And by drugs I mean fertility drugs!! Glorious fertility medications and the awesome side effects that they bring with them!!
Lets start with oral meds. Tiny little tablets...
Clomid- is often the first choice for treating infertility, because it's effective and been used for more than 25 years. Clomid is given to women who are not ovulating regularly or even at all. It is a anti-estrogen drug. As a result, it causes the hypothalamus and pituitary gland located deep in the brain to release hormones -- GnRH (gonadotropin releasing hormone), FSH (follicle stimulating hormone) and LH (luteinizing hormone) -- that will stimulate the ovaries to produce eggs. But what about the fun side effects?? Mood swings.... like the kind where your poor hubby moves to the couch instinctively the night of your first dose! Because he KNOWS he is already in trouble, he just isn't sure yet what he is going to do to get there!
Femara- is an oral drug which can be an effective fertility treatment for women with ovulation problems, or for those with unexplained infertility. This medication is in a class of drugs called aromatase inhibitors. Femara has mainly been used to treat certain cases of breast cancer. When the enzyme aromatase is inhibited, estrogen levels are suppressed. This results in the brain and pituitary gland increasing the output of FSH. In women that have polycystic ovary syndrome or anovulation the increase in FSH hormone can result in development of a mature follicle in the ovary and ovulation of an egg. But whew!!! what about those hot flashes? the kind where you're literally hanging out the bedroom window in the middle of January sweating while your hubby is turning into a Popsicle!
Metformin- is an insulin-sensitizing medication. It is typically used to treat patients with diabetes and is NOT a fertility drug. But it is often used to help women with PCOS and Insulin Resistance to get pregnant. There seems to be a connection between insulin and the reproductive hormones. While it isnt yet clear exactly how the two connect, it seems that increased insulin levels lead to increased levels of androgens, also known as the male hormones. High androgen levels lead to PCOS symptoms and problems with ovulation. The side effects.... oh boy!! In the words of my OB "this medication can cause some... gastro-intestinal upsets" And he was not exaggerating. Im talking about not leaving the house except when necessary and a bathroom is near by!!
If either of those meds are not doing the job you may move on to injectable medications! If you're lucky you will get a brand that comes in an "epi pen" but most still come with a vial and syringe.
Follistim, Bravelle, and Gonal F- injectable formulations of FSH. An injection given just below the skin (subcutaneous injection) that bypasses the hypothalamus and pituitary glands to directly stimulate follicle growth in the ovaries. Yes you will more than likely be giving this injection to yourself. Unless you trust another family member or friend with the task. Shots are typically given nightly for as few as 3 days but usually more like 8-10. Look forward to the mood swings and hot flashes I mentioned before as well as tenderness or rash at the injection site! Most of us put on a brave face and say "it wasnt as bad as I thought it would be" after our first injection.... and honestly... it isn't. But when have you ever thought getting a shot was pleasant? ever pleasant enough that you asked to do it yourself or if you could take the syringe home and do it 8 more times?
Menopur, Repronex, Perganol- Human Menopausal Gonadotropins (hMG). An injection that contains equal parts of FSH and LH (luteinizing hormone), given to stimulate the ovaries to produce multiple eggs during one cycle. These are the most potent ovulation medications currently used today. Potential side effects are about the same as those listed for FSH injections. Depression is always a fun side effect to deal with.... don't we all already fight to NOT let this struggle push us into depression? Isn't depression already a common occurrence in women with PCOS?
Some other medications you may encounter along the way...
Lupron- GnRH Agonists (Analogs) are injections given below the skin. These medications are used to enable the body to produce a higher number of quality eggs.These medications are also designed to prevent the mid-cycle hormonal surge which can result in a cancelled cycle. Side effects include insomnia, vaginal dryness, and painful intercourse! Oh the joys....
Cetrotide- GnRH Antagonists are injections administered for three to four days.These medications operate as antagonists of the gonadotropin causing the hormone (GnRH) to be released to help prevent premature ovulation. Same side effects as the Lurpon, so lets add in the fact that both can cause decreased breast size?? WTF!
Medrol- A steroid provided daily for four days during the cycle to assist with pre-embryo implantation. We all love how steroids make us feel right?? Angry. Hungry. FAT!!
Doxycycline- An oral antibiotic provided to the male partner during the female’s stimulation cycle to reducethe levels of bacteria which may be found in semen. This medication is also given to the female partner to decrease the risk of infection after aspiration of the follicles at the time of egg retrieval.
Progesterone- may be administered through a vaginal gel, suppository or in a pill. To help sustain a pregnancy in a woman who shows low levels of natural progesterone in early pregnancy. A common occurance in women with PCOS. Intra Muscular injections provided daily beginning two days after retrieval and finishing when the placenta is creating appropriate amounts of Progesterone. Side effects... lets just think about putting a suppository in our vaginas for a moment. Let that sink in..... has it sank? good.... now think about the fact that it will slowly and almost continuously leak out as the day goes by. Also, now that you are taking progesterone supplements in the 2WW (the 2 weeks between ovulation and finding out if you will get your period or are pregnant) You can experience all the joys of early pregnancy signs. Regardless of actually being pregnant.
Ovidrel, Novarel, Pregnyl- Synthetic Human Chorionic Gonadotropin (hCG)are Intra muscular injections used to trigger ovulation. Often used when other medications have been taken to induce ovulation. Often times this injection is also given at home. If you take one of these, be prepared to experience even more "early pregnancy signs" regardless of being pregnant. Nausea, Headache, and Tender Breasts.
lots of information via http://americanpregnancy.org/infertility/infertilitymedications.html
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