Rx Medications for Fertility- who is a good candidate and who is not?
One thing you may not know about me is that I used Clomid to get pregnant with my first son. After explaining how long I have been taking ovulation predictor tests and still not getting pregnant, my doctor said it was okay for me to try Clomid for a few months. They did not suggest taking medication. I had to ask for it and advocate for myself after doing some research and determining I was a good candidate.
On month 3 we were able to get pregnant. So let’s take this opportunity to look more closely at different medications often used for people struggling with infertility, how they work, who is a good candidate and who may not be. I discuss these with clients when they may need a little medical assistance, but often my clients get pregnant without these meds because we better understand the root cause for their infertility and use diet, lifestyle, supplements, to control their issues.
These medications can really help people get where they want and avoid additional medical therapies. That being said, we still need to work on having excellent egg quality and sperm quality to reduce the chance of miscarriage and genetic issues. This is a tool to use in addition to dietary, lifestyle, supplements, meeting all of the additional fertility pillars. Often I help my clients determine which ones to discuss with your healthcare provider so that they may advocate for their own reproductive health and often avoid additional and expensive medical therapies to get pregnant.If you are interested in learning more about working with a fertility consultant to guide you through this process, let’s set up a free consult today! APPLY HEReE
Commonly Used PRESCRIPTION Medications for Fertility
Fertility medications play a crucial role for many couples who are trying to conceive. These medications can address various issues that may be hindering pregnancy, from ovulation problems to hormonal imbalances. In this comprehensive guide, we'll explore the most commonly used fertility medications, how they work, and who is a good candidate for each.
1. Clomiphene Citrate (Clomid)
How It Works: Clomiphene citrate, commonly known as Clomid, is an oral medication that stimulates ovulation. It works by blocking estrogen receptors in the brain, which tricks the body into thinking estrogen levels are low. This triggers the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are essential for ovulation. It’s taken during specific times of your cycle and the dosing may vary based on your provider’s experience and preference. It is important to know there is an increased chance of twins- so keep that in mind. It's not a HUGE leap, but it’s definitely there. This medication may be used to increase chances of an IUI being successful. It is important to ask your healthcare provider if you are a candidate or not. Clomid has been more associated with hot flashes as a side effect.
Who Is a Good Candidate:
- Women with irregular or absent ovulation (anovulation).
- Women with polycystic ovary syndrome (PCOS).
- Couples with unexplained infertility.
Who Is Not a Good Candidate:
- Women with blocked fallopian tubes- there is mixed data on this. If you only have one blocked tube, you may be a candidate for clomid but you need to discuss with your provider. It may increase risk for an ectopic pregnancy, so you need to know this before taking it.
- Women with primary ovarian insufficiency.
- Women with severe male factor infertility unless combined with other treatments.
2. Letrozole (Femara)
How It Works: Letrozole is another oral medication that can induce ovulation. It is an aromatase inhibitor, which means it reduces the amount of estrogen in the body. Lower estrogen levels prompt the pituitary gland to release more FSH, stimulating the ovaries to produce eggs.I have seen this drug be the first-line choice for many healthcare providers. The risk for twins or multiples is a little less than those who took Clomid. and letrozole was more associated with fatigue and dizziness.
Who Is a Good Candidate:
- Women with PCOS.
- Women who have not responded to Clomid.
- Women with unexplained infertility.
Who Is Not a Good Candidate:
- Women with liver disease.
- Women with uncontrolled thyroid or adrenal dysfunction.
- Women who are already pregnant.
3. Gonadotropins
How They Work: Gonadotropins are injectable hormones, including FSH and LH, that directly stimulate the ovaries to produce multiple follicles. They are often used in more advanced fertility treatments such as in vitro fertilization (IVF).
Who Is a Good Candidate:
- Women who do not respond to oral medications like Clomid or Letrozole.
- Women undergoing IVF.
- Women with severe ovulatory dysfunction.
Who Is Not a Good Candidate:
- Women with uncontrolled endocrine disorders.
- Women with ovarian cysts or primary ovarian insufficiency.
- Women at high risk of ovarian hyperstimulation syndrome (OHSS).
4. Human Chorionic Gonadotropin (hCG)
How It Works: hCG is an injectable hormone that mimics LH, triggering the final maturation and release of the egg (ovulation). It is often used in conjunction with other fertility medications.
Who Is a Good Candidate:
- Women undergoing ovulation induction with gonadotropins.
- Women preparing for intrauterine insemination (IUI) or IVF.
Who Is Not a Good Candidate:
- Women with untreated thyroid or adrenal disorders.
- Women with a history of hormone-sensitive tumors.
5. Metformin
How It Works: Metformin is an oral medication commonly used to treat type 2 diabetes, but it is also effective for women with PCOS. It improves insulin sensitivity, which can help regulate menstrual cycles and promote ovulation.
Who Is a Good Candidate:
- Women with PCOS, especially those who are overweight or have insulin resistance.
- Women who have not responded to Clomid alone.
Who Is Not a Good Candidate:
- Women with severe kidney or liver disease.
- Women with a history of lactic acidosis.
6. Bromocriptine
How It Works: Bromocriptine is an oral medication that reduces prolactin levels. High prolactin levels can interfere with ovulation, and by lowering these levels, bromocriptine can restore normal ovulatory cycles.
Who Is a Good Candidate:
- Women with hyperprolactinemia (high prolactin levels).
- Women with irregular menstrual cycles due to high prolactin.
Who Is Not a Good Candidate:
- Women with uncontrolled hypertension.
- Women with a history of severe mental illness.
7. Progesterone
How It Works: Progesterone is a hormone that supports the uterine lining and is essential for maintaining pregnancy. It is often prescribed after ovulation or embryo transfer to enhance implantation and prevent early miscarriage.
Who Is a Good Candidate:
- Women undergoing IVF.
- Women with a history of recurrent miscarriages.
- Women with luteal phase defects.
Who Is Not a Good Candidate:
- Women with a history of breast cancer or other hormone-sensitive cancers.
- Women with liver disease.
All of these medicines have risks and potential side effects, determining which 1 is best for you is important. I help my clients navigate which 1 of these and they may be the best candidate for while also tailoring a customized plan to optimize fertility with a more natural aspect.
How a Fertility Consultant Can Help
If you have experienced infertility, miscarriage or want to avoid the former and get ship shape for fertility, I help people make sure that they have been worked up correctly and extensively. If you would like to set up a free consultation on how to decrease your risk for miscarriage and how to get pregnant FAST, I would love to help you turn things around so that you can be holding your sweet baby ASAP.
