Fertility drugs are a good starting point for treating infertility. Here’s how they work and what common options are available.
Navigating infertility is difficult, however, there are many medications, treatments, and options that can help you achieve pregnancy. One of these options is infertility medications, also referred to as fertility drugs. These medications help your body release natural hormones that trigger and regulate ovulation–the release of a mature egg from the ovary, which is necessary for conception.
Infertility can be scary, daunting, and a lot of other feelings. But you are not alone, and we are here to help. Here’s what you need to know about infertility medication options.
Understanding infertility Infertility is diagnosed when a person is unable to get pregnant after one year or longer of unprotected sex. It’s also common. In the US, 1 in 5 women between the ages of 15 and 49 experience infertility (1 ). Infertility can have many causes, including conditions such as polycystic ovary syndrome (PCOS ), endometriosis , ovulatory disorders, and low sperm count in men.
For pregnancy to occur, a fully mature egg must be fertilized by sperm. Fertility drugs work by helping the body produce enough hormones to stimulate the growth and release of a mature egg. The egg then travels down the fallopian tube where it awaits fertilization.
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How infertility medications work Your hypothalamus, the body’s control center, and pituitary gland, which regulates bodily functions, both release hormones including the gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH), which trigger the ovaries to produce eggs (2 ). Fertility drugs manipulate these natural hormones to stimulate egg growth. When fertility drugs are used to trigger or enhance ovulation, this is a process known as superovulation or ovarian hyperstimulation. These methods can improve the chances that one or more eggs will become fertilized, increasing the likelihood of pregnancy.
Fertility drugs can be administered either orally or by injection. Injectable medications are typically stronger and require more frequent doctor visits to monitor egg development and prevent overstimulation.
Fertility drugs are also used alongside assisted reproductive technology (ART) procedures, which are fertility treatments that involve eggs and embryos to help achieve pregnancy. The most common ART type is in-vitro fertilization (IVF), where an egg and sperm are combined in a lab to create an embryo, which is then implanted into the uterus. Intrauterine insemination (IUI), also known as artificial insemination, may also be recommended along with fertility medications. In IUI, a high concentration of healthy sperm is inserted directly into the uterus via a long narrow tube.
In these procedures, fertility drugs help stimulate the production of multiple eggs, allowing more to be collected and fertilized to create viable embryos. They are also commonly recommended as the first-line, less invasive treatment for infertility.
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Common medications for female fertility Here are some common fertility medications your doctor might recommend:
Clomiphene citrate (brand names: Clomid or Serophene): An estrogen-blocking drug that works by blocking the estrogen receptors in the brain, prompting the body to produce more hormones that trigger the ovaries to produce eggs. It’s taken orally for five consecutive days, beginning on the third or fifth day of your menstrual cycle. This drug has been used for over 40 years and is the most commonly prescribed medication to treat fertility for people with PCOS (3 ). Letrozole (brand name: Femara): Another oral medication that operates similarly to clomiphene citrate. Gonadotropins: Injectable medications used as a more intense alternative to Clomid. It’s administered daily for 8 to 10 consecutive days starting on day 2 of a woman’s menstrual cycle (4 ). Metformin (brand name: Fortamet): Used when insulin resistance is suspected to be the root of infertility, particularly in patients with PCOS. High levels of insulin can disrupt luteinizing hormone (LH) production, affecting ovulation and egg quality. Metformin helps increase insulin resistance which can help restore ovulation (5 ). Cabergoline and bromocriptine (brand names: Dostinex and Parlodel, respectively): These medications treat high levels of prolactin in the body (hyperprolactinemia). Prolactin is a hormone that is responsible for lactation and high levels can lead to fertility issues. Common medications for male infertility Medication can also improve fertility in some men:
Clomiphene citrate: Similarly to its effect in women, this medication stimulates hormone production and the release of FSH and LH which can increase sperm production (6 ). Gonadotropins: This would be via injection three times per week for as long as six months to increase sperm production. Risks and side effects Fertility drugs carry certain risks, including:
Multiple pregnancies, primarily twins: Oral fertility medications have a multiple pregnancy risk of less than 10% while injections have a risk of 30%. Side effects: These may include hot flashes, nausea, bloating, mood swings, irregular menstrual cycles, and headaches. Ovarian hyperstimulation syndrome (OHSS): Fertility drugs can sometimes cause OHSS, which make your ovaries grow and feel tender. Most cases usually resolve on their own, however, in severe cases it can cause rapid weight gain, painful enlarged ovaries, fluid in the abdomen, and shortness of breath. If you have any of these symptoms, it’s important to seek medical attention. Ovarian tumors: Most studies say there are few long-term risks associated with fertility drugs. However, some studies suggest that women taking fertility drugs for 12 months or more without a successful pregnancy may have an increased risk of ovarian tumors. Infertility medication options: the bottom line There are no over-the-counter fertility drugs available in the US. While OTC supplements like maca exist, results are mixed and are not as regulated or tested as prescribed medications. Fertility drugs are based on individual needs and are often used as a first line of treatment since they can directly address hormone imbalances and other ovulation-related issues. They are typically less invasive and less expensive than surgical or ART procedures, making them an accessible starting point for many dealing with infertility. Consult your doctor and fertility specialist to determine the best medication options that fit your needs.
