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9.3 Drugs Commonly Used in Infertility Treatment




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This article is from the Infertility FAQ, by Rebecca Smith Waddell bec@fertilityplus.org with numerous contributions by others.

9.3 Drugs Commonly Used in Infertility Treatment

Aspirin (low-dose or "baby" -- usually 81-82 mg): Used in treatment of
immune problems such as presence of anti-phospholipid antibodies or
the lupus anticoagulant -- mostly in conjunction with Heparin. Also
used by some to increase thickness of the uterine lining. Basically to
prevent clotting in the lining. Very few side-effects are observed
with low-dose aspirin. Full-strength aspirin and NSAIDs such as Advil
and Aleve should not be used as they may interfere with ovulation and
reduce the chance or pregnancy. Check http://www.ivf.com/immune.html
for information on aspirin therapy in pregnancy. Check
http://www.fertilityplus.org/faq/nsaids.html for more information on
ovulatory problems related to these drugs.

Birth control pills: Commonly used for suppression of the ovaries
prior to a stimulated cycles. Common side-effects include headaches,
weight gain, light periods, mid-cycle spotting, and elevated blood
pressure.

Bromocriptine, brand Parlodel: Used for reduction of prolactin levels
in both men and women. Side-effects include dizziness and drowsiness,
as well as more serious ones such as convulsions, black stool,
nervousness, shortness of breath, and more.

Clomiphene citrate, brands Clomid and Serophene: Used to induce or
enhance ovulation in women by stimulating the hypothalamus to release
more GnRH and the pituitary to produce more LH and FSH. Common
side-effects include drying of cervical mucus, headaches, cramping,
hot flashes, moodiness, sore breasts, vision problems, thinning of
uterine lining and formation of cysts. For men, it is used to lower
estrogen and to increase LH and FSH to increase sperm counts. See
http://www.fertilitext.org/clomid.htm.

Conjugated estrogens, brands, Premarin, Premaril and many others:
Given mostly as hormone replacement. Side-effects for men include
muscle spasms, weakness, numbness, shortness of breath, change in
vision, and headache. In women it can cause profuse bleeding. In both
sexes it may cause increased chance of yeast infection, hair loss,
acne or rashes, gastrointestinal problems, nausea and vomiting.

Danazol, brand Danocrine: Synthetic androgen used to treat
endometriosis. side-effects include acne and oily skin, muscle
cramps, weight gain, swelling of feet or lower legs, tiredness and
weakness.

Estradiol: Given often after IVF to keep E2 levels up. Side-effects
include nausea and bloating.

Follitropins, alpha and beta,(recominant FSH, R-FSH, R-hFSH) brands
Follistim, Gonal-F, Puregon:

Recombinant FSH (lab made, rather than made from urine of post
menopausal women), most often used for superovulation. Received
through subcutaneous injection, though Follistim is approved for
intramuscular injection in obese women. side-effects include
hyperstimulation, abdominal and pelvic pain and bloating.

Gonadotropin releasing hormone (GnRH): Used in treating PCO and low
sperm count.

Guaifenesin, brand Robitussin (many generics available): Used to thin
cervical mucus. Recommended dose is 2 teaspoons three times per day
with a full glass of water. Should be taken starting 5 days prior to
ovulation and continued until ovulation has occurred. side-effects
include nausea and gastrointestinal problems.

Heparin: Used in treatment of immune problems -- to prevent blood
clotting in the uterine lining. This is an anticoagulant which may
have side-effects such as nosebleeds, blood in urine or stool, and
bruising. Recommended that you take calcium supplements in addition to
pre-natal vitamins since Heparin depletes the supply.

Human chorionic gonadotropin (hCG), brands A.P.L, Profasi, Pregnyl,
Chorigon: For women hCG is used to induce ovulation, usually after
taking clomiphene citrate, menotropins or urofollitropins. Also used
to support the corpus luteum and keep progesterone levels
elevated. Side-effects include pregnancy symptoms such as nausea and
breast swelling. Interferes with the ability to take a pregnancy
test. Used to help a man's sperm count if the FSH, LH, and
testosterone levels are low. Sometimes used in conjunction with
menotropins. Only for men with the rare condition of hypogonadotropic
hypogonadism. Side-effects include moodiness and tiredness.

Intravenous immunoglobulin (IVIg): Treatment for immune
disorders. Side-effects are fast or pounding heart and trouble
breathing.

Leuprolide acetate, brands Lupron and Decapeptil: used to treat
Endometriosis, uterine fibroid tumors, and to suppress women prior to
IVF. Side-effects include moodiness, hot flashes, and irregular
vaginal bleeding.

Menotropins, brands Pergonal, Humegon, Repronex: FSH and LH, commonly
used for superovulation. Side-effects in women may include
hyperstimulation, soreness around ovaries, bloating and rash. For men,
side-effects include dizziness, loss of appetite, headache, irregular
heartbeat, nosebleeds, and shortness of breath.

Paternal white blood cell immunization: White blood cells from the
father are injected into the mother as a way of fighting certain
immune problems. Commonly given when partners are very similar
genetically because the woman's body may fail to recognize the
pregnancy and fight it.

Progestins, brand Provera: Used to induce a period when there is no
natural cycle. side-effects, bloating, headaches, mood swings,
swelling of face and extremities, increased blood pressure, and weight
gain.

Progesterone: Can be given as suppositories, vaginal capsules, oral
capsules, lozenges, and injections. Used to keep progesterone levels
elevated in the luteal phase. Side-effects include nausea and
bloating.

Progynon C (Ethinylestradiol 0.02mg): used to increase thin uterine
lining.

Steroids such as dexamethasone and prednisone: used to suppress
androgens in women with PCO and for certain immune
problems. side-effects include weight gain, blurred vision, and
increased thirst.

Tamoxifen: Used to treat men with elevated estrogen levels. It is

also used for women who fail to ovulate. The typical starting dose is
20mg on days 2-5 of the cycle. Women with irregular cycles can start
it any time, and the dose may be increased as needed.

Urofollitropins, brands Metrodin and Fertinorm (discontinued): Pure
FSH, most often used for superovulation. Received through
intra-muscular injection. side-effects include hyperstimulation,
abdominal and pelvic pain and bloating.

Urofollitropins, highly purified, brands Fertinex, Fertinorm HP and
Metrodin HP: Pure FSH, most often used for superovulation. Received
through subcutaneous injection. side-effects include hyperstimulation,
abdominal and pelvic pain and bloating. May not be as effective in
those with a body mass index over 26.



 

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