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Fertility Medications
Fertility medications are aimed to promote fecundity. Due to large research
and testing efforts, the fertility medications that you or any one from
your team will be taking are all extremely safe. However, women
do experience some common minor side effects and you should be aware
of them.
Fertility medications can be classified into the following groups:
Urofollitropin (Fertinex®, Metrodin®)
- Urofollitropin prepares the body for ovulation.
- Another hormone can then be given to actually cause ovulation.
- Careful monitoring is important to both determine that the drug is
acting as expected and to watch for potential adverse reactions. Work
closely with your doctor to assure optimal timing of these medications.
Please keep all scheduled visits with your physician.
- Make sure to give urofollitropin at a consistent time on each day
it is to be given.
- Since urofollitropin concentration can vary due to the method of
preparation, use ampules produced in the same lot for each cycle. Do
not save medication that has been reconstituted (mixed) for future
use. Medication should be used immediately after reconstitution.
- Your doctor may suggest rotating injection sites to keep areas from
becoming too sore. Urofollitropin can be injected into the abdomen,
thigh, or upper arm. Warm baths can soothe soreness from injections.
Ask your physician about these and other relief techniques.
Follitropin Alpha (Gonal F®)
Follitropin Beta (Follistim®)
- Follitropin Alpha and Follitropin Beta are genetically engineered
drugs which prepare the body for ovulation.
- Another hormone can then be given to actually cause ovulation. Careful
monitoring is important to both determine that the drug is acting as
expected and to watch for potential adverse reactions. Work closely
with your doctor to assure optimal timing of these medications. Please
keep all scheduled visits with your physician.
- Make sure to give Follitropin at a consistent time on each day it
is to be given.
- Follitropin should be protected from light and humid conditions.
Store below 77°
F.
- Do not save medication that has been reconstituted (mixed) for future
use. Medication should be used immediately after reconstitution.
- Your doctor may suggest rotating injection sites to keep areas from
becoming too sore. Follitropin can be injected into the abdomen, thigh,
or upper arm. Warm baths can soothe soreness from injections.
Ask your physician about these and other relief techniques.
Human Chorionic Gonadotropin (HCG)
- This medication is a hormone which stimulates the ovaries and
the testes.
- It is used in males to stimulate testicular descent or testicular
growth and development.
- In females, this medication is used in combination with other
drugs to induce ovulation.
- Proper timing of administration is very important. Work closely
with your doctor to assure optimal timing of administration.
- Do not save medication that has been reconstituted (mixed) for future
use. Medication should be used immediately after reconstitution.
- Your doctor may suggest rotating injection sites to keep areas from
becoming too sore. Chorionic gonadotropins can be injected into the
thigh, or upper arm. Warm baths can soothe soreness from injections.
Ask your physician about these and other relief techniques.
- The use of chorionic gonadotropin can cause a false positive result
from home pregnancy tests.
Clomiphene Citrate (Serophene®)
- Clomiphene initiates the series of hormonal events which result in
ovulation.
- Patients should have intercourse at least every other day beginning
the third day after the last clomiphene tablet and continuing for one
week.
- Use of an ovulation detection test, or charting of basal body temperature
(BBT) is very important to monitor the patient's response to clomiphene.
- Vasomotor symptoms (i.e. hot flashes, fatigue, insomnia, breast tenderness,
and flushing) occur in about 10% of patients. These adverse effects
are typically reversible upon discontinuation. If these effects become
bothersome, talk with your doctor.
- Call your doctor right away if you have severe lower stomach pain,
nausea, vomiting, weight gain, or vision problems (especially "flickering"
around the edge of your vision).
Gonadorelin (Factrel®, Lutrepulse®)
- Gonadorelin is often used in patients who are having ovulation difficulties
due to hormonal regulation.
- After reconstitution of gonadorelin, the solution should be stored
at room temperature and used within 24 hours. Reconstituted product
and diluent should be discarded after 24 hours.
- Gonadorelin is often given by using a programmable pump that injects
a small amount of the drug periodically throughout the day. This is
called "pulsatile therapy".
- Ovarian hyper stimulation has been reported following gonadorelin
use, but is rare with pulsatile therapy. Report any abdominal distension
and /or abdominal pain to your physician.
Leuprolide (Lupron®)
- This hormone is a synthetic hormone and is used to slow down
or inhibit
your cycle (down-regulation).
- When it is used, the body stops producing testosterone hormones in
males, and estrogen hormones in females. When the medication is stopped,
hormone levels return to normal.
- Leuprolide is used in the treatment of prostate cancer in men, precocious
puberty in children, and uterine fibroid tumors in women. It may also
be tried in breast or ovarian cancer in women. Leuprolide is useful
in the treatment of several sex hormone dependent disorders (e.g. endometriosis,
uterine fibroids, prostate disease in men).
- Leuprolide is often used to prepare the body for ovulation. Ovulation
is then stimulated by the use of other hormonal medications.
- Leuprolide should be stored below 77° F. Do not store near a radiator
or other very warm places. Do not freeze. Protect from light
in the original container until ready to use.
- Hot flashes occurs in 50 to 70% of patients. Unfortunately, hot flashes
do not appear to decrease with continued treatment. Please discuss
any potential side effects with your doctor.
Menotropins (Pergonal®, Humegon®, Repronex®)
- Menotropins prepare the body for ovulation. Another hormone can then
be given to actually cause ovulation.
- Work closely with your doctor to assure optimal timing of these medications.
- Sometimes a physician may prescribe menotropins for patients who
are already ovulating normally. This is frequently done in conjunction
with in vitro fertilization.
- Uncomplicated ovarian enlargement (accompanied by abdominal distention
and/or mild abdominal pain) occurs in about 20% of patients.
This usually subsides without treatment in 2-3 weeks. Patients
should advise their physician of any bothersome side effect.
- Careful monitoring is important to both determine that the drug is
acting as expected and to watch for potential adverse reactions. Please
keep all scheduled visits with your physician.
Estrace®
- These tablets are synthetic estrogen tablets, which aim to
prepare you for the pregnancy.
- They are used to thicken your endometrial lining in preparation for
an embryo transfer or intra-uterine insemination.
- Side effects include breast tenderness, nausea and a sensation of
water retention.
If you have any leg or calf numbness, chest pain, visual disturbances
or shortness of breath, notify your doctor. These latter side
effects are extremely uncommon.
Progesterone (Crinone®, and Suppositories, Oral
and Injectables)
- Progesterone is the body's natural hormone produced to maintain a
pregnancy.
- Following an embryo transfer (or occasionally insemination), these
medications are commonly used to boost or help support your own progesterone
to help maintain an early pregnancy.
- This medication can be administered as an oral medication, vaginal
suppository, or intra-muscular injection.
- Side effects seen with Progesterone are nausea, stomach pain, constipation
or diarrhea, mild headache, swollen or tender breasts, joint pain,
drowsiness, nervousness, and increased urination at night. These side
effects usually subside once your body gets used to the medication
and do not require medical attention unless they become bothersome.
If you are using the vaginal suppositories, you may experience some
vaginal irritation similar to symptoms of a yeast infection. Other
side effects that may be seen with Progesterone include changes in
vaginal bleeding, skin rash and depression. Contact your physician
immediately if any of these occur.
- Progesterone is often administered vaginally. If any other vaginal
products are to be used, separate their application by at least six
hours from the use of this drug.
- Store in a cool place, away from sunlight and moisture.
Ovarian Hyper Stimulation Syndrome (OHSS)
- Ovarian Hyper stimulation Syndrome is a condition which can
occur when the response to injections to stimulate egg production is
greater than normally would be expected.
- Symptoms associated with OHSS usually begin 4-5 days after the eggs
have been collected. In the mild to moderate form, symptoms may include
enlarged ovaries, tenderness in the areas of the ovaries, a feeling
of discomfort in the abdomen and nausea.
- If the syndrome is severe, patients may also experience swelling
of the abdomen causing shortness of breath and a reduction in the amount
of urine produced. This severe form of OHSS only occurs in less
than 1% of women affected.
- In cases where the OHSS is very severe, hospitalization may be necessary.
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