Fertility Drugs

What are fertility drugs?

There are several types and forms of fertility drugs, but most are made from hormones intended to stimulate the woman's reproductive system. One way that fertility drugs can be classified is according to their method of administration -- whether or not they are injected or taken by some other means (orally, as a nasal spray, etc.). Drugs that must be injected typically come in either an ampule or a vial and may be in either liquid or powder form. Many drugs come as a powder with accompanying diluents (usually water or a saline solution) that must be mixed with the powdered drug before it is injected.

Fertility drugs can also be classified according to the type of hormones (LH or FSH) they control and the part of the reproductive process (such as ovulation) they are meant to enhance.

Major classifications of fertility drugs

The following list provides an overview of four major classifications of fertility drugs.

• Progesterone - Progesterone is a naturally occurring hormone that is an important part of helping a woman to become pregnant successfully. Insufficient progesterone can make conception difficult, and some women's bodies do not produce enough of the hormone on their own. Supplemental progesterone can be used to mimic a regular menstrual cycle and to increase the chances of successful fertilization. The drug can be administered orally, through injection, or through vaginal gels and suppositories. Disadvantages of using progesterone include the possibility of nausea, constipation, headache, drowsiness, breast tenderness, joint discomfort, and depression. Some patients may require special supervision when taking progesterone, including those with a history of asthma, epilepsy, migraines, and cardiac problems.
• GnRH Agonists - Gonadotropin-releasing Hormone (GnRH) agonists are commonly used with In-Vitro Fertilization to increase the chances of pregnancy. GnRH Agonists are used to control the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) - the hormones that control ovulation - by first increasing and then suppressing them. GnRH Agonists give the doctor more control over the timing of ovulation, which is important for in vitro fertilization. The most common brand is Lupron, which may be administered on different schedules and by different methods depending on the particular physician and patient.
• Gonadotropins - If a woman is unable to achieve pregnancy due to low levels of LH or FSH production, or if she is undergoing In-Vitro Fertilization treatment, gonadotropin drugs may be administered, often in combination with other fertility drugs. These hormones come in two types of drugs: recombinant and urine-based. Both can be effective and are administered through injection. Recombinant drugs have proven slightly more successful, but if levels of LH are low, urine-based drugs may be preferable. The physician and the couple should make the decision about which drug is the best choice before treatment is begun.
• GnRH Antagonists - GnRH Antagonists achieve the same purpose as GnRH Agonists, preventing the release of LH and FSH so that the doctor can better control ovulation. More control over the timing of ovulation allows the doctor greater precision in timing with egg retrieval and other relevant procedures. The advantage of GnRH Antagonists is that they may be administered for a shorter duration than the Agonists, while producing the same result. Reported side effects include: abdominal pain, nausea, headache, vaginal bleeding, and, rarely, ovarian hyperstimulation syndrome (OHHS), a condition where the ovaries swell and enlarge.

Fertility drugs for women

The two examples below are specific fertility drugs that are often used by women who want to become pregnant and that have fairly high success rates in achieving their particular ends.

• Clomiphene, known by the brand names Clomid, Serophene, and Milophene, is a drug used to stimulate ovulation. The drug is taken orally for five days a month. By manipulating the release of the LH and FSH hormones, Clomiphene increases the chance of ovulation to 70-90%. Good candidates include women who infrequently or never ovulate, women with polycystic ovarian syndrome, and women undergoing In-Vitro Fertilization treatment.
• Human Menopausal Gonadotropin (hMG) is often used as an alternative to Clomiphene, if that drug does not work effectively. Like Clomiphene, hMG works by controlling and producing LH and FSH in order to induce ovulation. This drug can be helpful for women with low levels of estrogen, polycystic ovarian syndrome, luteal phase defects, unexplained infertility, and those about to undergo In-Vitro Fertilization. The success rate for inciting ovulation is usually 75% or higher.