Injectable fertility medications: Gonadotropin shots
Gonadotropin shots are injectable medications used for aggressive fertility treatment. These medications are hormones (either FSH alone, or FSH plus LH) that are naturally produced by the brain.
In a natural menstrual cycle, small amounts of FSH and LH are secreted from the pituitary gland. This usually results in one egg developing to the point of ovulation, which is why humans usually have one baby at a time.
At higher hormone levels, like those we achieve with the injectable gonadotropin shots, more eggs will develop. This is useful for infertility patients, where more eggs are needed to find the one most likely for pregnancy. Typically, two to four follicles are stimulated for ovulation in these types of fertility treatment cycles.
When combined with insemination, pregnancy rates with this treatment are relatively good (10% to 20% per cycle), but can come with a high risk of multiple gestation (twins, triplets or more).
Who needs gonadotropin shots?
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 (doesn’t ovulate on her own)
- In women who have hypothalamic amenorrhea as a cause for their anovulation
- In women who have failed oral medications and are not yet proceeding to IVF
- When age or ovarian reserve dictate 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 10% to 20% per treatment cycle with these medications.
Types of injections
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 twins, triplets or more. Thus, the decision to proceed with this therapy with natural or IUI cycles must be made carefully. Patients doing gonadotropin shots with IUI cycles will usually do so for three or four cycles before moving on to IVF.
Gonadotropin shots are used during IVF, usually in higher doses. When gonadotropins are used for IVF, patients can get high pregnancy rates (50% or more) with a low risk (1%) of multiples.
To find out if this fertility treatment is right for you, contact us for an appointment with our San Antonio fertility specialists.