Drug for infertility
Human Chorionic Gonadotropin (hCG)
A hormone produced by the placenta identical in action to the luteinizing hormone (LH) Promotes follicular maturation and ovulation Adverse effects: Ovarian hyperstimulation Dosage: IM 1 day after completion of menotropin treatment 7-9 days after completion of clomiphene treatment
Example of Dopamine Agonists
Cabergoline
Drugs that stimulate ovulation
Human chorionic gonadotropin (hCG)
menotropins [Repronex]
- Also known as human menopausal gonadotropin; [Usually administered in conjunction with human chorionic gonadotropin (hCG)] - Consist of equal amounts of LH and FSH - Promotes follicular maturation and ovulation - Used when gonadotropin production by pituitary is insufficient - Adverse effects: Ovarian hyperstimulation syndrome - Administered 9-12 days (subQ or IM) to promote follicular maturation...24 hrs after last dose, inject hCG (IM)
Drugs that promote follicular maturation
- Clomiphene - Menotropins - Follitropins - Lutropin alfa
Gonadotropin-Releasing Hormone Antagonists
- Used to prevent premature surge of endogenous LH in women undergoing controlled ovarian stimulation - Prevent LH release & eliminate chance of premature ovulation - Administered subQ daily beginning in the early follicular phase until day of hCG administration
Drugs for Endometriosis
- Used to relieve pain - Gonadotropin-Releasing Hormone Agonists - Leuprolide [Lupron Depot]- IM - Nafarelin- nasal spray teratogenic results in bone loss limit treatment to six months - Danazol- more adverse events; rarely used
Drugs that prevent premature ovulation
- ganirelix - cetrorelix
Examples of Gonadotropin-Releasing Hormone Antagonists
- ganirelix -cetrorelix
Dopamine Agonists
- inhibit prolactin secretion - Treat Hyperprolactinemia (excessive prolactin secretion) - Used to correct amenorrhea and infertility (associated with excessive prolactin secretion) - Monitor prolactin levels monthly to determine success of treatment - Results in normalization of menstrual cycle & return of fertility
clomiphene [Clomid]
- used to promote follicular maturation and ovuluation...blocks receptors for estrogen...which stimulates an increase secretion of LH & FSH - Should be avoided in pregnancy...so verify before beginning drug therapy - Ovarian effects are monitored by serial ultrasound exams - Dosage - administer for five days
Adverse effects of clomiphene [Clomid]
- vasomotor responses (hot flashes) - visual disturbances (blurred vision) - multiple births (usually twins) - ovarian hyperstimulation (severe abdominal pain)