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Fertility drugs were introduced in the early 1960s in the US, and have since helped many women to get pregnant (1). Most of the fertility pills stimulate ovulation, thus increasing the chance of pregnancy. These are prescription-only medications that may also be used for the treatment of certain medical conditions other than infertility.
Read this MomJunction post to know more about the benefits and risks of using fertility drugs.
When Do Women Need Fertility Drugs?
The World Health Organization (WHO) explains infertility as a disease of the reproductive system, defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (2).
Fertility drugs are suitable if you have infertility due to any one or more of the following health issues:
- Polycystic ovary syndrome (PCOS) and other ovulation problems
- Thyroid disorders
- Eating disorders
- Weight problems – underweight, overweight or following an extreme workout
- Issues with FSH (follicle-stimulating hormone) and LH (luteinizing hormone) levels
Most of the above conditions cause infrequent or missed ovulation, and your doctor may prescribe medications to address your specific problem (3).
How Do Fertility Drugs For Women Work?
Fertility drugs work by:
- Stimulating ovaries to produce more eggs
- Increasing certain hormonal levels in the body, thereby helping to mature and release more than one egg per cycle. It is known as controlled ovarian hyperstimulation (superovulation)
- Preventing premature ovulation during assisted reproductive technology (ART) procedures
Fertility drugs also work in conjunction with assisted conception treatments such as artificial insemination or IVF (4).
What Are The Best Fertility Drugs For Women?
Almost all fertility drugs help in ovulation, but the right medicine for you depends on what is affecting your ovulation and conception (5).
1. Clomiphene citrate
Clomiphene citrate causes ovulation by stimulating the pituitary gland. It is prescribed for women with PCOS or other ovulation issues. It is also recommended for improving the production of eggs in women with regular ovulation.
- The oral medication should be taken for five days during the initial phase of the menstrual cycle, for up to six menstrual cycles.
- It is found to cause ovulation in 80% of women, of which half were able to get pregnant. Its success rate depends on the age of women and other factors (6).
- The drug may also increase the likeliness of multiple pregnancies (7).
- It is available under the brand names of Clomid, Clomidac, Bemot, Clomifene, etc.
[ Read: PCOS And Pregnancy ]
2. Letrozole
Letrozole is also used to stimulate ovulation. The oral medication activates the pituitary glands to make more FSH, to induce ovulation and release eggs. It works for women with PCOS, and in normal women to improve the production of eggs.
- The medication should be taken for five days during the initial phase of the menstrual cycle.
- It may work better than clomiphene in women with PCOS.
- Women resistant to clomiphene citrate demonstrate an increase in the ovulation rate with the use of letrozole (8).
- It is available under the brand name Femara.
3. Human menopausal gonadotropin (hMG)
hMG is a combination of hormones FSH and LH. These hormones mainly stimulate ovaries to produce and ripen eggs. Gonadotropins are useful for women who have healthy ovaries but cannot ovulate (develop-eggs). This usually happens when there are problems with the pituitary gland.
- It is an injectable medicine, usually given subcutaneously (9).
- They are injected two to three days after the periods start, for up to seven to twelve days.
- The drug is available under the brand names Menopur, Pergonal, and Repronex.
4. Follicle-stimulating hormone (FSH)
This medication also works like hMG by stimulating the ovaries to produce more follicles and thereby more eggs.
- It is an injectable drug.
- The course of treatment lasts for ten to 12 days, depending on the time it takes for the eggs to mature.
- It is available under the brand names of Gonal-F, Follistim AQ, Fostimon, Bemfola, Puregon, Pergoveris, and Bravelle.
5. Human chorionic gonadotropin (hCG)
The injectable medication stimulates the eggs to mature and rupture.
- It is given as the final trigger in ART treatment.
- It is available under the brand names Choragon, Ovitrelle, Ovidrel, Pregnyl, and Profasi.
6. Gonadotropin-releasing hormone (GnRH) antagonists
GnRH antagonists are prescribed for women who are treated with the Controlled Ovarian Stimulation (COS) technique, which is used along with IVF (10). They work by suppressing the production of FSH and LH, which otherwise stimulate ovaries to release eggs. In this way, GnRH antagonists prevent spontaneous ovulation and allow the eggs to mature only at the time of IVF treatment.
- They are available as injections.
- They are usually combined with IVF treatment.
- Are available under the brand names of Lutrepulse and Factrel.
7. Metformin hydrochloride
Metformin usually helps improve the body’s sensitivity to insulin and treats diabetes. However, it can also treat ovulation problems in women with PCOS. This oral medicine restores the balance of estrogen and testosterone levels, which helps the body to ovulate regularly.
- In some cases, metformin is combined with clomiphene.
- The dose and duration of metformin depend on the clinical requirement.
- It is available under the brand name Glucophage.
[ Read: FertilAid For Women & Men ]
8. Bromocriptine and Cabergoline (Dopamine antagonists)
These drugs are used to treat abnormal levels of prolactin hormone that interfere with ovulation. Pituitary growths, thyroid disease, kidney disease, and antidepressants cause high levels of prolactin, leading to problems with ovulation.
- They are oral medications.
- They are available under the brand names Parlodel and Cycloset (Bromocriptine) and Dostinex (Cabergoline).
Disclaimer: The primary focus of listing these drugs is to help you understand their general usage, interaction, and side effects. The use of trade names is for identification. You should always check with your medical practitioner before using them.
Are There Any Side Effects Of Fertility Drugs In Women?
Like any other medical treatment, fertility drugs also have some side effects, primarily upon long-term usage. The unpleasant effects of some of the fertility pills include (11):
- Certain drugs cause mild reactions such as moodiness, hot flashes, headaches, restlessness, and irritability.
- The drugs increase the chances of multiple births.
- Higher risks of premature labor are associated with multiple births.
- Ovarian stimulation syndrome, which causes the ovaries to become abnormally large with fluid. The syndrome is associated with stomach pain, swollen stomach, nausea, shortness of breath, edema, and reduced urine.
- The chances of ectopic pregnancy are prevalent in women who undergo IVF treatments.
[ Read: Foods Which Improve Chances Of Pregnancy ]
It is time to leave your worries behind and contact your doctor. There are many useful drugs that your doctor might suggest increasing your chances of pregnancy. However, avoid self-medication as it is harmful to your health.
Have you ever taken fertility pills? Share your experience with us in the below comment section.
References:
2. Sexual and reproductive health; World Health Organization; Revised ICMART glossary
3. Female Infertility; Harvard Medical School; Health Publishing
4. In Vitro Fertilization; Human Fertilization and Embryology Authority
5. Medications for inducing ovulation; The American Society of Reproductive Medicine
6. Anderson Sanches Melo, et al.; Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice
7. CLOMID (clomiphene citrate tablets USP); Access data; The Food and Drug Administration
8. Sujata Kar; Clomiphene citrate or letrozole as first-line ovulation induction drug in infertile PCOS women: A prospective randomized trial; Journal of Human Reproductive Sciences
9. Fertility Treatments for Females; The Eunice Kennedy Shriver National Institute of Child Health and Human Development; the United States Department of Health and Human Services.
10. Qiaohong Lai, et al.; Comparison of the GnRH agonist and antagonist protocol on the same patients in assisted reproduction during controlled ovarian stimulation cycles
11. Derman SG and Adashi EY.; Adverse effects of fertility drugs; Department of Obstetrics and Gynecology, University of Maryland School of Medicine, Baltimore, USA
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Dr. Rita Bakshi
(MD)