Fertility Medications: Get the facts
The first step we recommend for patients experiencing challenges in trying to conceive is to learn as much as possible about fertility and its treatment options. Understanding the various types of fertility medications is an important component of education for all fertility patients, both women and men alike.
At Fertility C.A.R.E. we truly believe "Knowledge is power." To help you better understand currently available fertility medications, we've provided general information about them below.
For more in depth information about various fertility medications, visit the following fertility pharmaceutical websites:
Most Commonly Used Fertility Medications
The most common fertility medications are classified as ovulation induction drugs. Ovulation induction medications are approved for patients with various ovulation disorders with the goal of producing a single mature egg during a treatment cycle.
In addition, these drugs may be used for what is known as "super" ovulation in patients with normal ovulation function. These medications stimulate the ovaries to produce more than the usual one follicle per month, thus increasing the number of eggs exposed to sperm and increasing the chance for pregnancy.
One type of ovulation induction medication-clomiphene citrate (Clomid®, Serophene®)- is administered in a tablet form and usually results in one or two follicles each cycle.
Another type of ovulation induction medication is classified as gonadotropins (Repronex®, Follistim®R, Gonal-F®). They can stimulate the ovaries to produce many dominant follicles each cycle. Gonadotropins are currently administered by injection. These fertility medications can be used in combination with sexual intercourse, intrauterine insemination (IUI), or In-vitro Fertilization (IVF) to enhance your chance for conception.
What are the risks of fertility medications?
Use of fertility medications carries risks that can vary depending on the patient's diagnosis as well as the response to specific medications.
In general, the most common risks-often more associated with the gonadotropin class drugs-include the following:
- Ovarian hyperstimulation syndrome
This side effect occurs in about 1-5% of cycles. The ovaries become enlarged due to overstimulation by fertility medications. The blood vessels supplying the ovaries become 'leaky' and this results in fluid collecting in the abdomen. In severe cases (~1%) hospitalization is required for close monitoring. The problem lasts for 1-2 weeks but can be longer if pregnancy results. - Multiple births
Since fertility medications cause more follicles to be stimulated, there is a higher rate of multiple births. The multiple birth rate with clomiphene citrate is 5-10% and with gonadotropins it is 15-20% per pregnancy. In order to put these statistics in perspective, the chance for a couple to have a multiple birth spontaneously is about 1-2%. - Ectopic pregnancy
This situation occurs when the embryo implants outside the uterus, most commonly in one of the fallopian tubes. Ectopic pregnancy occurs in approximately 2% of women attempting to conceive, but this number may be slightly higher with the use of fertility medications. - Ovarian torsion
Twisting (torsion) of the enlarged, stimulated ovary can occur in about 1% of cycles. The ovary is cut off from its blood supply, causing abdominal pain. Surgery may be required to untwist the ovary or, rarely, remove it. - Ovarian cancer
Controversial and undetermined data exist associating fertility medications with ovarian cancer. The risk is probably related to continued ovulation in infertility patients. Pregnancy and the use of birth control pills, both of which prevent ovulation, decrease the risk. Recently, a summary of medical studies did not demonstrate a relationship between fertility drugs and ovarian cancer.