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Additional Fertility Medications

Your journey to parenthood with TFC may involve additional fertility medications.

The first step in your TFC journey to parenthood is to meet with one of our fertility specialists for a discussion of your medical history, a physical examination and a vaginal ultrasound. Your doctor will then determine what further testing needs to be done to better understand and treat your specific fertility obstacles. We will then work with you to develop a treatment plan, which may include fertility medications, that will hopefully help you achieve a successful pregnancy in the most cost-effective manner.

Fertility treatment is a team effort, and the staff at TFC is committed to making sure you understand your options and have our full support for your fertility journey.

Fertility medications used to stimulate ovarian follicles

In a natural menstrual cycle, a group of follicles (small cystic structures that contain eggs) starts the journey toward ovulation. Through normal attrition, typically only one follicle completes the process and ovulates. During fertility treatment, the goal is to enable this process to occur (which may be difficult in patients with irregular menstrual cycles) or to prevent the normal attrition process and allow multiple eggs to mature. Depending on your specific circumstances, different medications may be used during this process.

Clomiphene (Clomid®)

This is a medication used to induce ovulation, typically as part of an intrauterine insemination (IUI) cycle. It may also be used during an IVF cycle to help follicles grow. Clomid is generally well-tolerated but can cause hot flashes, headache and GI upset. Side effects are temporary and should resolve on their own. Should any vision changes develop, such as blurriness, Clomid should be discontinued and another medication used for future treatment. However, this is a very rare side effect.

Letrozole (Femara®)

This is a medication with similar use as Clomid. Letrozole is favored in patients with polycystic ovary syndrome (PCOS). It may also be used in some IVF cycles for patients who need to keep their estrogen low, such as in patients with estrogen-sensitive cancers.

Injectable Gonadotropins (Gonal-F®, Follistim®, Menopur®)

These medications contain hormones called follicle stimulating hormone (FSH) and/or luteinizing hormone (LH) and are used in IUI and IVF cycles to stimulate follicular growth. Patients self-administer these medications as a subcutaneous injection on a daily basis, and require close monitoring with bloodwork and ultrasound. Side effects can include local irritation at the injection site and also nausea, bloating and abdominal discomfort as the follicles grow.

Other medications that may be used during fertility treatment

Azithromycin (Zithromax®)

This is an antibiotic in the erythromycin family. In fertility treatment, it may be prescribed prior to a uterine procedure or before initiating IUI therapy to reduce the risk of infection. You may take this medication with or without food. Possible side effects include abdominal pain, nausea/vomiting, and diarrhea.

Birth control pills (Desogen®, etc.)

These pills contain both progesterone and estrogen and have many uses in fertility treatment. They may be used as a contraceptive agent prior to surgery, to prevent ovarian cyst formation, or to synchronize egg development in IVF. Possible side effects include breakthrough bleeding, nausea, fluid retention and mood changes.

Cetrorelix (Cetrotide®) / Ganirelix (Fyremadel®)

This is a gonadotropin releasing hormone antagonist that may be a component of your fertility treatment. This fertility medication helps to prevent premature ovulation in gonadotropin or IVF cycles, allowing more time for egg maturation. It is given as a subcutaneous injection, typically starting a few days after the initial medications to stimulate the ovaries. Possible side effects include local irritation, headache and nausea.

Doxycycline (Vibramycin®)

This is an antibiotic in the tetracycline family. In fertility treatment, it may be prescribed prior to a uterine procedure or IUI therapy. It may also be given as part of the egg retrieval process. It is recommended to take this medication with a full glass of water and with food to prevent stomach upset. It is also recommended to avoid lying down for 30 minutes after taking the medication to avoid reflux symptoms. Do not take vitamins or antacids within two hours of this medication. You should also avoid alcohol or excess sun exposure. Potential side effects include abdominal pain, nausea/vomiting and diarrhea.

Estradiol, micronized (Estrace®)

This is a form of estrogen that is used in fertility treatment to synchronize egg development in IVF or to thicken the lining of the uterus for an embryo transfer. Possible side effects include mood changes, headache and vaginal spotting.

Human chorionic gonadotropin (Ovidrel®, Pregnyl®, Novarel®)

These medications are used to initiate the final steps of egg maturation and trigger ovulation. These medications use human chorionic gonadotropin (hCG) to mimic a naturally occurring hormonal surge; hCG is also known as the pregnancy hormone. Therefore, a pregnancy test taken within two weeks after this medication may give a false positive result.

Leuprolide (Lupron®)

This is a gonadotropin-releasing hormone agonist with a variety of uses. It helps to prevent premature ovulation and allow more time for egg maturation. It may also be used in cases of severe endometriosis or in presurgical treatment of large fibroids. It can also be used as an alternate medication to hCG (see below) to trigger final egg maturation and ovulation. It is given as an injection – daily, monthly or every three months depending on the scenario. Possible side effects include: hot flashes, headache, nausea and mood changes. Patients who require more long-term treatment may be given another medication called Aygestin (an oral progesterone pill) to help minimize bone loss. However, this is not a concern with typical fertility-related use.

Methylprednisolone (Medrol®)

This is a steroid medication that is occasionally used to help pregnancy rates during embryo transfers. As only a small dose is given for a short duration, side effects are minimal.

Metformin (Glucophage®)

This is a medication that may be recommended in patients with polycystic ovarian syndrome (PCOS) and/or insulin resistance to both help regulate blood sugar and allow ovulation to occur. This may also be given to minimize the risk of ovarian hyperstimulation syndrome (OHSS) in higher-risk patients. Typical side effects include nausea, vomiting, diarrhea and abdominal pain. The dosage is slowly increased over several weeks to minimize side effects.

Progesterone (Crinone®, Endometrin®, Progesterone in oil)

Progesterone is a crucial hormone to maintain pregnancies. Progesterone is naturally produced by the follicle that releases the egg, and most patients do not need supplemental progesterone in natural cycles or after IUI. Most patients who undergo an embryo transfer will be given extra progesterone either as a vaginal suppository or intramuscular injection. Possible side effects of progesterone include constipation, fatigue, nausea, breast tenderness, mood effects, irregular bleeding and headache.

Medroxyprogesterone acetate (Provera®)

This medication is often used to bring on a period for women who do not menstruate regularly. It is usually taken for 10 days in a row, and a period is expected approximately three to four days after finishing the last pill. Side effects are similar to those of other progestins.

Learn more about fertility medications used for ovarian stimulation here.