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Author: Admin | 2025-04-28
Gonadotropin therapy a few days into their menstrual cycle and to follow up with their clinic routinely for dose adjustments if needed based on serum estradiol levels and ultrasound follicle measurements. Once a follicle appears to be mature, they may be instructed to inject human chorionic gonadotropin (hCG) on days 7, 10, and 13 following ovulation, which acts similarly to LH as an ovulatory trigger. A few products available include Pregnyl, Novarel, Ovidrel, or generic hCG. Sometimes ovulation induction is all that is needed, but oftentimes couples will go on to pursue an intrauterine insemination (IUI) or a complete assisted reproductive technologies (ART) regimen. A concern to be aware of when using infertility medications is the risk of multiple births, which is Again, infertility protocols will vary based on who you ask and where you are in the world. In countries outside of the U.S., pulsatile administration of gonadotropin-releasing hormone (GnRH) is indicated for some types of infertility and is given via infusion pump. GnRH triggers the production of FSH and LH. In the U.S., injectable GnRH agonists (i.e., Lupron) and GnRH antagonists (i.e., Ganirelix, Cetrotide) are commonly used as adjuvant therapy. The goal is to allow for lower doses of overall gonadotropin therapy and prevent an LH surge (with subsequent early release of an egg). However, the data to draw conclusions on this as adjuvant therapy is limited. Estrogen and progesterone therapies are frequently added in more complex ART regimens to mimic the hormones of maintaining a pregnancy. Prior to any of the medications mentioned above, you may also see metformin used in PCOS patients or bromocriptine used in hyperprolactinemic patients for ovulation induction. The graphs below provide a general understanding of the hormone patterns required to induce and maintain a pregnancy, which helps provide a reason for the medications used. Image courtesy of Harvard UniveristyInfertility journeys can be long and difficult. It is important for pharmacists to encourage individualized medication therapy to promote the best outcomes. Please refer to the table below for some advantages and disadvantages of the most commonly used infertility medications. Table of Infertility Medications
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