Fertility medication

Medicines to assist fertility remain the primary treatment for women with ovulation disorders; some are taken orally and some are injected. In general, these medications work by causing the release of hormones that either trigger ovulation or regulate it.

Even if you're using assisted reproductive techniques such as in vitro fertilisation, fertility medication is still an important part of treatment. Since the number and names of all of the infertility medications may seem dizzying, here are the basic facts on the medicines most commonly prescribed.

Clomifene for infertility

Indication: Clomifene is often the first choice for treating infertility because it's effective and has been used for more than 25 years. Clomifene is given to women who are not ovulating normally. Clomifene is an anti-oestrogen medication. As a result, it causes the hypothalamus and pituitary gland located deep in the brain to release hormones that will stimulate the ovaries to produce eggs. Gonadotrophin-releasing hormone (GnRH) is released from the hypothalamus and follicle-stimulating hormone (FSH) and leuteinising hormone (LH) are released from the pituitary gland. These fertility medicines are often used in combination with assisted reproductive techniques or artificial insemination.

Use: The typical starting dosage of clomifene is 50 milligrams per day for five days. You take the first pill preferably on the second day after you start your period. You can expect to start ovulating about seven days after you've taken the last dose. If you don't ovulate right away, the dose can be increased to 100 milligrams per day for the next two months. After you've begun to ovulate, most doctors suggest taking clomifene for no longer than six months. If you haven't become pregnant after six months, your doctor will probably prescribe a different medication.

Effectiveness: Approximately 60% to 80% of women who take clomifene will ovulate, and about half will be able to get pregnant as a result of taking the medicine. Most pregnancies occur within three cycles.

Side effects: The side effects of clomifene are generally mild. They include hot flushes, blurred vision, nausea, bloating and headache. Clomifene can also cause changes in the cervical mucus, which may make it harder to tell when you're fertile and may inhibit the sperm from entering the uterus. Like many fertility medicines, clomifene can increase the chances of multiple births, although it's less likely to cause the problem than some injectable hormones.

Injectable hormones for infertility

If clomifene on its own isn't successful, your doctor may recommend injectable hormones to stimulate ovulation. Some of the types are:

• Human chorionic gonadotropin (hCG)is usually used along with other fertility medication to trigger the ovaries to release the mature egg or eggs.
• Follicle-stimulating hormone (FSH)
• Human menopausal gonadotropin (hMG) combines both FSH and LH.
• Gonadotropin-releasing hormone (GnRH) stimulates the release of FSH and LH from the pituitary gland.
• Gonadotropin-releasing hormone agonist (GnRH agonist)
• Gonadotropin-releasing hormone antagonist (GnRH antagonist)