One of the most common questions that arises for people who experienced infertility or reduced fertility is concerned with the use of fertility drugs. What drugs are available, are they effective and are there any dangers and side effects? The answers to these questions fall mainly into two different areas: ‘standalone’ drugs, i.e. those which are used to treat infertility without any further medical intervention, and fertility medication which is used as part of an assisted fertility treatment programme.

In this article we look at the different types of fertility drugs for women and for men which may be prescribed in either situation. We also explain why they are needed and what effects they are intended to have. Right from the outset it is important to make it clear that any kind of fertility drugs to help get pregnant are only available on prescription and must always be taken under medical supervision.

Types of fertility drugs for women

The most used fertility drugs to help with becoming pregnant tend to be fertility drugs for women since they are mostly used to encourage ovulation. One of a small group of drugs are normally prescribed for women in certain situations. These include:

• women who have been diagnosed with Polycystic Ovary Syndrome (PCOS),
• women with a very irregular or completely unpredictable cycle of ovulation,
• women experiencing fertility problems which are linked to the hormonal output of the pituitary gland.

The most effective treatment in these cases is the prescription of one of a family of drugs which stimulates the ovaries to produce more eggs. These types of fertility treatment medications are frequently the first choice of treatment for women who have polycystic ovaries. They may also be used in the case of those who experience late, irregular or unpredictable periods. With this class of fertility drugs for women, it is well known that there is a risk of too many follicles developing at the same time, thereby increasing the possibility of multiple births. For this reason, it is vital to take these drugs only under the supervision of an infertility specialist.

Other types of fertility medication may be used specifically for women who are not ovulating normally due to overly high levels of insulin in the body. A different drug may also be used in the case of women whose glands produce too much of the prolactin hormone. This can reduce levels of oestrogen in the body, hindering the ovulation cycle. This type of treatment helps to reduce levels of prolactin production and return the cycle of periods and ovulation to normal.

Clomiphene citrate

Clomiphene citrate blocks estrogen receptors in the brain, causing the body to perceive low estrogen levels. In response, the pituitary gland secretes more FSH and LH, both of which are necessary for egg maturation and release during ovulation.

It is administered orally, reducing the discomfort some patients experience with injections.

Injected Hormones

Injectable hormones are used to stimulate the ovaries more intensively than oral treatments like clomiphene citrate. Examples include FSH (Follicle-Stimulating Hormone), hMG (Human Menopausal Gonadotropin), hCG (Human Chorionic Gonadotropin), and GnRH agonists and antagonists.

Other Fertility Drugs

Male fertility drugs: what can they use?

Gonadotrophins

It’s more common to prescribe fertility drugs for women to assist with ovulation and other fertility aspects. However, there are cases where fertility medication is appropriate for the male partner. For some men treatment is required because of a lack of gonadotrophins. It will stimulate the release of testosterone which in turn supports the production of sperm in the testicles. In these cases the appropriate treatment would be to directly boost levels of gonadotrophins.

Antioxidants and vitamins

Research is ongoing into the effectiveness of some vitamins and antioxidants such as vitamins C and E, zinc and selenium to improve fertility in men with a low sperm count or with low sperm motility. However, there is no conclusive evidence of their effectiveness and more research is needed before their effectiveness can be demonstrated.

Similarly, although certain over-the-counter remedies may claim to be helpful in treating infertility in men and/or women, they are always based on vitamin and mineral supplements or other non-medical ingredients such as essential oils. While they do no harm, they do not yet have any proven record of effectiveness.

IVF drugs: what is involved?

Far and away the most frequent assisted reproduction procedure involving IVF medications is the normal in vitro fertilisation process. These are the main stages that entail the use of IVF drugs:

Ovarian stimulation

The first stage which requires the use of an IVF medication is to stimulate the ovaries by the administration of daily injections. The effect of these is to cause the ovaries to produce more oocytes than the single one that they produce naturally each month. In this way a larger number of embryos can be obtained. So the very same effect that is a drawback with ‘standalone’ fertility medications is in fact an advantage when it comes to the IVF process, because harvesting a larger number of oocytes significantly increases the chances of success.

Retrieval of oocytes

Once scans have shown that the egg follicles have reached the optimum size and that there is a sufficient number of oocytes, an injection of the hormone hCG is given. This causes the oocytes to mature in a similar way to how they would in a natural cycle. The oocytes are then collected in a procedure known as follicular puncture. This is carried out in an operating theatre under sedation so that there is no discomfort for the patient, in a process that takes approximately 15 minutes.

Completion of the standard IVF technique

The two stages above are the ones which involve both IVF medications and the administration of hormones. For the rest of the process, there are no standard fertility drugs involved, although of course your medical specialist will advise you of any particular medication recommendations in light of your own individual circumstances.

Following retrieval of the oocytes, fertilisation takes place using a semen sample from the male partner. The process in conventional IVF involves placing an oocyte surrounded by spermatozoa on a culture plate. Alternatively, fertilisation can be effected via ICSI which consists of injecting a live spermatozoon directly into the oocyte with the aid of a pipette. Then the most viable embryos are selected and inserted into the patient’s uterus using a specially designed cannula.

Getting in touch with IVI

If you would like to know more about any of the issues around fertility drugs, we encourage all of our patients to browse our website which will always have the most current facts, figures and statistics available for you to see for yourself. Or if you would like to get a feeling for what to expect from your first appointment with IVI, have a look at our YouTube channel.

When you feel ready to take the next step, it’s easy to contact us, without any obligation, to discuss how we might be able to help you. You can phone us or you can complete our online contact form and one of our fertility specialists will get back to you. We’re here to answer your questions, to advise and help, and ultimately to assist you in achieving your dream of parenthood.