Other Fertility Drugs
Human chorionic gonadotropin (hCG)
The placenta produces HCG during pregnancy. It sets up the series of events that causes production of progesterone by the corpus luteum. hCG levels are measured to confirm pregnancy.
HCG can also be used to trigger ovulation in women who are undergoing stimulated IUI or IVF. In a normal ovulatory cycle, a surge of LH triggers ovulation and release of the egg(s). The body responds to hCG in the same manner as it does LH, so a surge of hCG can also initiate ovulation. In 98% of cases, patients who are receiving Lupron or Ganirelix Acetate can only ovulate when they are given an injection of hCG or LH. Insemination or egg retrieval can be precisely timed for 36 hours after the hCG injection.
Profasi and Pregnyl are human derived and Ovidrel is a recombinant product with a higher percentage of hCG per unit mass.
Hyperprolactinemia is a condition in which the levels of the hormone prolactin are abnormally elevated. This leads to abnormal ovulation and infertility. Prolactin levels normally rise in pregnancy to stimulate the production of breast milk. High prolactin levels in the absence of pregnancy can stop a woman from ovulating and are often due to a small tumor at the base of the pituitary gland. Treatment sometimes involves removal of the tumor by a neurosurgeon or the drug Parlodel (bromocriptine) is prescribed to normalize levels.
Infertility specialists rule out infections in the male and the female that could cause trouble getting pregnant during the initial infertility workup. Infections of the reproductive tract can be very serious and can cause pelvic inflammatory disease, which may scar and damage internal organs including the uterus and tubes in women and the testicles, vas deferens, and other structures in men
Common infectious agents that can cause infertility include gonorrhea, Chlamydia, and mycoplasma. Fortunately, there are a wide variety of antibiotics effective in treating these infections. The key is early diagnosis and treatment before the damage is done.
Birth Control Pills
Birth control pills are usually used to prevent conception; however, they are sometimes used in fertility treatment. Birth control pills may be administered in the cycle prior to the in vitro fertilization (IVF) cycle. Because oral contraceptives contain progesterone and estrogen, their use suppresses the production of follicle stimulating hormone (FSH). Since FSH is suppressed it is highly unlikely that any dominant follicle will be produced in the cycle where birth control pills are administered. Since the follicle is not produced, the next IVF cycle starts with no residual dominant follicles.