There are many drugs that are used when a couple undergoes a fertility treatment (IVF, insemination, egg donation, etc.). Some are very simple to use and have virtually no side effects and others are more complex and have greater side effects.
We shall now discuss the most commonly used drugs, what they are and their side effects. It should be noted that most medication is hormonal or works on that level, so that side effects in many cases will be similar to those which a woman may generally feel during her cycle or indeed during pregnancy.
Gonadotropins are the fertility drug par excellence. They serve to stimulate controlled function of the ovaries so that eggs can then be collected after being developed in them. They are mostly injectable, either intramuscularly or subcutaneously.
The brands of this drug are as follows and you can watch the following videos which outline in a simple way the correct way to administer them:
Menopur® 75 & 1200
The active ingredient in both Menopur 75 and Menopur 1200 is highly purified menotrophin which is obtained from the urine of post-menopausal women. This molecule contains both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and its use in assisted reproduction is with a view to controlled ovarian stimulation to encourage the development of multiple follicles. This means we are able to obtain an adequate number of eggs for in vitro fertilisation treatment (IVF/ICSI) which will give us the greatest possible chance of pregnancy, depending on the case in each particular woman/couple.
The dose will be determined by your gynaecologist and may vary depending on ultrasound scan and blood analysis (estradiol and progesterone levels) tests carried out throughout the treatment.
is the drug responsible for finishing the maturation of the eggs and also induces ovulation. Depending on the treatment you want to perform, whether artificial insemination (AIC) or in vitro fertilisation (IVF), it will be used to some degree. The patient must always respect the proper timing at the time of administration. As you approach the moment of ovulation, the symptoms may be similar to those experienced during the days prior to menstruation.
Oral contraceptives: are commonly used before a cycle of IVF for various reasons. Among them is to control the cycle and ensure a better response after medication.
Clomiphene citrate (Omifin ®) is an ovulation inducer. It has been used for many years and today it continues to be used on its own or in combination with other drugs. It is easy to take and has minimal side effects.
GnRH analogues: There are several types of these and they can be administered at different times of the IVF cycle according to the effect desired. They generally serve to better control ovarian stimulation and to create a better response to gonadotropins.
Antagonists: Since their introduction in the management of IVF cycles, they have made monitoring the stimulation process more comfortable, serving to prevent early ovulation and the cancellation of the treatment.
The active ingredient in Cetroide is cetrorelix acetate which is a gonadotropin-releasing hormone (GnRH) antagonist. Its purpose is to foment the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
An antagonist means that the molecule is able to adjoin onto the GnRH receptor itself, thus blocking it and stopping it from functioning.
Therefore, cetrotide is used in assisted reproduction treatment in order to avoid premature ovulation of eggs (caused by peaks in LH) so that they can be retrieved using ovarian drilling and, in the case of in vitro fertilisation (IVF/ICSI), fertilised later in the laboratory.
The active ingredient in orgalutran is ganirelix. This molecule is a gonatropin-releasing hormone (GnRH) antagonist, adjoining onto its receptor (located in the pituitary gland) and replicating its effect. In other words, releasing follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
Orgalutran is used, therefore, in in vitro fertilisation treatment, both in IVF and in ICSI with the aim of stopping egg ovulation taking place prior to ovarian drilling.
Progesterone: Typically taken vaginally in the form of an egg. It provides hormonal support in the luteal phase (after ovulation) when there is not enough or when the treatment requires it. Doses are variable and can also be taken orally.
Oestrogens: we use these drugs to prepare the endometrium and make it more receptive to embryo implantation in an egg donation treatment or when transferring vitrified embryos, etc. which in turn will lead to a normal pregnancy. It can be taken orally or transdermally.
In conclusion, the drugs used in fertility treatments can be handled differently depending on the effect that is sought in each case. This will be individualised for each couple, so that the same drug may be used in one way for one couple and in another way for another couple.