Infertility:Drugs

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.

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: 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.

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, PuregonRecombinant 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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