Fertility drugs remain the primary treatment for women with ovulation disorders; some are taken orally and some are injected. In general, these medications work by causing the release of hormones that either trigger or regulate ovulation.
Even if you're using assisted reproductive techniques such as in vitro fertilization, fertility drugs are still an important part of treatment. Since the number and names of all of the infertility medications may seem dizzying, here are the basic facts on the drugs most commonly prescribed.
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Indication: Clomid (clomiphene citrate) is often the first choice for treating infertility, because it's effective and been used for more than 25 years. Clomiphene is given to women who are not ovulating normally. Clomid and Serophene, the brand names of clomiphene, are anti-estrogen drugs. As a result, they cause the hypothalamus and pituitary gland located deep in the brain to release hormones -- GnRH (gonadotropin releasing hormone), FSH (follicle stimulating hormone) and LH (luteinizing hormone) -- that will stimulate the ovaries to produce eggs. These fertility drugs are often used in combination with assisted reproductive techniques or artificial insemination.
Use: The typical starting dosage of clomiphene is 50 milligrams per day for five days. You typically take the first pill on the third, fourth, or fifth day after you start your period. You can expect to start ovulating about seven days after you've taken the last dose of the drug. If you don't ovulate right away, the dose can be increased by 50 milligrams per day each month up to 150 mg. After you've begun to ovulate, most doctors suggest taking clomiphene for no longer than six months. If you haven't become pregnant after six months, your doctor will probably prescribe a different medication or refer you to an infertility specialist.
Effectiveness: Approximately 60% to 80% of women who take clomiphene will ovulate, and about half will be able to get pregnant as a result of taking the drug. Most pregnancies occur within three cycles.
Side effects: The side effects of clomiphene are generally mild. They include hot flashes, blurred vision, nausea, bloating, and headache. Clomid can also cause changes in the cervical mucus, which may make it harder to tell when you're fertile and may inhibit the sperm from entering the uterus. Like many fertility drugs, Clomid can increase the chances of multiple births, although it's less likely to cause the problem than some injectable hormones.
Injectable Hormones for Infertility
If Clomid on its own isn't successful, your doctor may recommend injectable hormones to stimulate ovulation. Some of the types are:
Human Chorionic Gonadotropin (hCG), such as Pregnyl, Novarel, Ovidrel, and Profasi. This drug is usually used along with other fertility drugs to trigger the ovaries to release the mature egg or eggs.
Follicle Stimulating Hormone (FSH), such as Follistim, Fertinex, Bravelle, and Gonal-F
Human Menopausal Gonadotropin (hMG), such as Pergonal, Repronex, and Metrodin. This drug combines both FSH and LH (luteinizing hormone).
Gonadotropin Releasing Hormone (GnRH), such as Factrel and Lutrepulse. This hormone stimulates the release of FSH and LH from the pituitary gland. These hormones are rarely prescribed in the U.S.
Gonadotropin Releasing Hormone Agonist (GnRH agonist), such as Lupron, Zoladex, and Synarel
Gonadotropin Releasing Hormone Antagonist (GnRH antagonist), such as Antagon and Cetrotide