Fertility Medications
Fertility medications, sometimes referred to as hormonal medications, play an important role in fertility treatments like in vitro fertilization (IVF). They foster egg production in the ovaries, stimulating both ovaries to produce as many mature eggs as possible. The more mature eggs that are produced, the greater the number of eggs that can be retrieved and fertilized, increasing the likelihood of a successful pregnancy.
If fertility medications are necessary for your treatment plan, the top-rated fertility specialists at NYU Langone Fertility Center (NYULFC) will create a personalized medication protocol that best aligns with your specific needs.
Types of Fertility Medications
There isn’t a one-size-fits-all approach to fertility treatment. Every aspiring parent has unique health circumstances and family-building goals. Common fertility medications include:
Letrozole
Letrozole is an oral medication frequently used in fertility treatment to induce or enhance ovulation. It works by blocking a substance called aromatase, which reduces the level of estrogen in the body. When estrogen levels decrease, the body responds by secreting hormones that aid in the induction of ovulation. Patients typically take letrozole at dosages of 2.5 mg, 5 mg, or 7.5 mg daily for a duration of five days.
Side effects are generally mild and include dizziness, fatigue, and hot flashes. Overall, letrozole is safe and highly effective, especially for patients experiencing conditions that impact ovulation, like polycystic ovarian syndrome (PCOS).
Clomiphene (Clomid)
Clomid is an oral medication that stimulates the production of ovarian follicles that will produce an egg. It's often prescribed to women who experience irregular ovulation or do not ovulate. Patients should take Clomid at approximately the same time each day, and the usual treatment course is five days in total.
Clomid is considered to be the first step in treating infertility and is cost-effective and less invasive compared to other types of fertility treatment cycles. Common side effects include nausea, bloating, and mood changes. There is also a higher risk of a multiple pregnancy (roughly a 7% chance of twins). Therefore, Clomid isn't recommended for women who are unwilling or unable to carry a twin pregnancy.
Fertility Injections
Fertility injections are commonly used during an ovarian stimulation cycle for IVF or egg freezing and may include:
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Gonadotropins: These injections stimulate the ovaries to mature multiple follicles simultaneously. There are two types of gonadotropins: FSH and HMG. The patient injects FSH via a "pen needle" and HMG with a traditional syringe. Both injections are administered under the skin with a small needle (the subcutaneous route).
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GnRH antagonists: These injections suppress the release of the luteinizing hormone (LH), helping prevent premature ovulation. Like gonadotropins, they're also administered through the subcutaneous route.
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GnRH agonists: GnRH agonists suppress the natural hormones released during a cycle, preventing premature ovulation. They are also administered via the subcutaneous injection route.
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Trigger shot: The trigger shot mimics the natural surge of luteinizing (LH) in the body, finalizing the maturation process of the stimulated eggs and preparing your body for retrieval. Various trigger medications may be used, including a "combination trigger." This shot includes hormones like human chorionic gonadotropin (HCG). Once you take the first trigger injection, ovulation occurs within 36 hours. It's crucial to take the trigger shot at the specific time instructed by your fertility team to avoid premature ovulation. Trigger medications are administered via subcutaneous injection.
Side effects for fertility injections include bruising or a reaction at the injection site, nausea, and abdominal bloating. While each patient reacts to medications differently, many describe side effects as mild or manageable.
Fertility Medication FAQs
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Progesterone may be prescribed during an IVF treatment cycle. It helps enhance the uterine lining’s ability to support embryo implantation and maintain pregnancy. Progesterone can be administered through intramuscular injections or used in combination with vaginal suppositories such as Endometrin or Crinone.
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The cost of fertility drugs depends on the length of the treatment cycle, the specific medications required, and the pharmacy from which they are obtained. For patients paying out of pocket, the cost of medications for one IVF cycle typically falls between $2,000 and $8,000, with most patients paying around $4,000 to $5,000. Insurance coverage may be available depending on your plan, so it's important to discuss your options with your provider before your initial fertility consultation.
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The number of injections needed for an IVF cycle depends on the length of your cycle. On average, a patient is prescribed two injections per day for the first five to seven days and three injections per day for an additional three to five days. The trigger shot involves two to three injections 12 hours apart. That makes 30 injections total, but this estimate may vary based on each patient's unique medication protocol.
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It’s completely normal to feel anxious about injecting fertility medications. At NYULFC, we offer orientation classes with our health educator where you’ll receive detailed instructions for injecting fertility medications. You can also refer to the following training videos for guidance at any point throughout the process:
Learn More About Fertility Medications at NYULFC
Fertility medications are crucial to maximizing your chances of conception during the fertility treatment process. The expert team at NYU Langone Fertility Center can assess your individual needs and recommend a personalized medication protocol for you.