If you or your partner have been unable to get pregnant, your doctor may recommend fertility drugs as part of their plan to help you grow your family. Fertility medication is common and often the first step in correcting or overcoming a couple’s infertility. Some women use fertility drugs to conceive, while others take medicine to prepare their bodies before IVF or to treat medical conditions that may be interfering with their body’s ability to get pregnant naturally.
Your reproductive specialist will recommend certain medications depending on what you need, and they will also be able to answer any questions you have about medications used to treat infertility and the side effects they may cause. But, as is often the case, you’ve likely walked out of the doctor’s office with more questions than you had when you came in. It’s important to understand what you’re putting in your body and how it will help you in your journey to start a family.
What Are Fertility Drugs For?
No two women are the same. Their unique stories and situations reflect in their infertility diagnosis and in the treatments they receive to increase their chances of becoming pregnant. When we say “fertility drugs,” we’re talking about medications used to stimulate ovulation and improve a woman’s chances of getting pregnant.
There are a lot of medications out there and, even with the best of intentions, your reproductive specialist may quickly overwhelm you with names and descriptions. In general, drugs used in fertility treatment have one of several goals.
1. Stimulate Ovulation
In many cases, your doctor’s first course of action will be to prescribe a medication that will stimulate ovulation for women who may not have regular periods. These medications work by increasing the amount of follicle-stimulating hormone a woman’s pituitary gland will secrete, signaling her body to ovulate at regular intervals. The idea behind this medication is that some women do not ovulate regularly, and by correcting this problem, their chances of conceiving go up.
The most common medication used to stimulate ovulation is clomiphene citrate, more commonly known as Clomid®. Clomid® is an oral pill doctors prescribe for a period of three to six months. For some women, this is enough, and they get pregnant because they are ovulating regularly for the first time. For other women, Clomid® itself may not be enough to result in pregnancy. In some cases, your doctor may prescribe it in conjunction with other medications and treatments — more about that later — or it may not have the intended results, and your doctor may opt to try another oral medication, such as Serophene®, instead.
Side effects of the medications mentioned above include mood swings, depression, nausea, increased chances of multiple births — aka twins — or miscarriage, headache, breast tenderness or blurred vision. Your reproductive specialist can prepare you for these side effects and help monitor the effectiveness of the medication in light of these side effects as well.
Some women find Clomid® does not work, especially if their infertility is due to polycystic ovary syndrome. In these cases, doctors have found some success with a drug called Femara. Originally developed for the treatment of breast cancer, Femara has become a viable option for stimulating ovulation.
In some cases, oral medications may not be enough to induce a woman’s body to ovulate regularly — or at all. When this happens, your doctor may recommend injections to stimulate ovulation. Women often use these along with oral medications, particularly when they are preparing for IVF or IUI. As a group, these injections are called gonadotropins, and they contain hormones designed to mature eggs and signal for ovulation regularly. Women typically administer these injections themselves in the privacy of their home.
The side effects of these injections are similar to those of Clomid® and other oral medications. However, the most significant difference between these drugs is that the chances of multiple births are significantly higher with gonadotropins. Your doctor can explain this in more detail and educate you on the risks you’ll face if you become pregnant with multiples. Women who get treated with gonadotropins are also at risk for developing ovarian hyperstimulation syndrome, which is painful swelling in the ovaries that occurs when a woman has high levels of hormone medication in her system. If this happens, call your doctor or seek medical help as soon as possible.
2. Prevent Ovulation
Doctors may need to suppress ovulation to eventually help a woman get pregnant. While that may seem counterintuitive when you’re trying to increase your chances of getting pregnant, sometimes it’s necessary in cases where a woman is preparing her body for IVF. In vitro fertilization bypasses the fallopian tubes by extracting the eggs directly from the ovary and fertilizing them in the laboratory, and ovulation might interfere or make it challenging to retrieve eggs for the procedure.
Depending on your situation, your doctor may prescribe birth control pills to regulate your menstrual cycle, which includes ovulation. Physicians commonly prescribe birth control pills one month before the procedure to retrieve the eggs. Or, doctors may prescribe them for women who do not initially respond well to Clomid®. Doctors have found some women respond better to Clomid® if they are on birth control for two months before beginning Clomid®.
Your doctor may also opt to administer GnRH antagonists, which are injections designed to delay ovulation. Similarly to oral contraceptives, these prevent ovulation before IVF so doctors can retrieve your eggs before your body releases them. For some women, these can also treat fibroids or endometriosis — both conditions that can affect pregnancy.
3. Treat Other Fertility Complications
Some women’s problems getting pregnant may not link directly to ovulation, but another medical issue. If this is the case, your doctor may not prescribe fertility drugs, but certain other medications, including:
- Progesterone suppositories or injections
- Estrogen to thicken your endometrial lining or improve your cervical mucus
- Heparin or aspirin to prevent clots after miscarriage or as a result of a blood disorder
If you are having trouble getting pregnant, it’s essential to be honest with your doctor about your medical history, which helps your team better understand what is going on in your body and pinpoint the cause of your infertility. While there are no guarantees, knowing everything about your health will improve their ability to help you conceive.
4. Address Underlying Medical Conditions
Your infertility may not relate directly to your reproductive system. Certain medical conditions — including diabetes, thyroid disorders, eating disorders, weight problems and abnormal hormone levels — can also prevent you from conceiving and carrying a pregnancy to term. Infection — and subsequent scarring — of the reproductive tract can also cause problems with conception.
If your doctor determines an underlying medical condition is causing your infertility, they may recommend certain medications to regulate or resolve those issues. While there is no cure for diseases such as diabetes, they are manageable, and pregnancy is possible with careful attention to medication and healthy living.
In some cases, treating the underlying problem may be enough to restore your body’s natural ability to conceive. In other cases, your doctor may still recommend fertility medications to improve your chances of conceiving.
Fertility Drugs for Men
Sometimes a couple struggling with infertility will discover their inability to conceive is partly — or even wholly — due to the male partner’s infertility. In the past, the medical community considered infertility a woman’s “problem,” but the truth of the matter is that one out of every three occurrences of infertility can trace back to the man.
In some cases, a man’s body may not be producing viable sperm. Other times, his sperm may not be making it to the proper spot for fertilization to occur. In these cases, doctors can identify the cause of the problem, including potential infections, correctable anatomical abnormalities or hormonal imbalances. However, in about 25 percent of cases, men have a low sperm count, and doctors cannot figure out why.
In cases where a man’s infertility is due to a hormonal imbalance, doctors can prescribe certain medications designed to increase a man’s bioavailable testosterone and decrease estradiol — a form of estrogen that plays a pivotal role in a man’s sex drive. The ultimate goal with these medications is to balance a man’s hormones so his body can produce a healthy amount of viable sperm and increase his chances of conceiving with his partner.
Sometimes, your doctor may prescribe Clomid® for male infertility. While it’s generally for female infertility — and has only received FDA approval for use in women at this time — doctors have found some benefits to prescribing it to men as well. Anastrazole is another prescription oral medication. Injections of hCG or hMG may be an option for some men as well.
In situations where male infertility is not due to hormonal imbalance, alternatives to medication are available. In the case of an anatomical problem, surgery may be the solution. But in other cases, especially those where a man has a low sperm count for no apparent reason, there are some ways men can increase their chances of helping their partner conceive.
If you are not a candidate for male fertility drugs or surgery, you can time sex with your partner’s ovulation cycle, increase the frequency of sex and avoid the use of lubricants that might impede the movement of sperm. If you’re looking to increase your chances of conceiving, also avoid tobacco products, marijuana, excessive alcohol consumption and whirlpools and hot tubs, since the heat can slow down the movement of sperm as well.
When Do Doctors Prescribe Drugs for Unexplained Infertility?
The use of medication as part of the treatment of infertility depends on the reason for your infertility. Typically, doctors encourage couples to undergo testing for infertility after 12 months of unprotected sex without pregnancy or, if you’re over 30, after six months. However, this is only a general rule of thumb, not a set-in-stone medical guideline. If you have reason to suspect an infertility issue, there is no reason to put off a visit to your doctor for evaluation.
The inability to get pregnant may be due to an underlying medical condition on the part of either partner. Sometimes, medications can correct these conditions, but other couples may find surgery or lifestyle changes provide significant benefits and improved chances of pregnancy. Once your doctor determines why pregnancy isn’t happening, they can decide whether or not you or your partner would benefit from medication alone or medication in conjunction with other treatment.
Doctors might prescribe medications alongside other treatments to increase your chances of being able to conceive, especially when a woman is getting ready to undergo IVF or IUI, or when a surrogate is preparing her body to receive a fertilized egg from the couple who has chosen her to carry their child. In these cases, fertility drugs and certain other medications pave the way for egg retrieval and implantation by providing the necessary hormones.
What Are Fertility Drug Side Effects?
As we mentioned earlier, there are specific side effects associated with fertility medications. Although they tend to be relatively mild, it’s important to understand what they are so you and your partner don’t get caught off-guard if you experience them.
One specific side effect bears a second mention — the increased risk of multiples. While there’s no guarantee you will have twins — or even triplets — couples should prepare for this possibility when a woman begins taking fertility medications. Your doctor will talk to you in greater detail about the risks associated with multiples and the odds of facing this scenario.
How Successful Are the Medications?
If you’re looking to increase your chances to become pregnant, fertility medications will undoubtedly do that. But putting a number on Clomid® success rates, or the success rates of other medicines, is difficult. Studies have shown 80 percent of women who take Clomid® will ovulate within the first three months of being on the medication. Of those 80 percent, 30 to 40 percent will become pregnant by the third cycle of ovulation.
In cases where women are taking receiving injections of gonadotropins, there is a 15 percent chance of pregnancy with each cycle.
The hard part about quantifying the success of medications is that they often prepare a woman’s body for additional procedures. So, saying someone did or did not get pregnant while taking Clomid® is not indicative of the drug’s success. That is why it’s so important to choose a reputable reproductive team to walk with you through the infertility journey.
At Western Infertility Institute, our team of doctors and health professionals are experienced in helping women and couples who are facing challenges in building their family. Some couples come to us because they have received a diagnosis of infertility. Other times, a single woman or same-sex couple will approach us with their longing for a child of their own. Whatever your situation, we understand the desire you have to build your family and experience the joy of raising a child. Our team shares your dream, and we are committed to providing the knowledge and support you need to make that happen.
Yes, it’s hard to put a number on our success stories. But we believe even if other clinics have told you the odds are against you, there is hope. And hope is much stronger than the numbers. A significant majority of our patients come to us for help and leave with a new baby. Sometimes it’s thanks to fertility medications and medical procedures, such as IVF. Other times, we can match patients with a loving, dedicated surrogate who is willing to carry a baby on their behalf.
Whatever your story, whatever you are facing, Western Fertility Institute is ready to help make your dreams of having a baby into a reality. Contact us today and let us help you grow the family you have always wanted.
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