Do You Suffer From Infertility?

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What are fertility drugs?

Fertility drugs are medications that stimulate reproduction when conception fails to occur naturally. They are most often issued to infertile women or women who are undergoing assisted reproduction procedures such as in vitro fertilization.

What are the different types of fertility drugs?

Fertility drugs are numerous and varied. They come in different forms, including pills, nasal sprays, gels, suppositories, and needle injections. They also vary in their respective effects on the reproductive process. Some drugs like progesterone correct for a very specific hormonal deficiency, while others such as gonadotropins can have a much more extensive effect on the reproductive process.

The most common fertility drugs include:

Clomiphene citrate
Gonadotropins
Gonadotropin-releasing hormone (GnRH) analogues
Progesterone

How do fertility drugs work?

For infertile couples, an initial attempt at inducing pregnancy is often made with the drug clomiphene citrate. This oral medication is also known as antiestrogen, and is marketed under the brand names Clomid, Serophene, and Milophene, among others. Clomiphene forces the pituitary gland to release hormones that stimulate the ovaries. The ovaries produce extra follicles, which in turn create multiple eggs, increasing the chances of conception. However, clomiphene is not particularly reliable, especially for women with low estrogen levels.

If clomiphene is unsuccessful in inducing a pregnancy, the next step may be another, slightly more powerful group of human-engineered fertility drugs called gonadotropin drugs. Gonadoptropins are hormones that are naturally secreted by the pituitary gland: examples include follicle stimulating hormone (FSH), luteinizing hormone (LH), and human chorionic gonadotropin (hCG). Methods have been developed both to donate these hormones and to produce them in a laboratory. Gonadotropin drugs – administered by injection – are used to produce multiple ovarian follicles and to induce ovulation in women, often prior to an assisted reproductive technology (ART) procedure.

There are several types of gonadotropin drugs. Human menopausal gonadotropin (hMG) is one of the most common. It is made from the refined urine of menopausal women, who have high levels of FSH and LH. The respective amounts of these hormones in urine-based gonadotropins can vary, from about a one-to-one ratio to mostly FSH. hMG gives the body enough of these hormones to stimulate production of multiple follicles. A common hMG brand is Humegon.

Another type of gonadoptropin drug, called recombinant follicle stimulating hormone (rFSH), is produced through recombinant DNA technology. Researchers have isolated the gene that is responsible for FSH production, enabling them to produce 99% pure FSH in a laboratory. This drug performs a function similar to hMG.

The gonadotropin drugs discussed so far – hMG and rFSH – are used early in the menstrual cycle to develop egg follicles. Once a woman’s follicles mature, her ovulation may be stimulated by a third gonadotropin: human chorionic gonadotropin (hCG). After the woman has ovulated, hCG helps maintain the pregnancy. hCG can also be used in conjunction with hMG to raise sperm count in men.

Gonadotropin drugs may be administered together with another fertility drug called a gonadotropin-releasing hormone (GnRH) anologue. GnRH is secreted naturally by the hypothalamus in order to start the pituitary gland’s production of LH and FSH. The GnRH analogue takes over the transmission of GnRH to the pituitary, giving the physician total control over this process and, thus, the timing of ovulation. GnRH can also be used to stimulate hormones that trigger sperm production in men, including men who are not producing sperm at all.

Other fertility drugs supplement a specific hormone that is deficient. An example is progesterone, which is produced naturally by a woman’s ovaries during ovulation. Progesterone prepares the lining of the uterus to receive a fertilized egg. Supplemental progesterone can be administered orally, through injection, or vaginally with a gel or suppository.