Your journey to parenthood with TFC may involve additional fertility medications.
The first step in your TFC journey to parenthood is to meet with either Dr Erika Munch or Dr Susan Hudson for a discussion of your medical history, a physical examination, and a vaginal ultrasound. Your doctor will then order testing to help determine what obstacles you face. We will then work with you to develop the most cost effective treatment plan that will hopefully help you achieve your dream of a successful pregnancy in the fastest, least expensive way possible. No matter what your treatment involves, the staff at TFC is here to make sure you understand your treatment options.
Fertility medications
Azithromycin (Zithromax®)
This is an antibiotic in the erythromycin family. It has multiple uses in medicine. In fertility treatment, it may be prescribed prior to a uterine procedure or before initiating IUI therapy. We choose to treat all patients undergoing a fertility evaluation with a Z Pack as it is both cheaper and more cost effective than culturing the cervix for infectious diseases and treating patients who have a positive result. You may take this medication with or without food. Possible side effects include abdominal pain, nausea/vomiting, or diarrhea.
Birth control pills (Desogen®, etc.)
These pills (containing a progestin plus a small dose of estrogen) have many uses in fertility treatment. They may be used in as a contraceptive agent prior to surgery or to prevent ovarian cyst formation and synchronize egg development in IVF. Some side effects that can occur include: breakthrough bleeding, nausea, fluid retention, and mood changes.
Cetrotide® (cetrorelix)
This is a gonadotropin releasing hormone antagonist. It helps to prevent premature ovulation in gonadotropin cycles or in IVF treatment, allowing more time for egg maturation. It is given as a subcutaneous injection, typically for 3-5 days.Possible side effects include local irritation, headache, and nausea.
Doxycycline (Vibramycin®)
This is an antibiotic in the tetracycline family. It has many different indications for use. In fertility treatment, it may be prescribed prior to a uterine procedure or IUI therapy. It is also used after an egg retrieval in IVF. It is recommended to take this medication with a full glass of water. You should not drink milk while taking this medication, although you should consider taking doxycycline with food to prevent stomach upset. To prevent irritation of the esophagus (the swallowing tube), do not lie down for 30 minutes after taking this medication. Do not take vitamins or antacids within 2 hours of this medication. You should also avoid alcohol or excess sun exposure while taking this medication. Potential side effects include abdominal pain, nausea/vomiting, diarrhea, or yeast infection.
Estrace®: (micronized estradiol)
This is a form of estrogen that is commonly used to thicken the lining of the uterus. Possible side effects include mood changes, headache, and vaginal spotting.
Lupron® (leuprolide)
This is a gonadotropin-releasing hormone agonist. It helps to prevent premature ovulation in gonadotropin cycles or in IVF treatment, allowing more time for egg maturation. It may also be used in cases of severe endometriosis or in pre-surgical treatment of large fibroids. It is given as an injection – daily, monthly, or every 3 months depending on the scenario. Possible side effects include: hot flashes, headache, nausea, and mood changes. In addition, the long lasting (depot) formulation of this medication can cause some loss of bone mineral density (osteopenia or even osteoporosis). In order to prevent this (as well as to block the hot flashes), we typically administer Aygestin (an oral progesterone pill) daily while patients are taking Depot Lupron.
Medrol® (methylprednisolone)
This is a steroid medication used in IVF which can help pregnancy success in cases of day 3 embryo transfer. It is started on the 2nd day following retrieval and continued for 4 days. Because this is short term use of a small dose of steroid, side effects are negligible.
Metformin (Glucophage®)
This is a medication which can be used in patients with pre-diabetes (“insulin resistance”) to both help regulate blood sugar and allow ovulation to occur. Typically, these patients also have polycystic ovarian syndrome (PCOS). Usually the medication dosage is increased over a number of weeks to minimize side effects. Possible side effects to this medication include: nausea, vomiting, diarrhea, and abdominal pain.
Ovidrel®
This medication is used to cause the final steps of oocyte maturation to occur and to trigger ovulation. Ovidrel is actually a recombinant (made in the laboratory) form of human chorionic gonadotropin or hCG – the pregnancy hormone. If you take a pregnancy test within 9-10 days after taking this medication, you may have a false positive result. Ovidrel is given as a subcutaneous shot. Possible side effects include: local irritation or nausea.
Progesterone: (Crinone®, vaginal suppositories, intramuscular injection)
This medication is used to either supplement the luteal phase (the 2nd half of the menstrual cycle) or to help maintain an early pregnancy. Progesterone is naturally produced by the follicle that releases the egg, and most patients do not need supplemental progesterone in natural cycles or even if they are taking Clomid. Most patients who are taking the gonadotropins combined with IUI and all patients undergoing IVF or frozen embryo transfer will be given extra progesterone. Possible side effects of progesterone include constipation, fatigue, nausea, breast tenderness, mood effects, irregular bleeding, and headache.
Provera® (medroxyprogesterone acetate)
This medication is often used to bring on a period for women who do not menstruate regularly. It may also be used to thin the uterine lining before a hysteroscopy procedure to enable the surgeon to more clearly see the entire uterine cavity. It is usually administered for 10 days in a row, and a period is expected approximately 3-4 days after finishing the last pill. Possible side effects are similar to other progestins and include constipation, fatigue, nausea, breast tenderness, mood effects, and irregular bleeding.