According to the American Urological Association, infertility affects about 6 million people in the United States. Failing to get pregnant despite having frequent, unprotected sex for at least a year defines infertility. Most cases of infertility in women result from problems with ovulation, according to the Mayo Clinic. Drugs that act like natural hormones are the mainstay of treatment for women. In comparison, fertility drugs appear to be of limited use in men with hormonal imbalances.
Most Commonly Prescribed Drugs
According to reports from the Mayo Clinic, male causes of infertility occur in 20 percent of cases. In about 30 to 40 percent of cases, infertility is due to both the male and female. Female causes of infertility occur in the remaining 40 to 50 percent.
According to American Society of Reproductive Medicine (ASRM) the most commonly prescribed hormone based drugs for females are clomiphene, human chorionic gonadotropin (hCG), human menopausal gonadotropin (hMG) and follicle-stimulating hormone (FSH).
Clomiphene
Clomiphene stimulates the release of the gonadotropic hormones, FSH and luteinizing hormone (LH), which encourages ovulation. Ovulation is defined as the release of a ripe egg from an ovary. Clomiphene is used only in patients with ovulatory dysfunction.
To take clomiphene, you must not be pregnant, have no ovarian cysts and no vaginal bleeding but you must have normal liver function. According to a report issued by the American Society of Reproductive Medicine (ASRM), "clomiphene will induce ovulation in about 80% of properly selected patients. About 40% to 45% of couples receiving clomiphene will become pregnant within six cycles."
Clomiphene is generally well tolerated at recommended dosages. Side effects usually are mild and transient and most disappear soon after treatment is finished. The most common side effects include ovarian enlargement (13.6 percent), vasomotor flushes (10.4 percent), abdominal-pelvic discomfort/distention/bloating (5.5 percent), nausea and vomiting (2.2 percent), breast discomfort (2.1 percent) and visual symptoms (1.5 percent).
Gonadotropins
Gonadotropins contain FSH or LH alone or in combination. They are indicated in women who fail to release eggs normally and who have tried clomiphene without success. They are also used to help women whose pituitary glands do not produce adequate amounts of FSH and LH.
HCG is structurally similar to LH and can be used alone or in combination with other fertility drugs to stimulate the release of an egg or multiple eggs by the ovaries. hCG is derived from pregnant women and collected from the urine. HMG contains equal amounts of FSH and LH. The FSH and LH in hMG is purified from the urine of postmenopausal women who have high levels of these hormones. HMG stimulates egg development in women who do not ovulate or who ovulate extremely irregularly. This medication can be used to induce development of multiple eggs when needed. According to the ASRM, women who use hMG should expect pregnancy rates that are similar to those of spontaneously ovulating women of the same age.
FSH, a fertility hormone medication, contains FSH only. When introduced first in 1996, it was produced naturally, but now it is manufactured using recombinant DNA techniques. FSH-based drugs are approved in women who have problems ovulating. They can also be used in combination with other fertility medications.
References
- American Urological Association: Infertility affects 6 million people in the U.S.
- Mayoclinic.com: Definition of infertility
- American Society of Reproductive Medicine: Medications for Inducing Ovulation:
- Human Reproduction Update: The present and future state of hormonal treatment for male infertility:
- Prescribing information for clomiphene
