Mother's Little Helper by David Constantine Fertility medications can make your dreams come true print article      send to a friend

"I would run through the Wal-Mart parking lot naked if it would help me get pregnant," says Erica, a 27-year-old schoolteacher. Erica is not alone in her feelings about having a baby. Many women, from all walks of life, have suffered the heartbreak of fertility problems. And many seem willing to try anything. For some, the answer may lie in fertility medications designed to stimulate ovulation, and end, god willing, in a pregnant, fully clothed woman walking through Wal-Mart.

The most popular of the fertility drugs is clomiphene (brand names Clomid, Serophene, and Milophene). Clomiphene is taken in pill form. Like other fertility drugs, it works by telling a woman's glands to produce more FSH (follicle stimulating hormones), which induce ovulation, says Dr. Benjamin Gocial, MD of the Women's Institute for Fertility, Endocrinology, and Menopause in Philadelphia. Clomid costs ten dollars a pill, and is taken for five days per cycle.

These medications are intended for women who ovulate irregularly or not at all. "Clomid will induce ovulation and correct the ovulation problem in about 80% of such patients," notes Dr. Gocial. "Pregnancy is a different issue."

With Clomid, most women can expect to get pregnant within three to six cycles. If you monitor the cycles carefully, and are not pregnant by the sixth cycle, consider moving on to stronger medications like gonadotropins.

The Next Level : The Injectibles

Gonadotropins, or human menopausal gonadotropins (hMGs), are purified LH (luteinizing hormones) and FSH. These drugs are injected, instead of swallowed, and are more potent and effective. They are also much more expensive. The minimum cost for the injectable gonadotropin medications is $1,000 per cycle. HMGs come in different forms for different fertility problems. Some commonly used injectible FSH Brand Names are Metrodin, Fetinex, Follistim, Gonal F, Pergonal, Humegon, and Repronex. With these drugs you should expect a pregnancy within 2, 3, or 4 cycles.

Side Effects

Fertility drugs alter the body's natural balance of hormones, and as a result, women undergoing these types of treatments should expect some side effects. "With Clomid, the side effects may include breast tenderness, abdominal bloating, pelvic discomfort from the enlarging ovaries, nausea, visual disturbances in the form of double vision or spots before your eyes or blurred vision, and hot flashes," says Dr. Gocial.

Erica concurs. " I have hot flashes (mainly at night), my side hurts during ovulation, and I have mood swings that could kill. I'm happy one minute, and yelling or crying the next."

Multiple Births

Multiple births are a concern when using any fertility drug. This occurs when a woman releases more than one egg during ovulation and they are fertilized together. It's troublesome because it can lead to dangerously low birth weights and developmental problems.

Cases of multiple births have received much media attention. Susan Treiser, MD, PhD, of IVF New Jersey, says the risk is not as pronounced as some would believe. "With Clomid, the chance of getting pregnant is only ten percent per cycle. The risk of multiples is about five percent of that ten percent. The vast majority of multiple births are twins." So what about the stories of women having quints and quads and the like, thanks to fertility drugs? "It is a very small percentage that have them. The really unusual cases are the ones that make the news."

The possibility of negative long-term side effects associated with the use of fertility medication is an issue of debate within the medical community. Studies have not linked any medications to ovarian cancer, but it should be noted that there has not been a significant long-term study completed on the topic. According to Dr. Gocial, "Some question whether there is an association between ovarian cancer and these medications, but this really has not been demonstrated."

With many different factors determining whether or not fertility medication is proper or needed, your best bet is to ask a fertility specialist questions that relate specifically to your case.