Difficulty Conceiving

Fertility Medications

With all the hormones necessary to regulate menstruation and ovulation, it's amazing to think that anyone's body is able to measure up. If you are one of the many women who have a hormonal imbalance causing infertility, you are in luck. In most cases, fertility can be restored through simple hormonal replacement therapy using fertility medications. When any of the hormones are absent or are not produced in sufficient amounts, synthetic hormones can be administered to act as your body's natural hormones. They must be taken at just the right time in order to be effective, and can be taken in conjunction with others to ensure the cycle goes smoothly.

The following is what should occur during a typical 28-day menstrual cycle, and the synthetic hormones that can be prescribed to mimic your body's natural process:

Day 1-4 (Menstruation):

1. your hypothalamus sends small pulses of GnRH
2. your pituitary gland responds to the GnRH and secrets the hormone FSH
3. your ovaries respond to the FSH and immature follicles, each of which contains an unfertilized egg, begin to grow

Synthetic Hormones:

• Clomiphene citrate (Clomid®, Milophene®, Serophene®)
• Menotropins (Humegon^TM, Pergonal®, Repronex^TM)
• Urofollitropins (Fertinex^TM)
• Follitropin beta (Follistim®)
• Follitropin alpha (Gonal-F®)

Day 5-14 (Post-Menstruation):

1. your pituitary gland continues to secret the FSH
2. your follicles continue to respond to the FSH by growing, and producing estrogen in increasing amounts
3. your uterus responds to the estrogen and begins to thicken
4. your hypothalamus responds to the estrogen and secretes massive amounts of GnRH
5. your pituitary gland responds to the GnRH and releases massive amounts of LH ("the LH Surge")

Synthetic Hormones:

• Human chorionic gonadotropin (hCG) (APL®, Profasi®, Choron®, Pregnyl®)

Day 14 or 15 (Ovulation):

1. your ovaries respond to the LH by expelling the egg of the mature follicle and prevent new follicles from developing

Day 15 - 28 (Luteal Phase)

1. the follicle which released its egg responds to the LH by releasing progesterone. It has enough progesterone for the remainder of your cycle and no more.
2. your uterus responds to the progesterone by thickening even more
3. if your egg is fertilized, it will secret hCG (Human chorionic gonadotropin) which will cause the follicle to produce more progesterone which is necessary to sustain pregnancy
4. if your egg is not fertilized, your uterus will respond by shedding its lining and the cycle will begin again

Synthetic Hormones:

• Leuprolide acetate (Lupron®)
• Goserelin
(Zoladex®)

The following chart lists each fertility medication. Please note that administration times and length of therapy may differ based on your personal circumstances.

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