Several fertility drugs may be used to treat female infertility based upon the cause(s) of infertility. Unfortunately, there are very few fertility drugs that have been proven effective in treating male infertility. When a male has a severe shortage of gonadotropin hormones (FSH and LH), FSH can be used to improve sperm count. However, this condition is very rare.
| There are Many Fertility Drugs Available to Treat Female Infertility. Unfortunately, Few Drug Options Exist for Male Infertility. |
Drug treatment for male infertility is very expensive as three months of treatment with injectable FSH is required. This is the time it takes for sperm to fully develop. Fortunately, even males with severe sperm deficiencies can produce children using ART procedures such as IVF with ICSI.
Ovulation induction medications stimulate the production of numerous follicles each of which contains an egg. Drugs, such as Clomid, regulate ovulation and can cause the development of several eggs; however, the effect is much less than with FSH. Clomid stimulates ovulation through its action on the hypothalamus. FSH (Follistim, Gonal-F, Repronex) acts directly on the ovaries inducing the development of multiple follicles.
Clomid is commonly prescribed as a first line therapy by many obstetricians/gynecologists. Clomid should not be used for more than 3-6 cycles as studies show that success is most likely to occur during this time frame. Also, continued use of Clomid can increase the chances of side effects and is expensive. If Clomid does not work, a reproductive endocrinologist/infertility specialist should be consulted. In many cases, women aged 35 or older should consult a specialist immediately as fertility can decline rapidly in this age group and there may not be enough time for Clomid trials.
FSH (Follistim, Menopur, Gonal-F, etc.) is used to induce the development of multiple eggs in an ART (IVF) cycle. Many eggs are needed so that enough develop to create viable embryos for transfer. Some eggs are normally lost during the ART processes. FSH is also given in stimulated IUI cycles and it is important to limit the chances for multiple births. These cycles should only be performed by a reproductive endocrinologist/infertility specialist. There is a lower chance for multiple births in an FSH IVF cycle because the number of embryos transferred is limited.
FSH is administered according to patient specific protocols. It is given once or twice daily during the follicular development segment of the menstrual cycle. Patients receiving FSH must come to our office during the cycle for transvaginal ultrasound and estradiol measurements. These tests insure that the follicles are developing properly and reduce the chance of side effects such as hyperstimulation syndrome.
Fertility drugs, such as the GnRH antagonists (Ganirelix, Cetrotide) and GnRH agonists (Lupron), interfere with the production of FSH and LH. Lupron is a GnRH agonist which works at the hypothalamus (a small gland located at the base of the brain ) whereas Antagon is a GnRH antagonist which completely blocks the effect of gonadotropin releasing hormone at the pituitary gland thus creating a "more complete "down regulation".
Drugs such as human chorionic gonadotropin (Ovidrel, Pregnyl) are given to finalize follicular development and cause ovulation of the eggs. Luveris (LH) is used for the same purpose. If a patient is receiving Lupron, ovulation cannot occur until hCG or LH is given. The eggs must not be ovulated before they can be retrieved.
Progesterone causes the lining of the uterus to thicken, become infused with greater blood supply, and provide an optimal developmental environment for the embryo. Progesterone is first produced by the “left over” follicular structure after ovulation known as the corpus luteum and later by the placenta. Progesterone deficiencies lead to poor development of the endometrium and reduced implantation and development. Progesterone can be administered to correct a luteal phase defect (too little progesterone) and is always given in conjunction with FSH induced cycles. This is because medications given in the IVF cycle interfere with the natural production of progesterone.
Major fertility drugs are discussed on separate pages and are listed below:
Fertility Drug Links
|
