| Drug |
Dosage |
Comments
|
| Clomiphene citrate (Clomid®) |
50 to 150 mg by mouth on days 5-9 of cycle |
Appropriate initial treatment for patients with unexplained infertility or polycystic ovary disease. Cervical mucous can become thick on this medication, and therefore IUI is often recommended if the woman does not conceive within three cycles. There is approximately a 20-25 percent pregnancy rate per cycle. If no pregnancy occurs after 3-6 cycles, other causes of infertility should be considered. About 1 percent of women will have overstimulation of the ovaries, in which they experience pain and abdominal swelling. Multiple births (twins, triplets) occur at a rate of about 5-10 percent. |
| Gonadotropin therapy with human menopausal gonadotropin (Pergonal®) or purified FSH (Metrodin®, Follistim®, or Gonal-F®) |
1-2 ampules injected into the muscle (administered at home by patient or partner) starting day three of cycle |
Requires frequent visits approximately every other day starting day seven of cycle for ultrasound measurement of follicle size and estradiol levels. When the appropriate follicle size and estrogen level are reached, a medication called hCG is administered intramuscularly and 12-36 hours later, timed intercourse or insemination should occur.
Success rate is extremely high for women with absence of periods due to hypothalamic problem (pregnancy rates of 90 percent over the course of six cycles), but slightly lower rates for women with polycystic ovaries or unexplained infertility. Not recommended for women with premature menopause due to low success rates. Complications include overstimulation of the ovaries (10-20 percent) and multiple births (25 percent, with 20 percent twins, 5 percent triplets or quadruplets).
|
| Agents to treat elevated prolactin levels (Bromocriptine® or Dostinex®) |
Bromocriptineª: 2.5-7.5 mg tablets daily by mouth Dostinexª 0.25-1 mg 2x/week by mouth |
Causes periods to resume in 90 percent of women with elevated prolactin levels. |
| Metformin (Glucophage®) |
500 mg po qd |
Resumes ovulation in 90 percent of patients with polycystic ovary syndrome. |
Table of Contents - Infertility Patient Guide
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This page was last modified on 3/18/2008
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