ASPIRIN
Indications for use: Aspirin is used alone or with Heparin to reduce the risk of recurrent spontaneous pregnancy loss. In addition, it is often used for the prevention of miscarriage.
Heparin
Indications for use: Heparin is used on its own or in conjunction with aspirin to prevent recurrent pregnancy loss due to elevated levels of antiphospholipid antibodies.
Clomiphene Citrate
Clomid, Serophene
If your basic infertility work-up indicates that you are not ovulating regularly or if you are ovulating very late or early in the cycle, your physician may suggest clomiphene citrate.
Indications for use: In women, clomiphene is used to induce ovulation, to correct irregular ovulation, to help increase egg production, and to correct luteal phase deficiency.
Dosage: Clomiphene comes in 50-mg tablets. The usual starting dose is one tablet on day 3, 4, or 5 of your cycle, and for 5 days afterward. Ovulation usually occurs on cycle day 13 to 18. If you do not ovulate, your physician may increase the dose in increments in future cycles; the maximum dose is usually 200mg daily. The American Society for Reproductive Medicine (ASRM) recommends that clomiphene be prescribed for three to six cycles only.
Follicle Stimulating Hormone (FSH)
Urofollitropins: Fertinex, Metrodin
Follitropins: Follistim, Gonal F
The primary difference between the urofollitropins (made from purified urine of postmenopausal women) and the follitropins (made synthetically, using recombinant DNA) is purity and consistency.
Indications for use: These drugs are used for the treatment of ovulation disorders and to stimulate follicle and egg production for intrauterine insemination (IUI), in vitro fertilization (IVF), or other assisted reproductive technology (ART) procedures.
Dosage: All FSH preparations require injections. Fertinex, Gonal F, Bravelle, and Follistim are all injected just beneath the skin (subcutaneous injections). Injections start on day 2, 3, or 4 at 75 IU (international units) to 225 IU or more per day. Dosage may be adjusted as the cycle progresses. This will be determined through blood (measuring estrogen-estradiol levels) and ultrasound monitoring (measuring follicular growth).
Human Menopausal Gonadotropin (hMG)
Pergonal, Repronex
hMG acts directly on the ovaries to stimulate follicle development.
Indications for use: hMG is used to stimulate the development of follicles in women who do not ovulate regularly and to stimulate ovulation for Intrauterine Insemination (IUI), in-vitro fertilization (IVF) and other assisted reproductive technology (ART) procedures.
Dosage: hMG comes in ampules of 75IU (international units) or 150 IU of FSH and LH. It is given by subcutaneous injection once or twice a day. Doses vary depending on patient response and type of treatment
Human Chorionic Gonadotropin (hCG)
Novarel, Pregnyl, Profasi
HCG is a hormone produced by the human placenta. Commercial hCG is made from the purified urine of pregnant women.
Indications for use: hCG is used for two reasons: First, hCG mimics LH, resulting in the release of matured eggs after controlled ovarian hyperstimulation (COH), with FSH or hMG, for example. Second, after ovulation has occurred, either naturally or in conjunction with IUI, IVF or ART, hCG may be used to support the corpus luteum and to enhance the quality of the uterine lining and the potential for implantation of the embryos.
Dosage: hCG comes in vials in dosages of 5,000 IU (international units), and 10,000 IU for injection. Dosages vary depending in the purpose of the treatment.
Gonadotropin-Releasing Hormone Agonists (GnRH agonist)
Lupron, Synarel
GnRH agonists are synthetic drugs that cause the release of FSH and LH initially but with continued use quickly suppress these hormones.
Indications for use: Continued used of GnRH agonists suppresses FSH and LH thereby creating a clean slate on which to create a controlled ovarian hyperstimulation cycle for in vitro fertilization (IVF) or other assisted reproductive technology (ART) procedures. GnRH agonists are used to prevent premature release of eggs in IVF or gamete intrafallopian transfer (GIFT) and to treat endometriosis or to shrink fibroids.
Dosage: Short acting GnRH agonists come in two forms: Lupron, a drug taken by subcutaneous injection daily, and Synarel, a nasal spray taken twice a day. The long acting form is taken by injection once a month.
antagonist, ganirelix acetate)
Antagon, Cetrotide
Indications for use: The drug is used in controlled ovarian hyperstimulation cycles for in vitro fertilization (IVF) or other assisted reproductive technology procedures.
Dosage: The drug is given by subcutaneous injection, usually starting on cycle day 8, and continued for several days. It is given in combination with ovulatory stimulating drugs.
Bromocriptine Mesylate and Cabergoline
Parlodel and Dostinex
In both men and women, hyperprolactinemia (overproduction of the hormone prolactin) can cause fertility problems by interfering with the normal production of FSH and LH.
Indications for use: Bromocriptine and cabergoline correct abnormal prolactin levels.
Dosage: Bromocriptine, an oral medication, comes in 2.5-mg (milligram) tablets. Because bromocriptine may cause gastrointestinal discomfort and dizziness, most physicians suggest taking one-half tablet per day at first, then slowly increasing it to 2.5 mg per day.
Progesterone
Progesterone is a natural hormone which is given after ovulation to improve the quality of the uterine lining. It can be taken by mouth, by vaginal suppository, gel or by intramuscular injection.
