Medical Health Encyclopedia

The drug often reduces the amount and quality of cervical mucous and may cause thinning of the uterine lining. In such cases, other hormonal agents may be given to restore thickness. Other side effects include ovarian cysts, hot flashes, nausea, headaches, weight gain, and fatigue. There is a 5% chance of having twins with this agent, and a slightly increased risk for miscarriage.

Superovulation with Gonadotropins and GnRH Agonists

Superovulation, also called controlled ovarian stimulation, is generally used if clomiphene does not work. This approach is the direct administration of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), collectively called gonadotropins. The intent is to mimic the natural process leading to ovulation and produce multiple follicles. Superovulation is generally used in conjunction with assisted reproductive technologies.

Many of the drugs used in superovulation are either taken from natural sources (menotropins) or are genetically developed:

• The standard agents are menotropins, which are hormones extracted from urine of postmenopausal or pregnant women. Menotropins contain high concentrations of FSH or LH. The specific agents that are administered either in combination or as FSH.
• Genetically developed hormones (called recombinant drugs) are proving to be very effective. These are pure hormonal agents and they are allowing the doctor to better tailor the regimen to the unique needs of the patient.

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Human Menopausal Gonadotropins (hMG). HMG (Pergonal, Repronal, Metrodin) is a menotropin that contains both FSH and LH and is obtained from the urine of postmenopausal women. HMG must be self-administered as an injection. It is one of the potent ovulation drugs now in use and is often used in assisted reproductive techniques. It may be effective in stimulating fertility in women with ovarian dysfunction, endometriosis, and unexplained infertility. HMG is administered as a series of injections two or three days after the period starts. Injections are usually given for seven to 12 days, but the time may be extended if ovulation does not occur. In such cases, an injection of human chorionic gonadotropin (hCG) may trigger ovulation.