Fertility medication, better known as fertility drugs, are drugs which enhance reproductive fertility. For women, fertility medication is used to stimulate follicle development of the ovary. There are currently very few fertility medication options available for men.
Agents that enhance ovarian activity can be classified as either Gonadotropin releasing hormone, Estrogen antagonists or Gonadotropins.
Female
Gonadotropin-releasing hormone
Either Gonadotropin-releasing hormone (GnRH) or any Gonadotropin-releasing hormone agonist (i.e. Lupron) may be used. GnRH stimulates the release of gonadotropins (LH and FSH) from the anterior pituitary in the body.
Oestrogen antagonists
Fertility medication inhibiting the effects of estrogen includes Clomiphene and Aromatase inhibitors.
Clomiphene
Clomiphene (trademarked as Clomid) is a selective estrogen receptor modulator (SERM). It is the most widely used fertility drug. It is used as an ovarian stimulator by inhibiting the negative feedback of estrogen at the hypothalamus. As the negative feedback of estrogen is inhibited, the hypothalamus secretes GnRh which in turn stimulates the anterior pituitary to secrete LH and FSH which help in ovulation.
Aromatase inhibitors
Although primarily a breast cancer treatment, aromatase inhibitors can also work as fertility medication, probably through a mechanism similar to clomiphene.
Gonadotropins
Gonadotropins are the hormones in the body that normally stimulate the gonads (testes and ovaries). For medication, they can be extracted from urine or by genetic modification.
For example, the so-called menotropins consist of LH and FSH extracted from human urine from menopausal women. FSH and FSH analogues are mainly used for ovarian hyperstimulation as well as reversal of anovulation.
There are also recombinant variants which are created by inserting the DNA coding for it into bacteriae. The bacterial DNA is then called Recombinant DNA. Examples of recombinant FSH are Follistim and Gonal F, while Luveris is a recombinant LH.
Human chorionic gonadotropin
Human chorionic gonadotropin (hCG) is normally produced during pregnancy. However, it can also replace LH as an ovulation inducer.
Other
hMG is a medication containing a follicle-stimulating hormone (FSH) and a lutenizing hormone (LH).
Male
There currently are no effective medications to treat oligospermia, so other assisted reproductive technologies are used.
Research in male fertility medication is currently ongoing. A study in Egypt assessed the efficacy of a combination of clomiphene and vitamin E in improving sperm count and sperm motility in male infertility.
Adverse effects
Estrogen antagonists and gonadotropins may stimulate multiple follicles and other ovarian hormones leading to multiple birth and possible ovarian hyperstimulation syndrome.
See also
- Diethylstilbestrol
Manufacturers:
- Ferring Pharmaceuticals
- Organon International
- EMD Serono
References
