Fertility Drugs and Medications: Naturopathic Treatments and Interactions in Ottawa
What are the common drugs used during fertility treatments?
The medications used during an in vitro fertilization (IVF), intracytoplasmic injection (ICSI), and Intrauterine Insemination (IUI) will vary from patient to patient based on individual cases. So will the dose of the medications given, and those doses may also change at different points of the fertility treatment cycle. There are however some common medications utilized in this process.
1. Clomiphene Citrate: commonly known as clomid, this medication works by blocking the estrogen receptors in the body. This triggers the pituitary gland in the brain to release a hormone called FSH, which stimulates follicle development. Clomid is commonly used in the treatment of polycystic ovarian syndrome.
2. Letrazole: commonly sold under the brand name Femara, this medication is usually used for polycystic ovarian syndrome as well. It works by inhibiting the aromatase enzyme in the body, which drastically reduces the production of estrogen. Similar to clomid, this in turn causes a release in FSH to help stimulate follicle growth and ovulation.
3. Ovulation stimulation medications: this includes a class of medications which mimic human Chorionic Gonadotropin hormone (hCG), and are used to stimulate ovulation in the body. hCG is similar to the LH hormone in structure, so its delivery stimulates the follicles to release eggs as well. Common names for this class of medication includes ovidrel and pregnyl.
4. Lupron and Zoladex: these medications fall in to a class called luteinizing hormone releasing hormone (LHRH) medications. They may be used in a long or short cycle. The long cycle is when you start the medication around cycle day 21 before your IVF, and the goal is to stimulate as many eggs to grow, but to prevent their ovulation. The short protocol is often used in patients with low ovarian reserve to increase their sensitivity to other fertility medications. In this case it is usually taken starting cycle day 2-3 followed by Gonal-F (FSH mimicking medication).
5. Orgalutran and Cetrotide: these medication fall in to the antagonist class, they prevent ovulation during IVF, and are usually started when the follicles are growing large and the goal is to prevent their ovulation so that they may retrieved during the retrieval process.
6. Progesterone: this can be prescribed in a gel, suppository, or intramuscular injection. After using fertility drugs, the body's ability to produce progesterone declines significantly. The supplementation with extra progesterone supports a healthy lining and supports implantation.
Are Herbs and Supplements Safe to use During Fertility Cycles?
A common myth is that because a product is natural, therefore it is safe and free of side effects. A supplement cannot have an effect on the body if it is free of side effects. Therefore, when using supplements, it is important to have an interaction check done to make sure that herbs and supplements you use are actually safe for your condition, for fertility in general, and that they do not interact with your fertility drugs. Dr. Singh, ND runs an interaction check with every patient and will advise if something needs to be discontinued and can recommend nutritional supplements that can prove beneficial during assisted fertility treatments in Ottawa.
Additional Medications Prescribed for Fertility Treatments
In addition to the above mentioned fertility medications, other medications may also be indicated or prescribed by a physician in some fertility cases. Some example of medications prescribed leading up to and during a fertility treatment can include:
Metformin: a medication used for the treatment of diabetes mellitus which helps to stabilize blood sugar levels and support sensitivity to the hormone insulin. It may be prescribed to patients that have been diagnosed with polycystic ovarian syndrome as well. This is because a factor which can worsen infertility in PCOS is poor insulin sensitivity. This can reduce your sensitivity to fertility medications, affect follicle growth and possible implantation too. Supporting the fertility treatment of PCOS with Metformin in some cases can help resume spontaneous ovulation, weight loss, and potentially improved outcomes with a fertility treatment.
Thyroid Medication: the thyroid hormone influences all aspects of fertility. Thyroid hormones are essential to support sex hormone production, follicle growth, ovulation, fertilization and support implantation for a healthy pregnancy. Usually the acceptable range for a normal functioning thyroid of a patient is broader than a patient going for fertility treatments or trying to conceive. In order to support optimal fertility outcomes some patients may be prescribed varying doses of thyroid medications. As the pregnancy continues and estrogen levels continue to increase, the thyroid function may continue to slow down, which will required graduated increases in the thyroid medication as well.
DHEA: this is a hormone produced by the adrenal gland. It may be prescribed alongside a common micronutrient, CoQ10, to help support egg quality. There are clinical studies that evaluated for the health of egg quality before and after treatment with DHEA and CoQ10 and found that when both of these treatments are prescribed, there was a significant improvement in the integrity of the follicles/egg cells. It is important to support egg quality for a treatment like intrauterine insemination (IUI) or in vitro fertilization (IVF) as the health of the eggs will affect the quality of the embryos, and better quality embryos may have a better chance of implanting and leading to a healthy pregnancy.
This information is presented for educational and informative purposes only. This is not a replacement or substitute for medical advice from your fertility doctor or physician. If you have any questions or concerns regarding fertility drugs, please follow-up with your fertility