Fertility drugs for women: What to know
Taking fertility drugs without a diagnosis will not necessarily increase the chances of getting pregnant.
According to the Centers for Disease Control and Prevention (CDC) in the United States, 12 percent of women ages 15–44 in the country have trouble getting pregnant.
Infertility can result from problems in males and females. Most doctors recommend seeking treatment if a woman cannot get pregnant or continues to have miscarriages after trying to conceive for 12 months or longer.
For women over 35, many doctors recommend seeking treatment after 6 months of trying to conceive.
Women who do not have regular periods and women with medical conditions that could affect pregnancy should talk to a doctor before trying to get pregnant.
Types of fertility drugs for women
Some fertility drugs try to prompt ovulation in a woman who is not ovulating regularly.
Others are hormones a woman must take before artificial insemination.
Drugs to cause ovulation
Some fertility drugs can treat ovulation issues.
Some women ovulate irregularly or not at all. About 1 in 4 women with infertility have issues with ovulation.
Drugs that can treat ovulation issues include:
- Metformin (Glucophage): This can decrease insulin resistance. Women with polycystic ovary syndrome (PCOS), especially those with a body mass index over 35, may be insulin resistant, which can cause problems with ovulation.
- Dopamine agonists: These drugs reduce levels of a hormone called prolactin. In some women, having too much prolactin causes ovulation issues.
- Clomiphene (Clomid): This drug can trigger ovulation. Many doctors recommend it as the first treatment option for a woman with ovulation problems.
- Letrozole (Femara): Like clomiphene, letrozole can trigger ovulation. Among women with PCOS, especially those with obesity, letrozole may work better. A 2014 study found that 27.5 percent of women with PCOS who took letrozole eventually gave birth, compared to 19.1 percent of those who took clomiphene.
- Gonadotropins: This group of hormones stimulates activity in the ovaries, including ovulation. When other treatments do not work, a doctor may recommend using a follicle-stimulating hormone and a luteinizing hormone in the group. People receive this treatment as an injection or nasal spray.
In about 10 percent of infertility cases, a doctor cannot find a cause. The medical term for this is unexplained infertility.
Drugs that aim to stimulate ovulation may help in cases of unexplained infertility. These drugs can enable a woman to optimize the chances of conceiving by timing intercourse. They can also reduce the effects of unidentified ovulation issues.
Hormones before artificial insemination
Drugs cannot treat some causes of infertility.
When this occurs, or when a doctor cannot identify the cause of infertility, they may recommend artificial insemination.
Intrauterine insemination (IUI) involves inserting sperm directly into the uterus around the time of ovulation.
It may improve the chances of conceiving when there is an issue with the cervical mucus or the mobility of the sperm, or when the doctor cannot detect the cause of infertility.
A doctor may recommend taking the following before IUI:
- Ovulation drugs: Clomiphene or letrozole, for example, can induce the body to ovulate and, possibly, to release extra eggs.
- Ovulation trigger: Because timing the moment of ovulation is essential, many doctors recommend an ovulation “trigger” shot of the hormone human chorionic gonadotropin (hCG).
- Progesterone: This hormone can help sustain early pregnancy, and a woman usually takes it via a vaginal suppository.
In vitro fertilization (IVF) involves removing one or more eggs so that a doctor can fertilize them with sperm in a petri dish. If the eggs grow into embryos, the doctor implants them into the uterus.
IVF requires several drugs, including:
- Ovulation suppression: If a woman ovulates too early, IVF may not work. Many doctors prescribe gonadotropin antagonist hormones to prevent early ovulation.
- Ovulation drugs: IVF is more likely to succeed, like IUI, if the ovaries to release several eggs. A doctor will prescribe clomiphene or letrozole to cause this.
- Ovulation trigger shot: IVF also has a better chance of success if the doctor can control the moment of ovulation using a trigger shot with the hormone hCG.
- Progesterone: A woman receiving IVF will take progesterone to help support early pregnancy.
When treating infertility, a doctor may recommend taking hormonal birth control temporarily to help regulate the menstrual cycle. It can also help prepare the body for artificial insemination.
What to expect
A doctor may recommend IVF if the diagnosed condition does not respond to medication.
Before recommending fertility drugs, the doctor must diagnose the issue, using blood work, imaging tests of the uterus and fallopian tubes, and ovulation tests.
They may also ask a woman to chart her menstrual cycles and take her basal body temperature each morning.
If the diagnosis is not a condition that will respond to medication, the doctor may recommend IUI or IVF.
A woman may need to wait a few months before beginning treatment because it is essential to take fertility drugs on specific days of the cycle.
If the first treatment does not work, a doctor may recommend more testing, another treatment cycle, or a different treatment.
Many women experience side effects of fertility drugs, especially those that contain hormones.
The most common side effects include:
- mood changes, including mood swings, anxiety, and depression
- temporary physical side effects, including nausea, vomiting, headaches, cramps, and breast tenderness
- ovarian hyperstimulation syndrome
- multiple births
- increased risk of pregnancy loss
Some research suggests that certain fertility drugs increase the risk of ovarian and endometrial cancers, among others.
Most health insurance policies in the U.S. do not cover infertility treatment.
However, if infertility results from a serious medical issue, such as an infection or PCOS, insurance may cover some of the treatment.
For many women, the cost is a significant factor. Deciding on the right treatment may mean weighing potential costs and benefits.
Some questions to ask a doctor include:
- What is the success rate for this treatment among people with my diagnosis?
- What is the average length of treatment before a successful pregnancy?
- How much does this treatment cost?
- Is there a less expensive treatment?
- What are my odds of getting pregnant if I do not use fertility drugs?
- Is there anything else I can do to increase my chances of pregnancy?
If a woman is trying to get pregnant with a male partner, he should also receive fertility testing. In some instances, both the woman and man have fertility issues, and treating only the woman may not be sufficient.
Drugs cannot treat all causes of infertility. For instance, blocked fallopian tubes are a common cause, and a procedure called hysteroscopy can often treat the condition.
Trying to get pregnant can be stressful, especially when fertility issues are a factor.
Many women who seek treatment for infertility can eventually get pregnant. Receiving the right diagnosis is critical when choosing drug-based treatment, so it is best to speak with a doctor beforehand.