Infertility In Women - Treatment

Highlights	Treatment	References
Introduction	Medications	Resources
Causes	Assisted Reproductive Technologies	References
Risk Factors	Lifestyle Changes
Diagnosis	Resources

Medications

Fertility drugs are often used alone as initial treatment to induce ovulation. If they fail as sole therapy, they may be used with assisted reproductive procedures, such as in vitro infertilization, to produce multiple eggs, a process called superovulation.

According to the American Society for Reproductive Medicine, fertility drugs can be divided into three main categories:

Medications for Ovarian Stimulation. Clomiphene (Clomid, Serophene); letrozole (Femara), follicle stimulating hormone (FSH) [Follistim, Gonal-F, Bravelle]; human menopausal gonadotrophin (hMG) [Humegon, Repronex, Menopur]; luteneizing hormone (LH) [Luveris]
Medications for Oocyte Maturation. Human chorionic gonadotropin (hCG) [Profasi, APL, Pregnyl, Novarel, Ovidrel]
Medications to Prevent Premature Ovulation. GnRh agonists (Lupron and Synarel); Gn RH antagonists (Antagon, Cetrotide).

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Clomiphene

Clomiphene citrate (Clomid, Serophene) is usually the first fertility drug prescribed for women with infrequent periods and long menstrual cycles. Unlike more potent drugs used in superovulation, clomiphene is gentler and works by blocking estrogen, which tricks the pituitary into producing follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This boosts follicle growth and the release of the egg. Clomiphene can be taken orally, is relatively inexpensive, and the risk for multiple births (about 5%, mostly twins) is lower than with other drugs.

Women with the best chances for success with this drug are those who have the following conditions:

Polycystic ovarian syndrome (PCOS)
Ability to menstruate but irregular menstrual cycle

Women with poorer chances of success with this drug have the following conditions:

Infertility but with normal ovulation
Low estrogen levels
Premature ovarian failure (early menopause)

One or two tablets are taken each day for 5 days, usually starting 2 - 5 days after the period starts. If successful, ovulation occurs about a week after the last pill has been taken. If ovulation does not occur, then a higher dose may be given for the next cycle. If this regimen is not successful, treatment may be prolonged or additional drugs may be added. Doctors usually do not recommend more than 6 cycles.