In some cases, our infertility specialists will utilize certain medications for fertility treatments. As a leading fertility center that pushes the boundaries of fertility research and bring the results to clinical treatment, CHR has recently introduced two new fertility medications into fertility care, DHEA and G-CSF. These medications are considered experiemental, but they are currently undergoing two clinical trials. For more information on how DHEA and G-CSF may boost your chance of conceiving, please contact us.
Clomiphene Citrate (Clomid or Serophene)
Clomiphene citrate, commonly known as Clomid, is often prescribed by fertility experts for patients struggling with ovulation issues without an apparent cause. Its popularity stems from the fact that it is an oral medication, making it more convenient than most injectable fertility treatments. Clomid is relatively affordable and carries a low risk of severe side effects. However, at CHR, we approach the use of Clomid with caution, especially when used without thoroughly diagnosing the underlying cause of unexplained infertility. While Clomid may seem like a cost-effective solution, prolonged use without results can accumulate costs and delay pregnancy, a concern particularly relevant for women in their late 30s and early 40s, given the ticking "biological clock."
Instead, CHR infertility specialists only recommend Clomid when tests confirm its suitability for an individual patient, particularly in IUI (intrauterine insemination) cycles. Clomid works by stimulating the brain's hypothalamus to release pulses of GnRH (gonadotropin-releasing hormone), which then triggers the pituitary gland to produce FSH (follicle-stimulating hormone) and LH (luteinizing hormone). These hormones work in harmony to encourage the development of follicles in the ovaries, leading to ovulation. This targeted use of Clomid ensures that patients receive the most effective treatment for their specific fertility challenges.
Human Menopausal Gonadotropin (hMG)
Human menopausal gonadotropin (hMG) is a fertility medication that contains the two types of gonadotropins produced by the human body: FSH and LH. hMG contains natural FHS and LH, taken from menopausal women (which is where the name comes from). hMG does what FSH and LH do: it regulates ovulation, and encourage the growth of multiple eggs in the ovaries, in preparation for either IUI or IVF. In specific, FSH initiates the growth of follicles (fluid-filled sacks in the ovaries that contain eggs), and when these eggs in the follicles are mature, LH triggers ovulation.
hMG is taken as subcutaneous injections (injections under the skin). Patients who did not respond well to Clomid may start producing eggs with hMG stimulation, partially because it skips the intermediate step of GnRH production in the brain to produce FSH and LH. Major brand names of hMG include Repronex and Menopur.
Follicle Stimulating Hormone (FSH)
As described above, FSH is a gonadotropin secreted by the pituitary gland in the brain. FSH starts the maturation process of eggs in the ovaries. Taken as subcutaneous injections, FSH is used in IVF cycles to stimulate the ovaries so that the patient will have more than one mature egg at the time of egg retrieval. There are a number of brand names for FSH, among them Bravelle, Follistim, and Gonal-f.
Leuprolide Acetate (Lupron)
Leuprolide Acetate, commonly known as Lupron or Serophene, is a medication classified as a gonadotropin-releasing hormone (GnRH) agonist. While GnRH normally stimulates the release of FSH and LH hormones, which are essential for egg maturation, GnRH agonists like Lupron work by suppressing the release of these hormones. This suppression plays a critical role in fertility treatments, such as in-vitro fertilization (IVF).
In IVF cycles, suppressing FSH and LH may seem counterintuitive, as these hormones are needed to mature eggs for ovulation. However, this suppression is crucial to prevent premature ovulation. IVF aims to stimulate the ovaries to grow multiple eggs, while ensuring they aren't released too early. By precisely controlling ovulation timing, infertility specialists can retrieve the eggs at their optimal maturity for fertilization. Leuprolide Acetate is administered as subcutaneous injections, similar to other fertility medications.
Ganirelix Acetate (GnRH Antagonist)
GnRH antagonist is a class of compounds that suppress LH, which would normally let the ovaries to release the mature eggs in the process of ovulation. GnRH antagonists have a similar structure to GnRH (gonadotropin-releasing hormone), and bind to the GnRH receptor, thus preventing the release of LH (and FSH). GnRH antagonist, often called by its brand name Antagon, is used in IVF cycles to prevent premature ovulation during ovulation induction. Unlike Lupron, GnRH antagonists are injected toward the end of an IVF cycle, before the hCG injection. Other brand names for GnRH antagonists include Ganirelix and Cetrorelix.
Human Chorionic Gonadotropin (hCG)
hCG is similar to LH in function: hCG triggers ovulation. In assisted reproduction technologies like IUI and IVF, hCG is a one-time injection taken at a specific time. hCG injection is carefully timed by the physician, so that the eggs are released from the ovary (ovulation) when they are at just the right maturity. It is extremely important that you follow your physician or nurse's instruction as to when you should do the hCG injection.
hCG is taken as an intramuscular injection (injection into the muscle), and is sold under a few brand names, including Novarel, Pregnyl, Profasi and Ovidrel.
CHR researchers brought DHEA into fertility care in 2005, revolutionizing the treatment of premature ovarian aging (POA). DHEA improves both the quantity and quality of eggs and embryos before the patient reaches early menopause. DHEA is taken as oral tablets, from at least six weeks before the start of an IVF cycle until a positive pregnancy test. For more information about our innovative treatment protocol using DHEA for diminished ovarian reserve, don't hesistate to reach our to our center in New York City.
Granulocyte colony-stimulating factor (G-CSF) is a medication that we are using for fertility treatment in exclusively experimental setting (G-CSF has been FDA-approved for another use). CHR physicians have come to think that G-CSF may improve thin endometrium that does not respond to conventional treatment, and we are currently conducting two clinical trials to test that hypothesis. For more information, we invite you to contact our practice.
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