Medications To Induce Ovulation Therapies For Diseases Which Cause Infertility.

 

 

Over the period of time, Infertility has become a complex issue and medical science is continuously innovating various modalities of treatment to overcome such problem. It is of utter importance especially for females to understand the diseases that cause infertility and medication which can be used for induction of ovulation.

Diseases which Cause Infertility

There are many diseases that may cause infertility, please find below the most common diseases causing infertility due to anovulation.

1-Polycystic Ovarian Syndrome (PCOS)

PCOS is the leading cause of  Infertility In Women, more than 20 million women around the world are currently suffering from this disease. PCOS is one of the predisposing factors for developing cardiovascular disease and diabetes mellitus in women. It is usually diagnosed by the clinical Triade of cyst in ovaries, irregular menstruation, and high level of male hormones in females such as testosterone which also causes hirsutism. It is usually treated with clomiphene citrate and metformin.

2-Uterine Fibroids

One of the causes behind the high infertility rate in women worldwide is the presence of the most common tumor known as uterine fibroids. Any fibroids of more than 4cm may harm the implantation of the embryo in the uterus. They are usually diagnosed by Ultrasound and can be treated by GnRH agonists such as Lupron, Zoladex and Viaduct. However, myomectomy is the only mode of treatment for larger fibroids to restore fertility.

3-Endometriosis

This disease is associated with chronic complains of pelvis pain, painful periods, difficulty in sexual intercourse, it is more commonly found in young women due to the formation of accessory stoma or a gland outside the wall of the uterus which causes inflammatory reactions and disturbance in pelvic anatomy. Currently, the treatment merely involves reducing the symptoms of this diseases, medications used for induction of ovulation are usually helpful in treating infertility caused by Endometriosis.

4-Hypothalmic Dysfunction

The dysfunction of the hypothalamus is usually due to obesity, emotional or physical stress which causes disturbances in the production of FSH, LH, and hyperprolactinemia. Such hormonal imbalance leads to irregular menstruation. Hypothalamic dysfunction can be diagnosed by various blood tests and ultrasonography. Their goal should be the correction of hormonal balance, cabergoline is one of the most effective medications for hyperprolactinemia, similarly, the root cause of FSH and LH imbalance should first be ruled out before treatment.

Medications used for Induction of Ovulation.

There are many medications available to boost the chances of pregnancy. These medications ensure the production of follicles by triggering ovaries to ensure multiples eggs are released so that one or more will be fertilized resulting in pregnancy. Below are the common medications used for Induction of Ovulation to treat infertility.

1-    Clomiphene Citrate

This medication is most commonly used worldwide for stimulating ovaries by raising FSH in women suffering from anovulation to ensure production of follicles containing eggs. The safe dosage is usually between 50-100 mg for five days and should be started from the third or fifth day after initiation of menstruation.

      Side effects:  Multiple pregnancies, ectopic pregnancy, mood swings, and pelvic discomfort.

2-    Metformin

This medication has been used for diabetes, weight loss and it is recommended to use more than six months in women with anovulation due to PCOS for restoring ovulation. It is sometimes used in combination with clomiphene citrate in the treatment of infertility caused by PCOS.

Side effects: - Liver function disturbance, Gastrointestinal upset.

3-    Gonadotropins

These are hormonal drugs which either contain LH or FSH alone to mimic LH surge and are used in women with anovulation along with LH and FSH imbalance. The aim of these drugs during infertility management are to achieve mature follicles to stimulate through HCG injection, however, if more than enough follicles develops then hCG injection could be avoided.

Side effect: multiple pregnancies, ovarian hyperstimulation syndrome, rash, swelling.

 

4-    Human Chorionic Gonadotropin (hCG)

The hCG injections are used during infertility treatment at mid-cycle to ensure enough eggs are released from the follicles. Ovulation occurs after 36 hours of hCG injection. It is also used in combination with clomiphene citrate during the treatment of infertility.

Side effects: multiple pregnancies, OHSS, breast tenderness, and mood swings.

5-    Dopamine Agonist

 In some women, irregular ovulation is due to high levels of prolactin which disrupts the FSH and LH levels causing anovulation. Medications like Dostinex and Parlodel restores the prolactin levels back to normal. More than 85% of women will start ovulation after such treatment.

Side effect: vomiting, dizziness, headaches, hypotension

Conclusion

To Conclude, infertility has become certainly a treatable condition. Anovulation is now treatable through the use of medications which could help the couple in fulfilling their desire of having a child. Medications mentioned above must not be taken without a prescription from your treating Gynecologist as improper intake may result in a life-threatening condition.