Womens Health

Triggering Ovulation With Medication

Physicians have a variety of medications that are successful in bringing on or regulating ovulation in women with PCOS and other ovulatory disorders. The most familiar of these drugs are the follicle stimulating hormone (FSH), and the luteinizing hormone (LH). These act on the body just like natural hormones to trigger ovulation. But today's physician has a much larger arsenal of drugs than ever before to treat anovulation, the most usual culprit in causing infertility.

*Clomid or Serophene (clomiphene citrate)-This oral medication triggers the pituitary gland to excrete the hormones that cause egg-carrying ovarian follicles to develop.

*Repronex (human menopausal gonadotropin, or hMG)-This injectable drug induces ovulation through direct action on the ovaries. Repronex is given when the pituitary glands fail to trigger ovulation.  This drug is a combination of FSH and LH. 

Single Ingredient

*Gonal-F, Follistim, Bravelle (FSH)-Unlike Repronex, these are all single ingredient, FSH drugs, but serve the same purpose as the combination drug, stimulating the production of egg follicles.

*Ovidrel, Pregnyl (human chorionic gonadotropin, or HCG)-This drug triggers the follicle to release its egg—or ovulate—and its use is favored in combination with other drugs such as Clomid, Repronex, and the FSH drugs.

*Factrel (gonadotropin-releasing hormone analogs or Gn-RH)-This drug helps regulate the cycle and can trigger follicle growth when combined with FSH.

Aromatase Inhibitor

*Femara (letrozole)-Femara is an aromatase inhibitor meaning that it affects the production of the female sex hormone, estrogen. The drug was intended as a treatment or preventative drug for certain breast cancers, but doctors have found it effective in its off-label use as a fertility drug where Clomid fails to do the trick.

*Glucophage (metformin)-This oral drug serves to trigger ovulation and is used where infertility is caused by insulin resistance, as in PCOS. 

*Bromocriptine-Bromocriptine inhibits the production of prolactin production, a major cause of ovulatory irregularities.

Multiple Births

While all of these drugs increase the chance that a woman will have a multiple birth, the injectable drugs give the highest risk. No matter which treatment your doctor chooses, you will need a constant assessment of your status through blood and ultrasound tests. Ultrasound is used as a tool to calculate the size of the maturing follicles. Other tests help monitor hormone levels.

The higher the number of fetuses carried in a single pregnancy, the higher the risk for premature labor. Preemies are at risk for a whole slew of health and developmental problems. The risk increases according to the number of babies carried at one time. Thus, quintuplets have a higher risk than do triplets for developing such problems.

Parents may not mind having more than one baby at once, but the fact is that multiples come with health risks. That's why some parents opt for a multi-fetal pregnancy reduction during which some fetuses are removed. This type of abortion may save the lives of the fetuses kept, but of course, there are many moral and emotional issues to consider.

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