ORAL STIMULATION:

Clomiphene Citrate (Clomid)

How does it work?

Clomid is often used for stimulating follicle development by tricking the body into believing that the estrogen level is low. This in turn causes the release of FSH and LH. These hormones stimulate follicular production and the release of more mature eggs. It is also used to stimulate ovulation in women that do not ovulate on their own.

What are the side effects?

Abdominal or pelvic discomfort, bloating, nausea/vomiting; Breast discomfort; Blurred vision, Headache; Irregular spotting

Femara (Letrozole)

How does it work?

Femara in a class of drugs called aromatase inhibitors. Femara has mainly been used to treat certain cases of breast cancer. It’s function is to block the production of estrogen causing the release of FSH and LH. When used for fertility, this release of FSH stimulates the production of follicles.

What are the side effects?

Hot flashes, headache, loss of appetite, general pain, weakness, nausea, or diarrhea

Tamoxifen (Nolvadex)

How does it work?

Tamoxifen was initially developed for the treatment of fertility, however, because its effects on estrogen levels it is most commonly used for the prevention of breast cancer. By blocking the actions of estrogen, FSH is released which stimulates the production of follicles.

What are the side effects?

Bone pain; constipation; coughing; hot flashes; muscle pain; nausea; tiredness; vaginal discharge; weight loss.

INJECTABLE STIMULATION

Gonal F / Follistim / Bravelle / FSH

How does it work?

Gonal F, Follistim, and Bravelle are FSH hormone. These are used to stimulate the ovaries to produce follicles.

What are the side effects?

Breast pain; discomfort, pain, or mild bruising at the injection site; headache; mild stomach pain or nausea; sinus inflammation; sore throat; stuffy nose.

Menopur (Menotropins)

How does it work?

Menopur is combination of FSH and LH hormones. It works by stimulating the ovaries to produce follicles.

What are the side effects?

Abdominal pain; back pain; breast enlargement; chills; dizziness; fever; flu-like symptoms; flushing; general body discomfort; headache; menstrual changes; muscle or joint pain; pain or rash at the injection site.

ANTAGONIST

Antagon (Ganirelix Acetate) / Cetrotide (Cetrorelix)

How does it work?

Ganirelix Acetate (Antagon) is a gonadotropin releasing hormone with antagonistic (blocking) activity. It is indicated for the inhibition of premature LH (luteinizing hormone) surges in women undergoing controlled ovarian hyperstimulation. Ganirelix Acetate works immediately by suppressing LH and FSH secretion. This allows for eggs to reach the level of development needed for fertilization.

What are the side effects?

Abdominal pain, headache, vaginal bleeding, nausea, and injection site reaction.

Triggers to Induce Ovulation

Novarel / Pregnyl / Human Chorionic Gonadotropin – HCG (Intramuscular/Subcutaneous) / Ovidrel (Subcutaneous)

How does it work?

HCG mimics the action of the LH surge and stimulates the release of an egg by causing ovulation. This allow to schedule the timing of the egg retrieval as close to ovulation as possible, therefore increasing the chances of a mature egg.

What are the side effects?

Headache; feeling restless or irritable; mild swelling or water weight gain;

depression; breast tenderness or swelling; or pain, swelling, or irritation where the injection is given.

UTERUS PREPARATION/TRANSFER MEDICATIONS

Crinone (vaginal gel)

Endometrin (vaginal tablet)

Prometrium (vaginal capsule)

Progesterone in Oil (intramuscular; available is peanut, sesame seed, or olive oil)

Progesterone

How does it work?

Progesterone is secreted by the corpus luteum after ovulation. In IVF it is given after the egg retrieval to help thicken the lining of the endometrium to prepare for implantation of the embryo transferred.

What are the side effects?

Bloating; breast tenderness; tiredness; nausea; vomiting; stomach cramps; diarrhea; constipation; mood swings; headaches; dizziness; drowsiness; vaginal itching, burning, and/or discharge (when used vaginally); pain, rash, or bruising at the injectionsite (when used as an injectable)

Estrace (Estradiol)

How does it work?

Estrace mimics the effects of estrogen normally produced by the ovary. It increases secretions from the cervix and growth of the inner lining of the uterus (endometrium).

What are the side effects?

Nausea, vomiting, loss of appetite; swollen breasts; acne or skin color changes; decreased sex drive, impotence, or difficulty having an orgasm; migraine headaches or dizziness; vaginal pain, dryness, or discomfort; swelling of your ankles or feet; depression; or changes in your menstrual periods, break-through bleeding.

OTHER MEDICATIONS – CASE BY CASE

Heparin / Lovenox (Enoxaparin)

How does it work?

Anticoagulants are used to treat and prevent blood clots in the veins, arteries, and lungs. When used after the embryo transfer it improves circulation to the uterus and potential pregnancy.

What are the side effects?

Mild pain, warmth, redness, or skin changes to the injection site; nausea; swelling; diarrhea; or swelling of the hands and feet.

Aspirin

How does it work?

Aspirin works by decreasing substances that release pain, fever, and inflammation in the body. It’s antiplatelet properties decrease the risk of blood clots and improves cirulation to the uterus.

What are the side effects?

Upset stomach; heartburn; drowsiness or headache.