Medications for Your Fertility Journey
Overcoming fertility challenges is often a multi-step process. Many couples and individuals need to undergo various treatments to successfully conceive and deliver the children they want. These treatments include hormone therapy, intrauterine insemination (IUI), egg harvesting and freezing, in vitro fertilization (IVF), donor sperm, eggs and embryos, genetic testing, surrogacy, and more. One common approach that fertility specialists choose is to prescribe medications to treat the causes and symptoms of infertility. Some medications can solve fertility challenges independently, while others help prepare the patient for more intensive approaches like IVF and IUI. Before beginning the fertility treatment process, it is important to understand what these medicines are and why doctors prescribe them.
Fertility medications are drugs that treat problems causing infertility. Roughly 11% of women and 9% of men in the United States experience fertility problems. These individuals can treat their conditions in part or entirely by using medications to do any of the following:
- Regulate hormone levels
- Stimulate ovulation
- Increase the number of eggs ovulated
- Enhance sperm count and motility
These medications help increase fertility and improve the user’s chances of a successful pregnancy.
Healthcare providers prescribe various medications as treatments for specific medical conditions or as part of more complex medical protocols, often involved with assisted reproductive technologies (ART). Here is a list of common medications, with familiar brand names below each entry.
- Clomiphene citrate: For ovulation induction with the intention to release one egg to treat ovulatory dysfunction (e.g., with Polycystic Ovary Syndrome (PCOS)) and for ovarian stimulation to cause the release of more than one egg during ovulation
- Clomid, Serophene
- Letrozole: An alternative to clomiphene citrate for inducing ovulation in women and commonly used with PCOS
- Human menopausal gonadotropin (hMG): Ovarian stimulation and especially for assisted reproductive technologies (ART) like IVF
- Follicle-stimulating hormone (FSH): FSH is used in the same treatments as hMG, plus for male infertility, as FSH injections can help stimulate sperm production and improve the chances of successful fertilization
- Follistim, Gonal-F
- Human chorionic gonadotropin (hCG): Luteal phase support and hypogonadism in men are just two of the treatments that use hCG
- Ovidrel, Pregnyl
- Gonadotropin-releasing hormone (GnRH) agonists: Commonly prescribed in endometriosis patients to suppress estrogen levels and in IVF cycles to provide control over ovarian stimulation and ovulation. Can also be used with GnRH antagonist protocols to trigger ovulation
- Gonadotropin-releasing hormone (GnRH) antagonists: Commonly used in IVF cycles to suppress estrogen levels and provide control over ovarian stimulation and ovulation
- Metformin: Metformin is frequently used in the management of PCOS, which assists in improving insulin sensitivity and lowers insulin levels, which can then help regulate the menstrual cycle, promote ovulation, and increase the chances of pregnancy
- Bromocriptine: Bromocriptine is primarily used to address fertility issues related to hyperprolactinemia and prolactinomas, helping to regulate ovulation and restore normal reproductive function in affected individuals
- Medroxyprogesterone acetate: Medroxyprogesterone acetate is primarily used to address menstrual irregularities, induce withdrawal bleeding, manage endometriosis symptoms, and provide contraception
Can fertility medications alone help someone conceive? The short answer to this question is yes, in many cases, they can. While fertility medicines are often prescribed in complex treatment protocols, many individuals can have specific problems treated by an individual medication. Success rates vary, but here are just a few examples of successful pregnancy rates from some of the more common drug therapies:
- Hormone shots: 32%
- Letrozole: 28%
- Clomid: 23%
While not technically a fertility issue as erectile dysfunction impacts sexual performance, not sperm count, erectile dysfunction medications can be prescribed in cases where couples wish to conceive through sexual intercourse. The most common medications are PDE5 inhibitors, and they help the body produce nitric oxide, a chemical which relaxes muscles in the penis while improving blood flow to help the patient get an erection from sexual activity.
The most common erectile medications are:
- Avanafil (Stendra)
- Sildenafil (Viagra)
- Tadalafil (Cialis)
Using erectile medications is not without risks beyond just the common side effects.
While most fertility medications are obtained primarily through official prescriptions from medical practitioners, the market offers plenty of opportunities to buy inexpensive erectile medication, often through internet shopping. Many of these sources are untrustworthy, and buyers run the risk of receiving counterfeit medicines which are ineffective, unsafe, or both. When using these medications, acquire them exclusively through a trusted medical practitioner and pharmacist.
Erectile dysfunction drugs may also have a negative impact on the user’s actual fertility. Some evidence shows these drugs lower sperm count. Some studies disagree, but many prospective parents may consider forgoing conceiving through intercourse and solving sexual performance issues separately, for example with intrauterine insemination (IUI).
Fertility medications can vary significantly in cost. The specific drug needed, the recommended dosage, treatment duration, and individual circumstances all play a part in determining the price, ranging from a few hundred to thousands of dollars per treatment cycle.
For example, medications which need to be injected, like FSH or hMG, can cost $1,000 to $6,000 per cycle. Meanwhile, oral treatments like Femara and Clomid are fairly affordable, with cycles ranging from $50 to $150.
Many government healthcare organizations or medical insurance plans (in the United States) cover fertility medications, which can reduce the patient’s out-of-pocket cost dramatically. Some states even require insurers to do so. This varies by jurisdiction or insurance plan, and aspiring parents may need to pay the bill on their own.
Because patients cannot always afford fertility medications, employers looking to attract and retain the best and most diverse teams should invest in comprehensive and flexible fertility benefits. When asked, 88% of employees challenged with fertility problems would switch jobs to get fertility coverage, while 61% of those with such benefits reported feeling more loyal to their company and appreciated the workplace culture. As the best candidates increasingly view fertility coverage as more of a must-have than a perk, companies should seriously consider working with ARC Fertility to provide the best possible family building care for their workforce.