Nashville Fertility

Fertility Medications

Fertility treatment involves harnessing and enhancing a woman’s menstrual cycle with medications. Most of the fertility medications used by the physicians at NFC are listed below with a short explanation of the uses of each.

Fertility Medications

Clomiphene Citrate or Clomid

Clomiphene Citrate or Clomid is used to induce ovulation. It is taken typically on cycle days 3-7 or 5-9 and ovulation occurs a week or two after stopping. Click here for more information about Clomid.
Dexamethasone is an oral steroid that has been shown to improve the ovarian response to hyperstimulation protocols in some patients undergoing IVF, especially if they have evidence of diminished ovarian reserve.
Estrace is taken orally or vaginally to increase circulating estrogen levels. This can be used to help thicken the uterine lining or to control the menstrual cycle in preparation for a treatment cycle or surgery.
Femara is used in a manner similar to Clomid to induce ovulation. Some patients who develop a thin lining during Clomid treatment may have normal endometrial development with Femara. Click here for more information about Femara.
Ganirelix is a pre-filled syringe that is taken in the evening to prevent Leutenizing Hormone (LH) release and therefore ovulation for 24 hours after injection. It is used in IVF cycles to prevent ovulation before egg retrieval.
Gonadotropins are injectable medications that stimulate follicular development in the ovaries. These medications are used to stimulate follicular development for IUI or IVF cycles. Multiple preparations are available which can contain pure FSH (Bravelle, Follistim, and Gonal-F) or a combination of FSH and LH (Menopur).
Lupron is also called Leuprolide Acetate and is a gonadotropin releasing hormone agonist (GnRH agonist). Lupron is used in IVF (via sub-q injection) to suppress ovarian function before starting FSH stimulation, and is continued during IVF stimulation to prevent untimely ovulation.
Metformin is an oral insulin sensitizing medication used to treat type II diabetes. It may be used to treat elevated insulin levels associated with PCOS, with the added benefit of often improved response to gonadotropins or clomid. For some (but not all) women metformin use will result in cyclic ovulation and menses.
Novarel is hCG used to trigger ovulation, and is reconstituted with sterile water and given as an intramuscular injection. Novarel can also be used for luteal support.
Oral Contraceptive Pills (OCPs) or Birth Control Pills (BCPs)
Oral Contraceptive Pills (OCPs) or Birth Control Pills (BCPs) are used to prevent or treat ovarian cysts, to capture the menstrual cycle, and to synchronize follicle recruitment. OCPs are often used to plan the timing of an IVF cycle or surgery, and can be used to induce a period for subsequent ovulation induction.
Ovidrel is recombinant human chorionic gonadotropin (hCG) product in a pre-filled syringe that is taken by sub q injection. It is prescribed when ovarian follicles are mature, resulting in ovulation and release of the egg or eggs. Ovidrel may also be taken after an IUI as luteal support, since it stimulates the corpus luteum cyst of ovulation to continue making progesterone.

Progesterone is used in many fertility treatment cycles after ovulation or egg retrieval as luteal support of the potential pregnancy. Progesterone in oil (PIO) is often used after IVF and begins the day of egg retrieval. If you are pregnant, these shots continue for a few more days or weeks depending on your situation, and you may transition to a vaginal form of progesterone like Endometrin or Crinone. Vaginal forms of progesterone may be used in place of PIO injections once a pregnancy is established or in patient who cannot tolerate progesterone injections.

Prometrium is a capsule taken after ovulation as luteal support, or to induce a missed period. Prometrium is usually taken orally, but sometimes is prescribed as a vaginal insert as well.

Provera is a synthetic progestin (progesterone like compound) that can be taken orally for 5-10 days to induce a missed period. Bleeding usually begins 3 days to 2 weeks after completing provera treatment.

Zithromax is an antibiotic prescribed before fertility treatment that kills bacteria that may interfere with embryo implantation. Couples are treated together and should start and finish treatment simultaneously to prevent bacteria from being passed from one partner to the other.

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