Fertility Medications are used to Regulate Hormones, Stimulate the Ovaries and Produce Eggs
for procedures like IVF.
Many medications are used in the treatment in the
treatment of infertility. Below is a list of the
most common prescription drugs and a description of
their use.
It is very important to be familiar with your insurance coverage for fertility medications. Contact your prescription insurance company and have them go over your coverage details explaining any requirements, such as if you are required to use a specific pharmacy, if an authorization is required, or if you have a life time maximum limit.
If you have coverage for your infertility medications, please be aware that it could take some time to obtain the necessary authorization and determine which pharmacy your insurance company requires you to use. Some insurance companies, such as Aetna, require an authorization for refills. Before filling your prescription please contact your insurance company or our Authorizations Department.
If you do not have insurance coverage for your medication please beware that prices vary from pharmacy to pharmacy and are subject to change. We suggest that you confirm the cost of the medication with the pharmacy and do a price comparison with other pharmacies prior to having your prescription filled. Please contact our Authorizations Department if you have any questions.
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.
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.
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.
This medication causes eggs to
mature and ovulate in women who ordinarily do not
ovulate on their own. It is typically given daily
from menstrual cycle days 3-7, 4-8, or 5-9. The
response to Clomid may be monitored with ultrasound
and/or ovulation predictor kit (OPK) testing.
Clomid can cause a false positive response on an OPK,
and so it is recommended to start OPK testing no
earlier than 4 days after the last Clomid pill.
If a woman does not respond to
the initial dose of Clomid (50mg), the dose may be
increased in subsequent cycles – up to a maximum
dose of 250 mg/day for five days. Once ovulation is
achieved, there is no benefit to using a higher dose
of Clomid (and higher clomid doses can cause
undesired effects on the uterine lining).
Possible side effects of Clomid
include: hot flashes, headache, nausea, bloating,
breast tenderness, and mood changes. If you
experience severe headaches or visual changes with
this medication, please notify your doctor or nurse
promptly.
Fertilization in patients
taking Clomid may be achieved with either
intercourse or intrauterine insemination (IUI).
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.
These medications help to
stimulate the growth of ovarian follicles. They are
given subcutaneously (underneath the skin) with very
thin/short needles. The response to these
medications is monitored by both ultrasound and
blood work. Typically, a patient will use these
medications daily over a 9-13 day period, though
some patients may need a shorter or longer time on
the medication.
Once the ovarian follicles are
thought to be mature, a final trigger shot (Ovidrel)
will be administered to cause the egg(s) to be
released. We recommend combining the gonadotropins
with IUI rather than intercourse in order to
maximize pregnancy rates, as many studies have shown
significantly higher pregnancy rates with IUI.
Use of this medication is
associated with a higher multiple pregnancy rate.
Ovarian hyperstimulation syndrome (OHSS) is also a
possible significant side effect of this
medication. In this condition, the ovaries can
become enlarged, and there can be temporary kidney,
blood clotting, and fluid problems. Women who are
at higher risk for OHSS are those who are younger
and those who have PCOS.
Side effects of these
medications include: abdominal bloating, headache,
local irritation, nausea, and breast enlargement.
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.
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.
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.
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.
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.
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.
