertility drugs to avert ovulation in a spontaneous manner. Specifically, this medicine works by stopping the production of LH and FSH to prevent spontaneous ovulating and reduce the levels of estrogen in the body.
Certain GnRH agonists like Synarel and Lupron provide a consistent GnRH flow. These drugs cause stimulation of LH and FSH initially and then, the product is halted. GnRH antagonists like Cetrotide work exactly the same way, though they do not trigger initial FSH and LH stimulation.
Fertility drugs provide options available. But the best way to learn about fertility specialists is by creating a personal treatment plan to address infertility issues. Ovulation issues are treatable using fertility drugs.
Risks of Fertility Drugs
Side effects and risk factors linked to fertility drugs depend on the medication taken. Oral-type fertility drugs like letrozole and Clomid have less potent side effects than injectable fertility drug forms such as gonadotropins, GnRH antagonists or agonists.
Most common side effects of fertility drugs are a headache, bloating, upset stomach, breast tenderness, mood swings, and hot flashes. Common fertility drug risks the chances of conception of multiple births such as twins, triplets or other multiple births. There’s also a chance of suffering from Ovarian Hyper-Stimulation Syndrome or OHSS. These are the side effects and risk factors that are the most well-known ones. Fertility drugs do really work the magic when it comes to lowering the chances of contraindications and complications. Side effects are undesired symptoms stemming from medication.
Whether side effects are experienced or not depends on medication is taken, the dosing of the medication and the body type. Consider the fertility drug named Clomid, for example. Some take this drug and feel okay. Others experience mood swings or headaches. It is not easy to predict what type of reaction will occur until the medication is taken.
Anxiety Over Side Effects
Judging the possible side-effects can further raise anxiety and risk experienced during certain side effects. This is the nocebo effect. If you lean towards anxiety, coping with detailed side effects and risk information is essential.
Side Effects of Clomid
For example, Clomid is a fertility drug that tricks the body into assuming there is not enough circulation of estrogen. This blocks receptors that react to the hormone. Side effects of Clomid are due to perceived low levels of estrogen. But one of the biggest problems of Clomid without medical supervision is the side effects. You can get overweight, experience hot flashes, massive bloating and stomach discomfort, mood swings, headache, nausea, breast tenderness, dizziness, abnormal menstrual flow or even vaginal dryness. Clomid can also lead to blurred vision. This occurs in less than 1.5% of women at the time of clinical trials. Blurred visions, flashing of lights or floaters can be a real problem. Inform the doctor in case this happens. About 7 women in 100 may even experience twin pregnancies due to ingestion of Clomid.
Side Effects of Letrozole
Letrozole is an off-label fertility drug. Also called Femara, it is actually used for treating breast cancer. But it also works to block estrogen receptors. Those with PCOS or resistance to Clomid can benefit from this medication. Side effects of this drug also include dizziness, fatigue, headache, bloating, difficulty sleeping, hot flashes, and even blurred vision, and difficulty sleeping. There can also be breast pain and abnormal menstrual flow. One of the biggest risks of this medicine is vision problems and the possibility of conceiving twins.
Side Effects of Gonadotropins
These injectable hormone fertility drugs range across FSH (like Gonal-F) and Follistim and Ovidral or hCG. Injectables can be used alone or in combination with drugs during the IVF cycle. Side effects linked to gonadotropins include nausea, GI disturbances, headaches, upper-respiratory tract infections, abdominal tenderness, bloating, acne, mood swings, weight increase, abnormal menstruation, injection site redness and soreness as well as dizziness. As against Clomid and Letrozole, twin pregnancies are more likely with gonadotropins up 30 percent. If one has IVF, choosing a single embryonic transfer reduces this risk.
GnRH Agonists Side Effects
GnRH agonists such as Lupron are used during the IVF treatment. This shuts down the reproductive system of the body so medical control over ovary stimulation or maturation is experienced. Lower estrogen levels can cause side effects too. The list of side effects due to GnRH agonists includes hot flashes, mood swings, headache, depression, vaginal dryness, anxiety, acne, joint pain, general body pain, fluid retention, nausea, stomach upset, weight increase, fall in libido, soreness at the injections site or giddiness.
GnRH Antagonists Side Effects
Akin to GnRH agonists, the antagonists also shut down the system of reproduction during the in vitro fertilization treatment. This can have lower side effects compared to GnRH agonists. Possible contraindications of these antagonists include abdominal tenderness, headaches, upset stomach, nausea, abnormal bleeding and soreness at the injection site.
Rare Risks
In rare cases, fertility drugs can trigger severe side effects. Doctors need to discuss this with the patient. Always tell the doctor if worrisome symptoms are being experienced, even if one is not sure if these are linked to medicines. It is better to inform the doctor rather than leave aside a serious side effect that could be lethal.
#1 Vision Disturbances
A tiny percentage of women experience visual disturbances when using Clomid and/or Letrozole. If this happens, one can see flashes of light, a sudden increase in floaters or blurred vision. Blurred vision comes along with a severe headache. Tell the doctor right away when this takes place. Vision disturbances should disappear once the medication is stopped. In rare events, long-term damage also results.
#2 Ectopic Pregnancy
Those using gonadotropins have a higher chance of developing an ectopic pregnancy, which can be lethal if ignored. If severe, acute pelvic pain is experienced, doctors need to be contacted on an immediate basis.
#3 Ovarian Hyper-Stimulation Syndrome/OHSS
These are when the fertility drugs lead to stimulation of the ovaries up to a point where multiple eggs are produced. Due to this syndrome, ovaries become over stimulated. This is possible during IVF treatment, but can also take occur through clomid and gonadotropin treatment. Most of the OHSS cases are not strong, but severe ones can also occur. In rare cases, this syndrome can even trigger blood clots or kidney failure.
Severe OHSS can harm not just fertility, it can even threaten your life. Receiving early treatment and catching symptoms quickly is vital.
#4 Ovarian Torsion
This is a complication linked to OHSS. Lower than 2 percent of women using gonadotropin drugs experience this. Fertility drugs can cause ovary enlargement. Sometimes the ovary twists. This cuts off the blood supply. Surgery may be needed to set it right or remove the ovary. Ovarian torsion is lethal. So, if you experience severe pelvic pain, you need to visit the ER at once.
#5 Allergic Reaction
Allergic reaction to fertility drugs is not common. But with any type of medicines including these reactions can always occur.
#6 Multiple Pregnancies
One of the most well-known risks of taking fertility drugs is the chance of multiple births or pregnancies. The possibility of conceiving twins or multiple births depends on the medication taken and the fertility treatment resorted to. For example, taking gonadotropins increases the chance of twin pregnancies by 3x times as against Clomid.
Some individuals think multiples are the only problem with IVF. But IUI or insemination can also increase the chances of multiple pregnancies. Chances of having twins are 10 percent if Clomid is taken. Chances of triplets or more births are less than one percent. As against this, 30% of the pregnancies from gonadotropin-based fertility drugs are multiple pregnancies. Around 75 percent of these are twins and 25 percent are triplets or more multiple pregnancies.
How to Lower Side Effects
While it is impossible to completely eliminate the side effects, some things can be done by you under the guidance of the doctor to reduce risks. Side effects need to be avoided or cut down on by taking medications at nighttime or with food. Always consider the best time and mode to take medications. Doctors also need to use the minimal low effective dosage. That is the reason why it is better to start the lowest dose and increase in case it does not work, rather than starting high. You also need to let your doctor know in the event that side effects are bad, especially with respect to mood-related effects. Always look for alternative drugs if one does not suit you.
To lower the chances of multiple births, close tracking of the cycle is important. With Clomid or Gonadotropins, ultrasound can be a way to test how potential follicles are growing. Remember that in the event of a conception, each follicle is a potential child. Doctors may also cancel the cycle if the chance of multiple pregnancies is higher. Your doctor could also ask you to abstain from intercourse. Through IVF treatment, the risk of multiple pregnancies can be reduced with a single embryonic transfer. This is not suited for every couple, however. Consult with your doctor about options. Fertility clinics need to be balanced in the treatment approach. It may be wonderful to have the best results guaranteed to you, but results cannot be guaranteed.
With careful tracking and responsible as well as ethical doctors, OHSS can be averted. The most important thing to do is to follow the doctor’s treatment and take care. Good prenatal care can definitely lower risks. With early treatment and detection, OHSS can be managed effectively.
To relieve the discomfort of side effects, the patient should communicate well with the doctor. Be clear about how to deal with challenges and complications. Tylenol also called acetaminophen is the most effective medication for any cramps or headaches. In fact, it is the treatment preferred during fertility treatment. Naproxen or Aleve/Midol and ibuprofen like Motrin or Advil should be avoided, as these drugs can come in the way of ovulation and implantation of the embryo.
Dress in multiple layers if you are experiencing hot flushes. Avoid warm drinks which can trigger a hot flash. For those of you that are burning up while dressing in layers you can easily take off some layers to ward off the heat. Wearing comfortable clothing is also essential. This can range across sweatpants, yoga-pants, or even flowing summer dresses.
Always make sure you reach out and get support and give yourself some leeway. Fertility treatments are likely to make individuals feel emotional and vulnerable. Mood swings can have additional side effects. If you are researching fertility treatment, be clear about the different types like intrauterine insemination and in vitro fertilization. Your fertility specialists can prescribe the best medications specific to medical conditions and history. Detailed instructions and guidance will be provided by the fertility center staff.
If you like to know more about Fertility drugs, please visit, FertilityDrugsOnline.com.