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Drugs Used in Fertility
Treatment
Clomiphene
Citrate (Clomid, Serophone)
This medication comes in a tablet form and is used for women who have
infrequent periods or long menstrual cycles. Common side effects include
headaches, blurred vision and hot flashes.
Gonadtropins
(Repronex, Menopur, Follistim, Bravelle, Pergonal and GonalF)
These are injectable medications that are used to induce the release
of the egg once the follicles are developed and the eggs are mature.
The response to these drugs varies according to the patient's age,
her FSH hormone levels and the amount of drugs given. The dose will
be clearly indicated on the Calendar. These drugs are given once (usually
in the evening) or twice daily (morning and evening). Mixing and injection
instructions will be given to the patient prior to treatment initiation.
The drug dosage changes as we move through a cycle. Vaginal ultrasound
examination together with blood hormonal tests will be performed 3
days after the start of these medications and these tests help us
in determining the dosage schedule subsequently.
Side effects may include abdominal distention/discomfort, bloating
sensation, mood swings, fatigue or restlessness. In most cases, the
side effects are relieved by follicular aspiration.
Glucophage (Metformin)
Metformin is given to patients as an insulin lowering medication.
Most commonly used in PCOS patients, the medication has been shown
to reverse the endocrine abnormalities seen with polycystic ovary
syndrome within two or three months. The use of Metformin can result
in decreased hair loss, diminished facial and body hair growth, normalization
of elevated blood pressure, regulation of menses, weight loss and
normal fertility.
Birth Control
Pills (BCP)
Most patients start the treatment cycle with the birth control pills
(oral contraceptives). By putting the patient on BCPs, we are able
to manipulate the menstrual cycle and this allows for flexible scheduling.
In this manner we are able to better plan ahead and provide the patient
with specific treatment dates that can be set well in advance. The
patient will usually take these pills for a period of 3-5 weeks. This
will in no way harm the patient's chances of conceiving.
Lupron
Lupron suppresses the ovaries and will then permit a better response
with the fertility medications. Lupron is administered as a subcutaneous
injection. (Under the skin with a small needle). The patient will
take daily Lupron injections until otherwise indicated.
Additional Medication
Often patients are placed on Heparin and Baby Aspirin for immunologic
problems. Folic acid is a vitamin that every patient attempting to
conceive should take prior to conception. It has been shown to reduce
the incidence of serious birth defects (neural tube defects such as
spina bifida) when taken during the first 50-70 days after conception.
Most prenatal vitamins have adequate amounts of Folic acid in them.
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