Fertility Medications

For women that have ovulation dysfunction, we frequently prescribe fertility medications to stimulate the ovaries.  These medications can help regulate ovulation and may even trigger ovulation to occur.  Fertility medications can be taken orally or may be given as an injection, depending on what Dr. Gehlbach recommends.  

Clomid and Letrozole

When a woman is not ovulating at all or is ovulating at irregular times in her cycles, we may prescribe an oral medication to induce ovulation.  These medications are frequently the first choice of medications for women with ovulatory dysfunction because of the ease of use, it's less expensive, and have been working effectively for many years.  In most patients, oral medications have 80% success rates in stimulating ovulation to occur.

These medications are usually taken orally once daily for 5 days early in the menstrual cycle. Side effects may include mild headache, mood swings, vaginal dryness, ovarian cysts, and visual disturbances. Patients who achieve pregnancy with oral medication have a 5-10% risk of having twins.

Response to oral medications is often monitored by pelvic ultrasound, and treatment is often combined with closely timed intrauterine insemination (IUI) to increase the chance of pregnancy.

Gonadotropins

Normally produced by your pituitary gland, gonadotropins are an important part of the conception process.  These hormones, consisting of follicle stimulating hormone (FSH) and luteinizing hormone (LH), are what help the ovaries to produce a mature follicle which your body releases in hopes that fertilization will occur. 

Extra gonadotropins can be given as part of infertility treatment.  With carefully monitoring and dosing, these hormones can help a woman to produce more than on mature follicle for ovulation.  Gonadotropins when used in combination with intrauterine insemination (IUI), have proven to be a very successful infertility treatment option.

Dr. Gehlbach will choose the best medication regimen for your particular situation and in some cases may change the medications from cycle to cycle, depending on the results.  These medications are not available in oral form and must be administered by subcutaneous (under the skin in the fatty tissue) route.  The nurses will educate you on the different types of medications as well as how to prepare and administer them.

With a gonadotropin cycle, you will need to contact the office with the start of your menstrual cycle.  Our office will schedule a baseline ultrasound to look for any ovarian cysts you might have in your ovaries that might disrupt the cycle.  After confirming that no cysts are present, you will be started on the stimulation medications.  Gonadotropins are very strong medications that require frequent monitoring to ensure your body responds appropriately.  Upon starting the stimulation, you will visit the office every 3-4 days for blood work and ultrasounds.  When several follicles reach maturity, we will prescribe an injection of hCG that will trigger ovulation. 

Following the trigger shot, the intrauterine insemination (IUI) will occur.  The side effects from stimulation with gonadotropins are common, but not limited to:

• bloating
• slight abdominal discomfort,
• multiples pregnancy
• and in rare instances ovarian hyperstimulation syndrome (OHSS)

If you fail to achieve pregnancy after gonadotropin therapy combined with intrauterine insemination, it may be recommended that you meet with your physician to discuss moving on to more advanced