Infertility drugs help people conceive a child and help women carry the child to term. Infertility affects both men and women.
Infertility is defined as the inability to become pregnant after 12 months of regular, unprotected sex.
According to the World Health Organization, an estimated 48 million couples and 186 million individuals live with infertility worldwide.
In the U.S., about 12% of women ages 15–44 have trouble getting pregnant or carrying a pregnancy to term (called impaired fecundity), according to the Center for Disease Control and Prevention.
About 6% of married women ages 15–44 live with infertility. Almost 9% of men ages 25–44 report that they or their partner went to the doctor for advice, testing, or infertility treatment.
Fertility may be affected by environmental and lifestyle factors such as smoking, excessive alcohol consumption, obesity, and exposure to environmental toxins or radiation.
Other disorders such as diabetes, infections, and autoimmune disorders may also cause infertility. Certain sex-specific factors also impact strong fertility.
For women, infertility may be caused by:
- Physical problems of the reproductive organs: disorders that block fallopian tubes caused by untreated sexually transmitted infections (STIs) or complications of abortion, surgery, or postpartum sepsis
- Uterine disorders: endometriosis (uterine inflammation), uterine fibroids (benign uterine tumors), or a congenital uterine deformity (such as septate uterus)
- Ovary disorders: Polycystic ovarian syndrome (PCOS), functional hypothalamic amenorrhea (FHA, anovulation caused by excessive exercise, stress, or low body weight), diminished ovarian reserve (DOI, fewer eggs in the ovaries than normal), or premature ovarian insufficiency (POI, ovarian failure before the age of 40)
- Hormonal imbalances/endocrine system problems: hypopituitarism or pituitary cancers
For men, infertility can result from:
- Problems ejaculating semen: obstruction in the tubes that carry semen caused by genital tract infections or injuries, premature ejaculation, retrograde ejaculation (where the semen goes back into the bladder), or erectile dysfunction
- Low levels or absence of sperm: varicocele (enlarged veins in the scrotum), medical treatments that impair sperm production such as chemotherapy, genetic disorders (Klinefelter’s syndrome, Y-chromosome microdeletion, myotonic dystrophy, or cystic fibrosis)
- Abnormal sperm shape/motility
- Chronic use of certain medications (such as glucocorticoids), supplements (such as anabolic steroids), hormones (such as too much estrogen or testosterone), or illicit drugs
- Hormonal disorders: Cushing’s syndrome, congenital adrenal hyperplasia, pituitary cancers, or testicular cancers
FEMALE INFERTILITY DRUGS
Drugs to treat female infertility typically focus on inducing ovulation. Many drugs to treat infertility increase a woman’s chance of releasing multiple eggs, which increases her chances of becoming pregnant with multiple fetuses.
Ovarian stimulation can help with strong fertility
- Clomiphene (Clomid, Serophene); pill. Increases the levels of follicle-stimulating hormone (FSH) and pituitary gland secretes, which induces ovulation. The American Society for Reproductive Medicine (ASRM) recommends only using clomiphene for 3-6 cycles.
- Letrozole (Femara); pill. Lowers progesterone levels, causing the pituitary gland to make more FSH. Frequently used off-label to induce ovulation.
- Human menopausal gonadotropin, hMG (Menopur, Metrodin, Pergonal, Repronex); injection. An equal combination of the hormones FSH and luteinizing hormone (LH) stimulates the ovaries to release multiple mature eggs during one ovulation cycle. This is the most potent ovulation medication used currently. Used in women who don’t ovulate due to pituitary gland problems.
- Human chorionic gonadotropin, hCG (Novarel, Ovidrel, Pregnyl, Profasil); injection. Another hormone is given with hMG to stimulate ovulation.
- Follicle-stimulating hormone, FSH (Bravelle, Fertinex, Follistim, Gonal-F, Urofollitropin); subcutaneous injection. Works like hMG; directly stimulates mature egg development in the ovaries.
- Gonadotropin-releasing hormone, GnRH (Factrel, Lutrepulse); injection. A hormone that stimulates the pituitary gland to release FSH and LH, which help eggs grow and induce ovulation.
- Bromocriptine (Parlodel); pill. A dopamine agonist. Lowers high levels of prolactin produced by the pituitary gland, regulating ovulation.
- Cabergoline (Dostinex); pill. Works like bromocriptine; A dopamine D2 receptor agonist. Lowers high levels of prolactin produced by the pituitary gland, regulating ovulation.
- Metformin (Glucophage); pill. It helps the body regulate blood sugar levels, lowers testosterone levels, and helps induce ovulation. Used in women who have PCOS or insulin resistance. Also used in both men and women to help control diabetes.
Premature ovulation inhibitors
- GnRH analogs/agonists (Lupron, Synarel, Zoladex); subcutaneous injection or nasal spray. Prevent a woman from ovulating by shutting down FSH and LH production in the pituitary gland and reducing estrogen levels. It can also prevent a mid-cycle hormonal surge that can disrupt menstrual cycles. Used during in vitro fertilization (IVF) cycles to prepare the uterus for embryo transfer.
- GnRH antagonists (Antagon, Cetrotide, Ganirelix Acetate); injection. Has similar effects as GnRH agonists. Prevents premature ovulation by blocking ovarian hormone release.
Other Promising Medications For Strong Fertility
- Progesterone (Crinone, Prometrium); injection, vaginal gel, suppository, or pill. A hormone that prepares the uterine lining for embryo implantation; it can be continued for the first 6–12 weeks of pregnancy. It can also restore menstrual cycles in women with irregular or absent menstruation, potentially prompting their bodies to resume ovulation independently.
- Methylprednisolone (Medrol); pill. A steroid is taken daily for four days during the stimulation cycle to help pre-embryo implantation.
- Doxycycline; pill. An antibiotic is given to reduce the risk of infection after egg removal for assisted reproductive technologies (ART).
- Fertility supplements, typically pills. Non-prescription supplements, including vitamins, minerals, herbs, and antioxidants.
MALE INFERTILITY DRUGS AND OTHER OPTIONS
Although there are not as many options for men for strong fertility as there are for women, there are a few drugs and lifestyle choices that improve a man’s chance of achieving pregnancy with their partner, including:
- Medications: a man may take the antibiotic doxycycline to decrease bacteria levels in his semen, typically given during his female partner’s stimulation cycle.
- Heat regulation of the testes: making sure the testes do not get too hot or remain hot for long periods of time by avoiding hot tubs/saunas and wearing loose underwear (boxer shorts rather than briefs).
Male infertility may also be overcome by procedures that facilitate fertilization, including:
- Intrauterine insemination (IUI), also called artificial insemination: Sperm is prepared and inserted into a woman’s uterus. A woman may also be treated with medications to induce ovulation before the IUI procedure in order to achieve strong fertility.
- Assisted reproductive technologies (ART): fertility treatments where the eggs, sperm, and embryos are handled outside of the body. Most ART procedures involve removing a woman’s mature eggs using a needle, combining the eggs and sperm in a laboratory, and placing the embryos into the woman’s uterus. The most common ART is in vitro fertilization (IVF).
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“Infertility.” World Health Organization. September 14, 2020. https://www.who.int/news-room/fact-sheets/detail/infertility (accessed March 1, 2021).
“Infertility FAQs.” Centers for Disease Control and Prevention. January 16, 2019. https://www.cdc.gov/reproductivehealth/infertility/index.htm (accessed March 1, 2021).
“Types of Medications.” RESOLVE: The National Infertility Association. https://resolve.org/what-are-my-options/medications/types-medications/ (accessed March 1, 2021).
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