If you and your partner are struggling to have a baby, you’re not alone.
About 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention (CDC). Roughly 16% (or 1 in 6) couples in Canada experience infertility. This number has doubled since the 1980s.
What Is Infertility?
Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older).
Women who can get pregnant but are unable to stay pregnant may also be infertile. Pregnancy is the result of a process that has many steps.
Causes of Infertility
To get pregnant
- A woman’s body must release an egg from one of her ovary’s (ovulation).
- A man’s sperm must join with the egg along the way (fertilize).
- The fertilized egg must go through a fallopian tube toward the uterus (womb).
- The fertilized egg must attach to the inside of the uterus (implantation).
Infertility may result from a problem with any one or several of these steps. 91% of women can get pregnant at age 30, 77% by age 35, 53% by age 40.
Infertility can be traced to either the man or woman, or a combination of both:
- 3 times out of 10, the cause is in men.
- 4 times out of 10, the cause is in women.
- 2 times out of 10, the cause is a mix of factors from both male and female.
- 1 time out of 10, no specific cause can be found.
How Is Infertility Treated?
Infertility may be treated with medications, surgery, artificial insemination, or assisted reproductive technology.
What Medications Can Be Used to Treat Infertility?
If you’re a woman with infertility issues, your doctor may prescribe medications to help you get pregnant.
Fertility medications generally work like the natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. They’re also used in women who ovulate to try to stimulate a better egg or extra eggs.
There are quite a few of these medications, but here are the basics on the ones that are most commonly prescribed.
- Clomid or Serophene
Clomiphene citrate (Clomid) has been used for more than 40 years. Many doctors recommend it as the first treatment option for a woman with polycystic ovarian syndrome (PCOS) or other problems with ovulation.
Clomid and Serophene, the brand names of clomiphene, cause ovulation by acting on the pituitary gland in the brain. These medications are taken by mouth for a few days each month.
About 60% to 80% of women who take clomiphene will ovulate, and about half will be able to get pregnant. Most pregnancies happen within three cycles.
- Gonadotropins
If Clomid or Serophene do not work on their own, your doctor may recommend injected hormones to trigger ovulation.
Gonadotropin medications include human menopausal gonadotropin or hMG (Menopur) and FSH (Gonal-F, Follistim AQ, Bravelle).
Another gonadotropin, human chorionic gonadotropin or hCG (Ovidrel, Novarel, Pregnyl), is used to mature the eggs and trigger their release at the time of ovulation.
- Metformin
Metformin (Glucophage) can decrease insulin resistance.
Women with polycystic ovary syndrome (PCOS), especially those with a body mass index over 35, may be insulin resistant, which can cause problems with ovulation.
- Letrozole
Letrozole (Femara) belongs to a class of medications known as aromatase inhibitors and works in a similar fashion to clomiphene. Letrozole may induce ovulation.
- Bromocriptine and Cabergoline
Bromocriptine (Parlodel) and cabergoline (Dostinex), dopamine agonists, may be used when ovulation problems are caused by excess production of prolactin (hyperprolactinemia) by the pituitary gland.
Side column links:
Prescription Infertility Medications
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