What You Need to Know
Fertility medications are a normal part of fertility treatment and are commonly used in IUI and IVF. They are used to stimulate ovulation, prepare your body for IVF treatment, and to help avoid recurrent pregnancy loss.
Your reproductive endocrinologist will develop a treatment plan for your unique needs. Following are some fertility drugs you may encounter in your treatment.
Clomiphene
Clomiphene citrate is the generic name of Clomid® and Serophene®. These drugs are used to stimulate ovulation in women who have irregular or absent periods. They work by stimulating the hypothalamus to produce more FSH or follicle stimulating hormone and LH, or luteinizing hormone. These are naturally occuring hormones which trigger ovulation in a menstrual cycle. Use of clomiphene citrate in IUI increases the risk of multiple births. There is also a risk of overstimulating the ovaries, causing side effects such as pelvic pain.
Gonadotropins
Gonadotropins are injectable fertility drugs which contain FSH, LH, or both. They are given to help your body make the hormones needed for egg production and to produce multiple eggs for IVF treatment. Just like the natural hormones, the FSH medications stimulate the ovaries to produce more eggs and the maturing of eggs. Follistim®, Gonal-f®, and Bravelle® are this type of medication. Combination medications which contain LH as well as FSH, known as human menopausal gonadotropins, are Repronex and Menopur.
Gonadotropin-Releasing Hormone (GnRH) Agonists
GnRH agonists are synthetic hormones that are used to closely time and control ovulation as part of an IVF cycle. Leuprolide, known as Lupron® or Zoladex®, and nafarelin or Synarel® work by regulating the pituitary gland and causing it to temporarily stop producing FSH and LH. These help you produce more and higher quality eggs. Agonists are taken as injections or, in the case of Synarel, a nose spray, for a few weeks prior to starting your IVF and are continued until hCG is administered.
Gonadotropin-Releasing Hormone (GnRH) Antagonists
GnRH antagonists block the effect of GnRH on the pituitary gland, temporarily stopping production of FSH and LH. The antagonists work almost immediately, unlike the agonists, which take a few days. The purpose is to control ovulation as part of an IVF cycle or an IUI procedure so you don’t ovulate too early due to the natural hormones your body would produce, which could cause the procedure to be cancelled. These medications are injected. The GnRH antagonists include Ganirelix Acetate Injection and Cetrotide.
Human Chorionic Gonadotropin (HCG)
The hCG drugs are used to help the eggs mature when they are ready, mimicking the natural surge of LH when eggs are mature. Pregnyl®, Novarel®, Ovidrel®, and HCG (Generic) are usually used in a single dose, before egg retrieval takes place.
Progesterone Medications
Many reproductive endocrinologists will prescribe progesterone shortly after egg retrieval. Progesterone helps prepare the uterine lining for embryo transfer and implantation. Progesterone medications include Crinone®, Endometrin®, Prometrium® and Progesterone in Oil injection. Progesterone may be given by injection, a vaginal gel, a suppository, or a pill.
