Everything you need to know about fertility drugs [Photo Gallery]

Find out how common fertility meds work, if they are effective, and if they have any side effects.

Starting a family seems to be a natural next step when a couple ties the knot. Unfortunately, the road to parenthood isn’t always smooth for some.

According to Thomson Fertility Centre, a healthy woman below the age of 30 who regularly has unprotected sex, only has a 20 to 40 per cent chance of getting pregnant in any given cycle. If you’ve been trying for more than a year with no news, there is a concern for infertility.

Age is a crucial factor in determining the level of fertility. While women below the age of 30 should see a gynaecologist if they have trouble conceiving after trying for one to two years, those above 30 years are advised to seek help after six to nine months, and after three months for those above age 40.

Infertility treatment varies depending on the individual’s life stage and condition, although you can expect drugs to be part and parcel of the process. See a fertility specialist, who will advise you on the treatment and drugs suitable for you.

Meanwhile, get a heads up on how common fertility drugs work, plus wise up to their side effects. 

1.    Clomiphene citrate (Clomid)

What: It is the most common fertility drug used to treat irregular or absent menstrual cycles. The drug triggers the brain to release follicle-stimulating hormones (FSH) to stimulate the ovary to ovulate and grow follicles. It helps to make menstrual cycle length more predictable so as to improve timing of intercourse or artificial insemination. The drug is generally safe and effective, resulting in ovulation in 80 per cent of women.
How to use: Take 50 to 150 mg orally for five days, starting from the second day of one’s menstrual flow.
Side effects: Thinning of uterus lining, thickening of cervical mucus, hot flushes, breast tenderness, pelvic pressure or pain or visual disturbances. Five to eight per cent of women end up carrying twins.

2. Human Menopausal Gonadotropin (hMG)

What: When Clomiphene Citrate doesn’t work, Human Menopausal Gonadotropin (hMG) is often used to stimulate the growth of follicles and induce ovulation. It is often prescribed for women who have follicle-stimulating hormone (FSH) and luteinizing hormone (LH) issues, or are undergoing IVF or IVI. Studies show that about 90 per cent of women on hMG will ovulate with some 40 per cent conceiving when the fallopian tubes are open and ready, the sperm count adequate, and the ovary’s egg reserve is normal.
How to use: An injection that contains equal parts of FSH and LH is given to stimulate the ovaries to produce multiple eggs during one cycle.
Side effects: Allergic reactions, abdominal pain and discomfort, headaches or bruising may occur at the injection site.

3. Follicle-Stimulating Hormone (FSH)
What: Another ovarian stimulating drug, follicle-stimulating hormone (FSH) is also a commonly prescribed injection for women. FSH increases the size and production of follicles, which, in turn, increases the number of eggs in a cycle.
How to use: An injection given under the skin that bypasses the hypothalamus and pituitary glands to directly stimulate follicle growth in the ovaries. 
Side effects: Abdominal pain, nausea, breast tenderness, weight gain, urinating less than usual. In more serious cases, a sudden build-up of fluid in the stomach or chest area which can be life threatening. Medical help is needed immediately for such cases. 
 

4. Human chorionic gonadatropin (hCG)

What: Human chorionic gonadotropin (hCG), a hormone produced by the placenta during pregnancy, is made by cells that nourish the egg after it has been fertilised and attaches to the uterine wall. When used as a fertility drug, hCG induces ovulation as well as testosterone production in men. After the hormone is administered, ovulation should occur 36 to 48 hours later. When this drug is used together with IVF, the doctor will have a better indication as to when exactly to retrieve the eggs.
How to use:
An injection that comes in 250mcg prefilled syringe or a box with a 10,000 unit vial of powder and a vial of diluent (liquid) to mix with the powder. 
Side effects:
Headache, irritability, depression, breast tenderness or pain at the injection site.

 

5. Letrozole
What: For women who don’t find Clomiphene Citrate effective, Letrozole, which is widely used to treat breast cancer, is an alternative. The difference: While Letrozole inhibits the Aromatase enzyme responsible for the production of oestrogen in the body, Clomiphene Citrate blocks estrogen receptors. Both meds will stimulate the ovaries, triggering ovulation.
How to use: Oral medication ― your doctor will prescribe the dosage.
Side effects: Hot flushes, headaches or breast tenderness.

6. Gonadotropin releasing hormone agonists (GnRH)
What: GnRH, which controls the release of FSH and LH hormones, so as to regulate periods ― stops the production of oestrogen and progesterone and suppresses ovulation. Besides being used to treat infertility, GnRH also treats conditions like endometriosis, uterine fibroids, management of heavy menstrual bleeding and severe premenstrual syndrome or premenstrual dysphoria disorder.
How to use: Injection given below the skin or nasal spray. 
Side effects: Hot flushes, vaginal dryness, decreased libido, mood swings or decreased bone mineral density.