Graduating from Clomid - An overview of infertility medications

Clomid is an oral medication which is typically prescribed as a first line of defense for women who are experiencing difficulties with ovulation and conception. Typically, if a woman is going to respond to Clomid she will do so within 3-6 months. If Clomid fails to work, she will most likely be prescribed medications that are administered via injection. It's not as scary as it sounds. An overview of the most commonly prescribed infertility medications appears below.

The exact medication prescribed will be based upon diagnosis and recommended protocol, such as In Vitro Fertilization. Typically these medications are injected into the fat just under the skin (subcutaneous) or in the muscle (intramuscular). Women may choose to self injection or to ask a friend, partner or spouse to administer the injections. During the course of treatment, patients may be required to receive up to 90 shots per cycle. Prescirbed medications include:

GnRH Agonists (leuprolide acetate, Lupron) and GnRH Antagonists, (Ganirelx Acetate or Cetrotide).

GnRH agonists and antagonists work by suppressing a woman's natural hormone production to prevent ovulation from occurring prematurely and are given by subcutaneous injection.

Gonadotropins, Follicle Stimulating Hormone (FSH): Bravelle, Follistim, Gonal-F; Follicle Stimulating Hormone & Lutenizing Hormone (FSH&LH): Menopur, Repronex; Lutenizing Hormone: Luveris; hCG: Novarel, Profasi, Ovidrel).

These medications stimulate the ovaries to develop and mature follicles and ultimately eggs. They are usually give subcutaneously but may also be given intramuscularly. Although these medications must be prepared a bit differently prior to administration, the actual injections are the same.

Bravelle, Menopur and Repronex are all supplied in vials. Using the supplied needle-free reconstitution device (Q-cap) and a syringe, the liquid is mixed with the powder to prepare the medication for injection.

Follistim and Gonal-F are pre-mixed medications administered using a pen device.

Luveris is sometimes used in conjunction with FSH injections to assist with follicle development.

Novarel, Profasi, Ovidrel, commonly referred to as hCG, this medication is given to induce the final maturation of eggs, and if an egg retrieval is not performed, will also stimulate ovulation.

Progesterone. A hormone, progesterone is naturally produced after ovulation. Should a pregnancy have taken place as a result of an ART procedure, the progesterone will prevent the uterine lining from shedding, thus preserving the developing embryo or embryos. As the pregnancy progresses, the production of progesterone will be taken over by the placenta. For some patients, especially those undergoing IVF, insufficient quantities of progesterone are often produced. In these circumstances, progesterone supplementation will be prescribed. This medication may be given by intramuscular injection or vaginally (as a gel, suppository, or insert). Progesterone supplementation is generally begun around the time of an egg retrieval or ovulation and may be recommended well into the first trimester of pregnancy until the pregnancy has produced sufficient hormonal production to maintain itself

Crinone is a vaginal gel.

Endometrin is a vaginal insert.

Generic progesterone is a vaginal suppository.

Infertility medication can become quite expensive but is sometimes covered by health insurance. Your coverage will be determined in large part by your state of residence.

Pharmaceutical companies sometimes offer discounts on infertility medications for individuals who do not have insurance coverage, such as EMD Serono's Compassionate Care Program or Ferring Pharmaeutical's HEART Program.

Reprinted with permission from

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