Injectable Fertility Medications: Gonadotropin shots

Gonadotropin shots are injectable medications that are used for aggressive fertility treatment. These medications are hormones (FSH or FSH plus LH) that are naturally produced by the brain. In a naturally occurring menstrual cycle, small amounts of FSH and LH are secreted from the pituitary gland. This results in one egg developing to the point of ovulation in any one menstrual cycle. At higher doses, like those we achieve with the injectable gonadotropins, more eggs will develop. Typically two-three follicles are stimulated for ovulation in these types of fertility treatment cycles. Especially when combined with insemination, pregnancy rates with this treatment are relatively high (20-25% per cycle).

Gonadotropin shots are a particularly good treatment in certain situations:

• when Clomid and Femara are not successful in causing ovulation in a woman who is anovulatory
• in women who have hypothalamic amenorrhea as a cause for their anovulation
• when menstrual cycles are regular and a fertility evaluation is basically normal
• in women with endometriosis
• when age or ovarian reserve dictates that treatment should be aggressive

Side effects from taking these shots include bloating, cyst development, cramps, and rarely ovarian hyperstimulation syndrome. A woman 35 years of age or younger can expect a pregnancy rate of 20-25% per treatment cycle with these medications.

There are several different brands of these medications. The ones used at Texas Fertility Center – San Antonio include Follistim ®, Gonal F®, and Menopur®. These medications are equal in their quality and pregnancy rates, so if your insurance plan prefers one medication over the other, we will be happy to prescribe it for you to maximize your insurance coverage.

Gonadotropin treatment has a high (up to 20%) risk of multiple gestation (including high order multiples). Thus, the decision to proceed with this therapy must be made carefully. Using these medications for IVF (in vitro fertilization) rather than in combination with IUI lowers the risk of multiple gestation. We will typically treat patients with gonadotropins and IUI for three-four cycles before considering moving on to IVF.