When Clomid Fails

Once fertility treatments are the recommended route for conceiving a pregnancy, a woman who is experiencing ovulatory difficulty will likely begin treatment with Clomid, the most popular and successful of fertility drugs available. Should that fail, there are a number of other fertility drugs which may be considered, depending upon the situation and which drugs have been tried and found insufficient.

Used For Both Men And Women, Gonadotropins Can Help

One type of drug treatment that is used for both men and women who are undergoing fertility treatment is gonadotropins. These medications, in women, stimulate the ovaries to produce multiple mature eggs in a cycle. They also help men who have a hormonal imbalance linked to low sperm count or poor sperm quality or motility. Gonadotropins are given by intramuscular injection every evening for anywhere from 10 to 18 days. They are marketed under the trade names Pergonal, Repronex, Menogon, Fertinex, Follistim, Gonal F, Puregon, Pregnyl, Novarel, Profasi, and Ovidrel.

What Gonadotropins Do

Gonadotropins can help a woman conceive because they induce the production of several eggs in the ovaries. This type of treatment may come in the form of human menopausal gonadotropins (hMG) which consists of follicle stimulating hormone (FSH) and luteinizing hormone (LH). It is injected for seven to 12 days and will translate into a dose of follicle stimulating hormone which will prompt the ovaries to produce more than the usual single egg. Following this procedure, injections of human chorionic gonadotropin (hCG) will help the ovaries to actually release the eggs into the fallopian tubes for fertilization.

How They Are Administered

Gonadotropin treatment, in the form of hMG or pure follicle stimulating hormone (FSH) shots are given three days into the monthly menstrual cycle and continue for seven to 12 days each month, depending upon how long it takes for the eggs to mature. Frequent and close monitoring to see if the drug is working is important as are frequent trans-vaginal ultrasounds and blood tests. When the eggs are mature, an hCG injection is administered, which means there will likely be ovulation within 24 to 36 hours. Either sex at home or a scheduled IUI (intrauterine insemination) will take place.

A maximum of three to six cycles of this nature are completed and if success rates don't improve, then the dosage is increased or other types of fertilization techniques are recommended.

As With Any Drug, There Are Side Effects

As with any type of drug treatment, there are side effects from the use of gonadotrpins. Abdominal tenderness, bloating, fluid retention and weight gain along with having a hard time self-injecting the drug are frequent and common effects of using this drug. There have been some improvements with the newer and purer gonadotropins like Gonal F and Follistim which cause fewer side effects and can be injected using smaller needles under the skin.

Another effect of using fertility drugs is the very real possibility of multiple births. While having more than one baby at a time can be a blessing, multiples can also increase the risk of miscarriage or other complications.

Fertility treatments are emotionally intense and take their toll on a couple undergoing procedures. It is important to have as much support as possible during the process, knowing that the success rate is reasonable and is increasing over time as drugs and procedures improve.


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