Infertility Drug Therapies

Clomiphene (Clomid, Serophene) - a nonsteroidal estrogen-suppressing drug that stimulates ovulation. If you ovulate irregularly or not at all, particularly if you have polycystic ovarian syndrome (PCOS), clomiphene can help you conceive. (If you have PCOS and this treatment does not seem to work for you, your doctor may also prescribe metformin [see below]) Clomiphene is also prescribed to stimulate egg production before a treatment such as in vitro fertilization (IVF).

About 80% of women who take clomiphene ovulate, usually within the first three months of treatment. Of those who ovulate, 40% get pregnant. The success rate is affected by factors such as age or the quality of the partner's sperm.

Clomiphene can help men with a hormonal imbalance linked to a low sperm count or poor sperm quality or motility (movement).

Letrozole - used to treat infertile women who have an ovulation problem. Letrozole is very similar to clomiphene in the way it works. However, letrozole is quickly cleared from the body. It only works for the cycle in which it is taken and is less likely to adversely affect the uterine lining and cervical mucous. The usual dosage of letrozole is 2.5 mg., one tablet each day.

Metformin - an insulin-sensitizing drug that can help you respond to clomiphene

Gonadotropins - Gonadotropins are hormones that stimulate egg-production during IVF. The most frequently prescribed are Gonal F, Bravelle, Follistim, Pergonal and Repronex. They are taken as subcutaneous injections.

GnRH Agonists - Lupron, taken as a subcutaneous injection, and Synarel, a nasal spray, shut down production of gonadotropin-releasing hormone (GnRH). These drugs are prescribed to fine tune the timing of egg production during the IVF treatment cycle. They are also prescribed to prevent the midcycle hormone surge that can cancel a cycle.

GnRH Antagonists - Antagon and Cetrotide stop production of GnRH more quickly than agonists. These medications, given by injection, are used to prevent premature ovulation. Treatment usually lasts three or four days.

hCG – Human chorionic gonadotropins (hCGs) are used to induce the final maturational changes in eggs and prepare them for retrieval during IVF treatment. hCGs are taken as an intramuscular injection. The most frequently prescribed are Pregnyl, Profasi and Novarel.

Medrol - Medrol is a steroid hormone given daily, typically for a period of four days during the cycle, to assist pre-embryo implantation.

Doxycycline - Doxycycline is an antibiotic pill given to the male partner during the female's stimulation cycle to reduce the low levels of bacteria that may be found in the semen and which may affect sperm during an IVF cycle. To reduce the risk of infection after aspiration of the follicles during egg retrieval, it may also be given to the female partner.

Progesterone - Natural progesterone may be taken as a daily intramuscular injection beginning two days after egg retrieval and continuing until the placenta is making adequate amounts of progesterone. Progesterone can also be given in pill form or as a vaginal gel or vaginal suppository.