When to Consider Moving on To Trigger Shots for Fertility Treatment?

According to the Centers for Disease Control and Prevention (CDC) in the United States, 12 percent of women ages 15–44 in the country have trouble getting pregnant.

Infertility can result from problems in males and females. Most doctors recommend seeking treatment if a woman cannot get pregnant or continues to have miscarriages after trying to conceive for 12 months or longer.

For women over 35, many doctors recommend seeking treatment after 6 months of trying to conceive.

Types of Fertility Medications for Women

If you're a woman with infertility issues, your doctor may prescribe medications to help you get pregnant.

Fertility medications generally work like the natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. They're also used in women who ovulate to try to stimulate a better egg or extra eggs.

There are quite a few of these medications, but here are the basics on the ones that are most commonly prescribed.

1. Clomid or Serophene

Clomiphene citrate (Clomid) has been used for more than 40 years. Many doctors recommend it as the first treatment option for a woman with ovulation problems.

Clomid and Serophene, the brand names of clomiphene, are taken by mouth and stimulate ovulation by causing the pituitary gland to release more FSH and LH, which stimulate the growth of an ovarian follicle containing an egg.

About 60% to 80% of women who take clomiphene will ovulate, and about half will be able to get pregnant. Most pregnancies happen within three cycles.

• Gonadotropins

If Clomid on its own doesn't work, your doctor may recommend injected hormones to trigger ovulation.

Instead of stimulating the pituitary gland to release more hormones, these injected treatments stimulate the ovary directly to produce multiple eggs.

Gonadotropin medications include human menopausal gonadotropin or hMG (Menopur) and FSH (Gonal-F, Follistim AQ, Bravelle).

Another gonadotropin, human chorionic gonadotropin (Ovidrel, Novarel, Pregnyl), is used to mature the eggs and trigger their release at the time of ovulation.

As with clomiphene, injected hormones have a high rate of success in helping you to ovulate. Among women who do start to ovulate, as many as 50% are able to get pregnant.

Concerns exist that there's a higher risk of conceiving multiples and having a premature delivery with gonadotropin use.

• Metformin

Metformin (Glucophage) can decrease insulin resistance.

Women with polycystic ovary syndrome (PCOS), especially those with a body mass index over 35, may be insulin resistant, which can cause problems with ovulation.

• Letrozole

Letrozole (Femara) belongs to a class of medications known as aromatase inhibitors and works in a similar fashion to clomiphene. Letrozole may induce ovulation.

However, the effect this medication has on early pregnancy isn't yet known, so it isn't used for ovulation induction as frequently as others.

• Bromocriptine and Cabergoline

Bromocriptine (Parlodel) and cabergoline (Dostinex), dopamine agonists, may be used when ovulation problems are caused by excess production of prolactin (hyperprolactinemia) by the pituitary gland.

In about 10 percent of infertility cases, a doctor cannot find a cause. The medical term for this is unexplained infertility.

Medications that aim to stimulate ovulation may help in cases of unexplained infertility. These medications can enable a woman to optimize the chances of conceiving by timing intercourse. They can also reduce the effects of unidentified ovulation issues.

Reference:

• Webmd.com
• Mayoclinic.org
• Medicalnewstoday.com