10 Facts about Fertility Drugs you don’t Know
Last updated on June 29th, 2023 at 12:55 pm
10 minutes read.
With approximately 9% of the population experiencing infertility, an increasing number of couples are seeking fertility treatment.
Consequently, concerns regarding the long-term risks of fertility medications causing cancer, since despite their multiple modes of action, all can induce multiple ovulation and alter the production of steroid hormones.
However, there’s good news on that side because most studies show that fertility treatments do not increase the risks of invasive ovarian cancer, malignant melanoma, or cancers of the endometrium, cervix, breast, thyroid, or colon. (1, 2 )
Taking fertility drugs without a diagnosis will not necessarily increase the chances of getting pregnant.
Let’s find out 10 solid facts about Fertility Drugs you may have not been aware of.
Feel free to skip ahead if you wish:
Fertility Drugs
How to take them
What are Fertility Drugs
Fertility drugs are actually hormone-stimulating medications prescribed to women who cannot get pregnant after trying to conceive for at least one year.
For example, fertility drugs like Serophene and Clomid block estrogen from entering the bloodstream so the hypothalamus and pituitary glands are forced to release gonadotropin and follicle-stimulating hormones.
Women who do not have enough of these two hormones in their bloodstream may be unable to produce the eggs necessary for conception.
Serophene and Clomid are sometimes used to increase fertility in women undergoing an assisted reproductive technique (ART) such as artificial insemination.
Another type of fertility drug is Letrozole, which inhibits the release of estrogen and encourages FSH production.
Women diagnosed with polycystic ovary syndrome or unexplained anovulation may find Letrozole helpful for increasing the production of FSH essential for normal egg ovulation. (3)
Types
Some fertility drugs try to prompt ovulation in a woman who is not ovulating regularly while some are hormones
Studies show that some women ovulate irregularly or not at all and about 1 in 4 women with infertility have issues with ovulation. (4, 5 )
Types of Fertility Drugs 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. (6, 7, 8, 9, 10, 11 )
Is there any difference between clomiphene and letrozole?
Although they work differently, clomiphene and letrozole both help stimulate ovulation. But below are some other key differences that exist between these fertility pills.
Warning
FDA approval
Only clomiphene is the infertility drug approved by Food and Drug Administration. Letrozole is used off-label for this purpose. It’s only approved for treating breast cancer. However, studies suggest that it works at least as well as clomiphene, and in some cases even better. (13, 14, 15, 16 )
Effectiveness
How effective are Fertility Drugs?
Clomiphene is a first-choice option in treating PCOS-related infertility and has been for decades. Studies show that it works pretty well to stimulate ovulation.
In fact, between 60% and 85% of people taking clomiphene successfully ovulate. But only about 30% to 50% actually get pregnant after using the medication for 6 menstrual cycles. (12)
Although used off-label, letrozole is also considered a first-choice option, especially for people with PCOS. This is because it works at least as well as clomiphene, if not better. (13)
One study of people with PCOS found that people taking letrozole had higher ovulation and live-birth rates than those taking clomiphene.
This study found that about 28% of people taking letrozole got pregnant and gave birth. Only about 19% of those taking clomiphene had the same success. (14)
In another study of people with unexplained infertility, there was no difference between pregnancy and live-birth rates with letrozole compared to clomiphene. This means the two were similarly effective. (15)
Keep in mind that infertility treatment depends on more than just the medications that you take.
It includes other factors, such as your age, lifestyle, and environment. So it’s important to remember that everyone will respond differently to a treatment. (16)
A rare but notable side effect of clomiphene is called ovarian hyperstimulation syndrome (OHSS). It happens when your ovaries grow too large and become swollen.
While most cases are mild, some can become serious. Contact your healthcare provider if you experience severe stomach pain, diarrhea, and trouble breathing after taking clomiphene. (17)
Clomiphene and letrozole are used to treat certain types of infertility. They affect certain hormones in your body. But in order to understand how these pills work, we need a basic understanding of ovulation.
Fertility drugs help millions of women every year achieve pregnancy. While some women enjoy success with fertility drugs, some will need to combine fertility drugs with assisted reproductive technology (ART) to conceive.
Which hormones drive ovulation?
During typical ovulation, your ovaries develop and release one mature egg per menstrual cycle. That egg can then potentially be fertilized by sperm.
This timed process is driven mainly by hormones, including:
- Estrogen
- Follicle-stimulating hormone (FSH)
- Luteinizing hormone (LH)
- Progesterone
Hormone imbalances can lead to problems with ovulation, such as polycystic ovary syndrome (PCOS). PCOS is a common cause of infertility.
People with PCOS either aren’t able to ovulate or ovulate irregularly. And without an egg, fertilization, and pregnancy can’t occur.
How do fertility drugs work in the body?
Fertility drugs generally work like natural hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) which trigger ovulation.
Clomiphene and letrozole help stimulate ovulation. They can also raise the number of mature eggs that are released per cycle. This helps give you a better chance of getting pregnant.
These fertility pills are often prescribed at the same time as planned intercourse or artificial insemination (intrauterine insemination, or IUI). (18)
How to take fertility drugs
You usually take the first pill on the third, fourth, or fifth day after you start your period. You can expect to start ovulating about 7 days after you’ve taken the last dose.
If it doesn’t happen right away, your doctor may ask you to increase your dose by 50 milligrams a day each month, up to 150 milligrams. (19, 20)
Your doctor will help discuss ways you can measure when ovulation happens
Related: How to Treat and Prevent Pelvic Inflammatory Diseases (PID)
How long do fertility drugs last in your body?
After you take the medication, clomiphene stays in your body a lot longer than letrozole. Clomiphene can take a few weeks to fully leave your body.
Letrozole only takes a few days to a week to leave. The longer a medication stays in your body, the longer you could experience side effects.
Risk and Side Effects
There are some risks and side effects associated with fertility drugs.
The most common fertility drug side effects include:
- bloating
- headache
- breast tenderness
- upset stomach
- hot flashes
- mood swings
The most common fertility drug risks are conceiving multiple pregnancies (like twins or triplets or more) and developing ovarian hyperstimulation syndrome (OHSS). (21, 22, 23, 24)
Most studies have found that there are no significant differences in the risk of multiple pregnancies between clomiphene and letrozole (25, 26 )
Related: List of Best Aphrodisiac Foods to Increase Your Libido
Related: What’s Sperm Motility and How Does it Affect Fertility?
10 facts about Fertility Drugs
If you’re considering starting a fertility treatment journey or you know someone who’s considering such a thing, here are the real truth you should be aware of before anything:
Most fertility drugs are “ovulation induction” drugs meant for women with ovulation disorders. The goal of an ovulation induction drug is to produce one mature egg during each treatment cycle.
Fertility drugs called gonadotropins are ovarian-stimulating drugs formulated to produce multiple dominant follicles during each cycle.
Administered via injection, gonadotropins are sometimes combined with in vitro fertilization or intrauterine insemination procedures to improve the chance of conception.
Before prescribing a fertility drug, doctors need blood and imaging tests to help them determine what is causing infertility.
In some cases, patients may need to chart their menstrual cycle for several months or take a basal body temperature every morning.
If a fertility doctor does not think fertility drugs will improve conception chances, the doctor may recommend IVF or IUI.
Side effects of fertility drugs are usually minimal and temporary. The most common side effects are nausea, bloating, headache, moodiness, and breast tenderness.
When women suffer infertility due to premature ovulation, doctors may prescribe medications called GnRH agonists.
Injected into the skin or administered as a nasal spray, GnRH agonists enable a woman’s body to make higher numbers of viable eggs by preventing the mid-cycle surge of hormones from “canceling” the cycle.
Some herbal fertility supplements such as black cohosh or red clover claim to help women get pregnant by restoring hormonal balance.
No clinical evidence exists to support these claims. Only FDA-approved fertility drugs have been researched and shown through rigorous data analyses to significantly improve a woman’s ability to conceive.
Ovarian hyperstimulation syndrome is a condition affecting about one to two percent of women using fertility drugs.
OHSS causes enlargement of the ovaries and abnormal shifts in the body’s chemical and fluid balance. There is also a slight risk of blood clots developing in the major veins.
Fertility drugs may not work for women with structural abnormalities of their uterus, fallopian tubes, or other reproductive system components.
If a doctor finds a woman’s fallopian tubes are blocked due to tubal scarring or fluid, surgery may be necessary to correct the problem.
Fertility drugs are most successful for women who do not smoke, drink alcohol or take illegal drugs. Eating healthy foods also supports fertility drug treatment by ensuring the patient is receiving the appropriate nutrients.
Some fertility drugs may require women to learn how to inject themselves at home. The timing of fertility drug injections may need to correlate with the timing of intercourse.
Conclusion
Fertility drugs are actually hormone-stimulating medications prescribed to women who cannot get pregnant after trying to conceive for at least one year.
Infertility drugs include Metformin (Glucophage), Dopamine agonists, Clomiphene (Clomid), Letrozole (Femara), and Gonadotropins.
The steps to take the drug are to take the first pill on the third, fourth, or fifth day after you start your period. You can expect to start ovulating about 7 days after you’ve taken the last dose
Clomiphene is a first-choice option in treating polycystic ovary syndrome (PCOS)-related infertility and has been for decades. Studies show that it works pretty well to stimulate ovulation.
In fact, between 60% and 85% of people taking clomiphene successfully ovulate. But only about 30% to 50% actually get pregnant after using the medication for 6 menstrual cycles.
However, these drugs should not be taken without a doctor’s prescription because only clomiphene is FDA-approved others may be sold with or without a label.
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The most common fertility drug side effects include: bloating, headache, breast tenderness, upset stomach, hot flashes, mood swings
While the most common fertility drug risks are conceiving multiple pregnancies (like twins or triplets or more) and developing ovarian hyperstimulation syndrome (OHSS).
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