The 4-1-1 on Fertility Drugs
If you’re ready to grow your family but nature isn’t cooperating, you may be at a point in your conception journey where you’re considering the use of fertility drugs.

Fertility drugs can be very effective and are often the first treatment option for women dealing with ovulation disorders. Millions of couples who rely on fertility pills safely get pregnant and stay pregnant with their use.

If you’ve yet to have a conversation with your obstetrician around fertility drugs, Dr. Mark Dow, who heads up Assisted Reproductive Technology Services (ARTS) at Texas Health Presbyterian Hospital Plano, offers some guidelines for when to make the call.

“If you are under the age of 35, you should talk to your OB/GYN about an infertility workup after one year of attempted pregnancy,” Dow advises. “However, if you are 35 years of age or older the discussion may be warranted after six months of trying to conceive. A conversation may also be in order if you have a history of multiple miscarriages, endometriosis, pelvic inflammatory disease or irregular ovulation.”

“It’s important to note that not all OB/GYNs have specific training in infertility. Look for a physician with extensive fertility experience or a board-certified reproductive endocrinologist/infertility specialist. This is especially critical when starting fertility drugs, as you will need to be carefully monitored during medication usage,” Dow adds.

There are two main types of fertility drugs prescribed for ovulation disorders: oral and injectable medications. In general, these medications work by causing the release of hormones that either trigger or regulate ovulation. They serve the purpose of giving your reproductive system a little nudge.

Even if you go the route of using an assisted reproductive technique such as in vitro fertilization (IVF) or intrauterine insemination, fertility drugs will still be an important part of your treatment. The many variations of fertility medications may seem a bit overwhelming, so here are some basic facts on the drugs most commonly prescribed and why they are helpful:

  • Clomid (clomiphene citrate) is a fertility pill that can boost your levels of follicle stimulating hormone (FSH). It is useful in helping women who do not ovulate regularly produce an egg every month - a process known as controlled ovarian hyperstimulation - to increase the likelihood of fertilization and a healthy pregnancy. Clomid has been shown to be effective in up to 80 percent of women who would not otherwise ovulate but is limited in its effectiveness in helping women who already ovulate become pregnant. It has a relatively low risk for side effects.
  • Injectable gonadotropins stimulate the ovaries directly by helping to mature developing follicles and trigger the release of eggs. Your doctor may prescribe an injectable gonadotropin if Clomid doesn’t work for you or if you are preparing for an ART treatment.
  • The fertility drug progesterone is a hormone that prepares the lining of the uterus for the arrival and implantation of an embryo. Progesterone is delivered by intramuscular injection or by vaginal suppository.
  • Lupron suppresses your body’s own hormone production, thus preventing follicle development and egg release. Fertility specialists use Lupron in combination with other medications to improve and balance your hormone level for better control of your cycle.
  • Antagonists are a class of fertility drugs used for pituitary suppression if you’re preparing to undergo an IVF cycle. They can be effective in preventing a premature rise in hormone level and inducing a shorter course of ovarian stimulation.

Like any prescribed medication, Dow emphasizes that it is important to discuss the risks, benefits and side effects of fertility medications with a qualified physician before beginning a treatment course.

“Although fertility treatments don’t come with as high a multiple rate as they used to and most physicians practice protocols intended to keep multiple gestations low, having any kind of assisted reproduction - especially the kind that stimulates ovulation - increases the chance of multiple births,” says Dow. “About 20 to 25 percent of women who take ovary-stimulating drugs or undergo IVF conceive twins or higher-order multiples.”

“Multiple births lead to increased risks not only to newborns but mothers as well. Women shouldn’t fear the use of fertility drugs but it’s essential that they understand the possible outcome. For many women facing infertility, the benefit of being able to grow their family is tremendous and far outweighs the potential risks,” he adds.

Find a physician specializing in infertility or to learn about women’s health and fertility services available through Texas Health Resources, visit our fertility services page.