Fertility medication

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Overview

Fertility medication may in a larger sense include any medication that enhances fertility, but in a specific sense consists of agents that stimulate follicle development of the ovary. It is a variant of assisted reproductive technology.

Agents that enhance ovarian activity can be classified as either Gonadotropin releasing hormone, Estrogen antagonists or Gonadotropins.

Gonadotropin releasing hormone

Either Gonadotropin releasing hormone (GnRH) itself or any of its agonist may be used. GnRH releases gonadotropins from the hypothalamus in the body. GnRH agonists includes i.e. Lupron.

Estrogen antagonists

Fertility medication inhibiting the effects of estrogen includes Clomiphene citrate and Aromatase inhibitors.

Clomiphene citrate

Clomiphene citrate is a SERM. It inhibits the negative feedback of estrogen and therefore stimulates ovulation.

Aromatase inhibitors

Although primarily a breast cancer treatment, aromatase inhibitors can also work as fertility medication, probably by a mechanism similar to clomiphene citrate.

Gonadotropins

Gonadotropins are the hormones in the body that normally stimulate the gonads (testes and ovaries). For medication, they can be extracted from urine or by genetic modification.

Menotropins

Menotropins are urinary gonadotropins, i.e. they are extracted from the urine.

Recombinant gonadotropins

Recombinant gonadotropins are gonadotropins created by inserting the DNA coding it into bacteriae. The bacterial DNA is then called Recombinant DNA. Examples of recombinant FSH are Follistim and Gonal F, while Luveris is a recombinant LH.

Human chorionic gonadotropin

Human chorionic gonadotropin (hCG) is normally produced during pregnancy. However, it can also replace LH as a fertility medication.

Adverse effects

Estrogen antagonists and gonadotropins may stimulate multiple follicles and other ovarian hormones leading to multiple birth and possible ovarian hyperstimulation syndrome.