What Are Fertility Drugs?
If you're having infertility issues, your doctor may prescribe medicine to help you get pregnant. These meds, called fertility drugs, work by causing your body to release hormones that trigger or regulate ovulation — the release of an egg from your ovary.
Even if you already use another method to boost your chances of getting pregnant, such as in vitro fertilization, fertility drugs are still an important part of treatment.
Your doctor can guide you toward the treatment that is best for you. Here are some of the common fertility drugs they may recommend.
Clomid or Serophene
Clomiphene citrate has been used for more than 40 years. Your doctor may prescribe it if you're not ovulating normally. Clomid and Serophene, the brand names of clomiphene, are among a class of medications called estrogen-blocking drugs. They are also known as ovary stimulants, as they cause the hypothalamus and pituitary gland, located in your brain, to release hormones called gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These hormones trigger your ovaries to make eggs.
These drugs are often used along with other fertility methods, like assisted reproductive techniques or artificial insemination. Clomiphene is also the most commonly prescribed infertility treatment for people with polycystic ovary syndrome.
How to use clomiphene
The typical starting dosage of clomiphene is 50 milligrams a day for five days. You usually take the first pill on the third, fourth, or fifth day after you start your period.
You can expect to start ovulating about 7 days after you've taken the last dose. If you don't ovulate during your first cycle, your doctor may recommend raising your dose by 50 milligrams a day each month, up to 150 milligrams, for up to six cycles.
After you start to ovulate, most doctors suggest taking clomiphene for no longer than six months. If you haven't become pregnant after half a year, your doctor will probably prescribe a different medication or suggest that you see an infertility specialist.
How well does clomiphene work?
About 60%-80% of those who take clomiphene will ovulate, and about half of them will be able to get pregnant. Most pregnancies happen within three cycles.
Side effects of clomiphene
They're generally mild. They include hot flashes, blurred vision, nausea, bloating, irregular menstrual cycles or spotting, and headache.
Clomid can also cause changes in your cervical mucus, which may make it harder to tell when you're fertile and may stop sperm from getting into your uterus.
Like many fertility drugs, Clomid can raise your chance of multiple births. The rate of multiple pregnancies — primarily twins — is just under 4%.
Injected Fertility Hormones
If clomiphene citrate on its own doesn't work, your doctor may recommend hormones to trigger ovulation. Some of the common types are:
Human chorionic gonadotropin, such as Novarel, Ovidrel, Pregnyl, and Profasi. This medication is usually used along with other fertility drugs to trigger your ovaries to release an egg.
FSH, such as Bravelle, Fertinex, Follistim, and Gonal-F. These drugs bypass the hypothalamus and pituitary glands to directly trigger the growth of eggs in your ovaries.
Human menopausal gonadotropin, such as Menopur, Metrodin, Pergonal, and Repronex. These drugs combine FSH and LH.
GnRH agonist, such as Lupron, Synarel, and Zoladex. These drugs help the body produce a high number of quality eggs.
GnRH antagonist, such as Antagon and Cetrotide. These drugs help prevent premature ovulation.
How well do injected fertility hormones work?
As with clomiphene, injected hormones have a high rate of success in helping you ovulate. Among those who do start to ovulate, as many as 50% are able to get pregnant. That percentage is true for people who have conditions such as endometriosis that may be interfering with their ability to conceive.
Side effects of injected fertility hormones
Some people experience breast tenderness, mood swings, or headaches. You might have skin irritation at the site of the injection.
There's also a risk of a condition called ovarian hyperstimulation syndrome, which makes your ovaries grow and become tender. It usually gets better without any problems. In rare cases, you could experience a severe form, which causes:
- Nausea and vomiting
- Rapid weight gain
- Dehydration
- Blood clots
- Kidney dysfunction
- Twisting of your ovary
- Fluid buildup in your chest or belly
The drugs also raise your chances of multiple births.
Antagon
Antagon, the brand name for ganirelix, is a GnRH antagonist. It's an injectable medication used to prevent LH surges in people undergoing controlled ovarian hyperstimulation (COH) — a fertility treatment involving the use of medications that stimulate the ovaries to produce multiple eggs.
Antagon treatment may also reduce the need to take FSH.
How to use Antagon
Antagon is injected under the skin and may be done at home or in a clinic or doctor's office. The recommended doses can vary, depending on your health and the suspected cause of infertility. A standard dose is a daily injection of 250 micrograms for five or six days during the middle of your menstrual cycle.
How well does Antagon work?
Research suggests that about one-third of people with COH treated with ganirelix become pregnant.
Side effects of Antagon
Side effects of Antagon can include:
- Abdominal pain
- Bloating
- Diarrhea
- Nausea and vomiting
- Non-menstrual vaginal bleeding
- Unexplained weight gain
Dostinex and Parlodel
Dostinex is the brand name for cabergoline. Parlodel is the brand name for bromocriptine. These drugs are used to treat hyperprolactinemia or abnormally high levels of prolactin in the body. Prolactin is the hormone responsible for lactation, and high levels can lead to fertility problems, among other complications.
How to use Dostinex and Parlodel
Dostinex and Parlodel are available as oral tablets taken once daily, unless otherwise recommended by your health care provider.
How well do Dostinex and Parlodel work?
Parlodel has been shown to bring prolactin levels into a healthy range in 60%-90% of people taking it for hyperprolactinemia. Dostinex is similarly effective and is usually stopped once prolactin levels have been normal and consistent for about six months.
Side effects of Dostinex and Parlodel
Some of the more common side effects include:
- Constipation
- Dizziness
- Headache
- Nausea
Those side effects usually don't require a doctor's attention. If you experience more serious side effects, such an allergic reaction and skin rash or trouble breathing, you should get medical attention as soon as possible.
Over-the-Counter (OTC) Fertility Drugs
There are no OTC fertility drugs available in the U.S. These medications require a prescription and should only be taken under the supervision of your health care provider.
However, there are many OTC supplements that promise to boost fertility. Evidence of their safety and effectiveness is mixed, and medical experts do not recommend them.
Lepidium meyenii, also known as maca, is a plant that grows in the Andes mountains and has been touted for its supposed fertility benefits. There is some research suggesting that supplements containing maca and other herbs and vitamins may help stimulate ovulation and raise the chances of conception. But it's not clear what role maca itself plays. More research is needed.
You can find countless other "fertility blends" of vitamins and supplements online and on store shelves. But just as prescription medications can cause side effects, OTC supplements carry risks, too. The other concern with supplements is that they are not regulated as thoroughly as medications, which means supplements may contain ingredients not listed on the label or may contain ingredients in higher or lower amounts as those listed on the label.
Takeaways
Fertility treatments include a wide range of possible medications and procedures, and factors such as your age, overall health, and any underlying medical conditions must be considered when determining the right approach for you. Rather than be overwhelmed by it all, find a fertility specialist you feel comfortable with and who will patiently and thoroughly answer your questions. You may need to try more than one treatment plan, so it's important not to give up if your initial efforts aren't successful.
Fertility Drugs FAQs
What fertility drug has the highest success rate?
Clomiphene and gonadotrophins are the most commonly used fertility drugs because they tend to be the most effective.
How are fertility drugs given?
Some fertility drugs are taken orally, while others are injected in the stomach, thigh, buttocks, or upper arm, depending on the type of drug used and the dose.
Can fertility drugs cause cancer?
There is little evidence to show that fertility drugs raise ovarian cancer risk. And raised breast cancer risk associated with clomiphene may be due to the use of the drug well beyond standard guidelines.
