Fertility medication

Overview
Fertility medication may in a larger sense include any medication that enhances fertility, but in a specific sense consists of agents that stimulate follicle development of the ovary. It is a variant of assisted reproductive technology.

Agents that enhance ovarian activity can be classified as either Gonadotropin releasing hormone, Estrogen antagonists or Gonadotropins.

Gonadotropin releasing hormone
Either Gonadotropin releasing hormone (GnRH) itself or any of its agonist may be used. GnRH releases gonadotropins from the hypothalamus in the body. GnRH agonists includes i.e. Lupron.

Estrogen antagonists
Fertility medication inhibiting the effects of estrogen includes Clomiphene citrate and Aromatase inhibitors.

Clomiphene citrate
Clomiphene citrate is a SERM. It inhibits the negative feedback of estrogen and therefore stimulates ovulation.

Aromatase inhibitors
Although primarily a breast cancer treatment, aromatase inhibitors can also work as fertility medication, probably by a mechanism similar to clomiphene citrate.

Gonadotropins
Gonadotropins are the hormones in the body that normally stimulate the gonads (testes and ovaries). For medication, they can be extracted from urine or by genetic modification.

Menotropins
Menotropins are urinary gonadotropins, i.e. they are extracted from the urine.

Recombinant gonadotropins
Recombinant gonadotropins are gonadotropins created by inserting the DNA coding it into bacteriae. The bacterial DNA is then called Recombinant DNA. Examples of recombinant FSH are Follistim and Gonal F, while Luveris is a recombinant LH.

Human chorionic gonadotropin
Human chorionic gonadotropin (hCG) is normally produced during pregnancy. However, it can also replace LH as a fertility medication.

Adverse effects
Estrogen antagonists and gonadotropins may stimulate multiple follicles and other ovarian hormones leading to multiple birth and possible ovarian hyperstimulation syndrome.