Fertility Drugs For Women And Men – What Medications Are Used For Maintaining Pregnancy?
It’s not easy to get through the unhappiness of not having children. If you are one of those who is finding hard to get pregnant, you might sit down with your doctor for a lengthy lesson on fertility treatment methods. Sometimes it may be difficult to find out the stumbling block on your way to parenthood. So, your doctor may suggest you different treatment methods one of which is using fertility drugs.
Who needs fertility drugs?
Most of the fertility drugs are meant for inducing ovulation in women. If a woman is not having a problem with ovulation, she might not need or fertility drugs might not help her. It might happen that some underlying condition such as PCOS is causing a woman not to ovulate though she has viable eggs.
How fertility drugs work?
These medications cause a woman’s body to release hormones. This, in turn, stimulates ovaries to release eggs. Even woman who are already using some other methods to enhance fertility such as IVF would still need these medications as a part of the treatment.
Fertility drugs can be divided into four categories:
- Medications that are meant for triggering ovulation
- Medications aimed at suppressing or controlling menstrual cycle
- Medications used to treat underlying conditions
- Medications meant for treating some other aspects of infertility
- Medications used for maintaining pregnancy
There are plenty of these drugs available in the market, but we will go through the ones that are commonly found in the prescription list.
Drugs for triggering ovulation
Clomid or Clomiphene Citrate
Used for 40 years, this medication is probably the first attempt by any doctor to treat fertility problem in a woman. Clomid is taken orally and is used to treat ovulation dysfunction in women. These drugs block estrogen and send a message to the hypothalamus and pituitary gland in the brain to release a bunch of hormones.
These hormones namely FSH (follicle-stimulating hormone), GnRH (gonadotropin-releasing hormone) and LH (luteinizing hormone) stimulate ovaries to produce and release eggs. Clomid is commonly used during in vitro fertilization or artificial insemination procedures.
Though the direction of every doctor differs, usually, 50 mg/day of clomiphene is recommended for 5 days. The first pill is typically taken on the 3rd, 4th or 5th day of periods. After 7 days of taking this medication, you can expect ovulation. If the ovulation does not occur, you might be advised to increase the dosage to up to 150 mg per day.
If ovulation occurs, the doctor would recommend taking this medication for not more than 6 months in a row. If pregnancy does not occur within this timespan, the doctor will either prescribe another medicine or refer you to an infertility specialist.
Clomid can start ovulation in about 60-80 percent of women. Out of these, about 40 percent of woman will get pregnant, mostly within three ovulation cycles.
The most common side effects are mild headache, nausea, hot flashes, bloating, blurred vision and mood swings. This medication may also cause changes in cervical mucus which can make it difficult for the sperm to enter the uterus. It may also cause multiple pregnancies.
If Clomid fails to bear any effective results, the doctor may suggest injectable drugs to trigger ovulation. Some injections are given into the muscles while some others are given beneath the skin. You can also get the same in buttocks, arms or upper thighs.
These are one of the strongest ovulation inducing agents. In female reproductive phase, these hormones stimulate the ovaries and cause them to mature and release healthy eggs. These medications are injected in the fatty tissue. You may also be directed by your doctor or nurse on how to inject this drug at home.
Gonadotropins can be recommended alongside other medications, often during IVF treatment. While these are primarily meant for women, men may also be prescribed to increase their testosterone level and semen health.
Depending on the case, the doctor may also suggest human menopausal gonadotropin. These drugs are a combination of FSH (Follicle-stimulating hormone) and LH (Luteinizing hormone) and recommended for women with healthy ovaries that can’t produce eggs.
Follicle-stimulating hormone (FSH)
Known as urofollitropin, these drugs stimulates the growth of eggs. These are often suggested to women whose ovaries are working properly but eggs don’t mature. Some strains of this hormone are created in a lab.
Normally, these drugs are taken during the menstrual cycle, usually the second or third day of sighting bright red blood. These drugs are taken continuously 7-12 days and are often combined with Clomid that is taken orally.
Injected drugs have high success rates with increasing ovulation. Up to 50 percent of woman who begins ovulating after taking these injectable hormones, can become pregnant.
Mostly, the side effects are of mild nature such as tenderness, swelling, blood blisters, minor infection and bruising. Women are also likely to get a condition known as ovarian hyperstimulation syndrome (OHSS) which can cause ovaries to become enlarged, filled with fluid.
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Drugs that suppress ovulation
During IVF treatment, the ovulation has to be prevented before the eggs are retrieved. If eggs are released in the body, they will be of no use. These drugs can be birth control pills or GnRH antagonists which act against LH and FSH hormones, resulting in suppression of ovulation. Where birth control pills are taken orally, GnRH antagonists are injected.
Some of these include –
- Ganirelix Acetate – Injectable
- Cetrorelix Acetate - Injectable
- Leuprolide Acetate - Injectable
- Goserelin - Implantation
- Buserelin – Nasal spray
- Nafarelin Acetate – Nasal spray
Common side effects can be headache, discomfort in abdomen and pain at injection site.
Drugs to treat underlying condition
In many cases, an underlying condition can cause infertility. Treating the underlying condition is often enough to treat infertility. However, in some cases, a combination of fertility treatment and treating underlying condition works best.
- Metformin – Metformin hydrochloride is often used in women who are resistant to insulin. This occurs mostly in women who are diagnosed with PCOS (polycystic ovarian syndrome).
- Antibiotics – These medications are recommended for men and women who have an infection in the reproductive tract. The scarring may prevent fertilization.
- Thyroid regulating medications – They are prescribed to treat underactive (hypothyroidism) or overactive (hyperthyroidism) thyroid gland which might be causing fertility problems.
Drugs for treating other fertility problems
During fertility treatment, you may also be prescribed drugs such as:
- Aspirin – The drug cut the chances of miscarriages by preventing blood clotting during pregnancy. Aspirin is not recommended in early pregnancy. The doctor may also prescribe a combination of blood-thinning aspirin or heparin.
- Cabergoline and bromocriptine (Dopamine agonists) – These drugs lower the levels of certain hormones such as prolactin that can cause difficulty in becoming pregnant.
- Estrogen – These drugs are recommended if the endometrial lining of a woman is too thin or if she experiences vaginal dryness and painful sexual intercourse.
Some women can feel nausea, headache and nasal congestion.
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Drugs that maintain pregnancy
In pregnant women, hormone progesterone plays an important role in the growth of the baby. Most women have an adequate amount of progesterone required for their baby. However, some may need supplements, especially those who have a history of unexplained miscarriage or are undergoing fertility treatments.
- Progesterone vaginal suppositories – This is the most common progesterone treatment method suggested to pregnant women with low progesterone levels. These suppositories which come in solid dosage form are taken only once a day. As the name denotes, this has to be inserted into the vagina. Some doctor suggests lying down for 30-60 minutes after inserting while some other suggest putting it before going to bed.
- Progesterone injections – Progesterone can also be administered intravenously but the effect is considered less effective as compared to suppositories as the latter can be better absorbed. Injections are mostly used during IVF treatment and are given in the upper thigh muscle or outer quadrant of buttocks.
- Progesterone pills and creams – Supplements can also be taken in the form of oral pills. As per creams, there are hundreds of them available over-the-counter but only doctor prescribed should be taken.
Possible side effect include drowsiness, breast tenderness, nausea, and depression. Progesterone causes no harm to the growing baby.
Fertility drugs for men
Many people still think fertility drugs are meant only for women but the fact is the opposite. While it’s true that most of the traditional fertility drugs are prescribed for women, they are also sometimes used to treat infertility in men. This is because the same hormones are responsible for reproduction in both of them.
Here are the most common fertility drugs prescribed to men with their usage:
- Clomiphene – This non-steroidal drug increases the production of follicle stimulating hormone, luteinizing hormone as well as the pituitary hormone. The purpose of these hormones in men is to direct the testicles to secrete testosterone hormone that helps in the production of more healthy sperm. Initially, 25 mg thrice a week is recommended and then increasing to 50 mg/day as per requirement.
- Gonadotropins – Human Chorionic Gonadotropin (HCG) stimulates the testicles for the production of testosterone hormone and sperm. While Human Menopausal Gonadotropin (hMG) does the same thing when secondary hypogonadism (problem in the pituitary gland) occur in men.
- Synthetic testosterone pills – These come in the form of pills, gels, and injection and usually used to restore the testosterone levels to normal. Gels are considered as safer.
- Letrozole – This drug deals with a variety of problems in men such as enlarged breasts and infertility. In terms of fertility, letrozole boosts testosterone levels to produce more sperm.
- Imipramine – It is used in the treatment of retrograde ejaculation, a male fertility disorder in which semen is ejaculated via urethra instead of the penis.
- Bromocriptine – High levels of prolactin hormone can increase infertility in men, especially those with sperm impairment. This medication keeps the prolactin levels in check.
Taking these drugs especially gonadotropin may cause headache, mood changes, tiredness and weight gain. Drugs for retrograde ejaculation may cause dizziness, restlessness, and nausea.
Although these drugs can be found over-the-counter, they are not recommended without consulting the doctor. Talking with the doctor will also determine the length of the course as well as the dosage.
Talking with the doctor
You must review these drugs with your doctor and discuss the treatment options. Learning more about your treatment options may help you choose the best course of action that would bless you a healthy bundle of joy in future.