Many women who are having a hard time conceiving try intrauterine insemination (IUI). This procedure involves selecting the fastest sperm from a sample, and injecting them directly into a woman’s uterus. It is often recommended for those who have unexplained infertility.
While it’s possible to undergo IUI without the help of fertility medication, one way to improve the chances for a successful implantation is to take certain types of fertility medication during the period of time that one is getting IUI treatment. This is especially helpful for women who experience ovulation problems.
If you elect to undergo IUI, depending on your unique fertility, you might be prescribed one or more of the following.
Clomiphene citrate (Clomid, Serophene)
Clomiphene citrate is described as a “first line” of fertility treatment, as it’s relatively easy and inexpensive. Women take the drug orally, and it works by triggering the body to release ovulation-stimulating hormones.
Possible side effects from clomiphene citrate include hot flashes, mood changes, nausea, visual disturbances, and thinning of the uterine lining. Between 60%-80% of women will ovulate with clomid, and around half of those women will conceive. Used together, IUI and clomiphene citrate have about a 10% success rate per cycle for women under 35 who have open fallopian tubes.
Aromatase inhibitors
Aromatase inhibitors are more commonly used in breast cancer treatment, but two in particular – Letrozole and Anastrozole – can sometimes be used as an alternative to clomiphene citrate. While clomiphene citrate is extremely helpful in stimulating ovulation, it can decrease the quality of cervical fluid and the endometrium, and some women experience decreased fertility as a result. Aromatase inhibitors stimulate ovulation as well as follicular development, without the decreased fertility effects of clomiphene citrate.
Aromatase inhibitors carry less risk of a multiples pregnancy than does clomiphene citrate. Its use tends to have a lower risk of side effects than clomiphene citrate. However, there isn’t as much research available surrounding aromatase inhibitors for IUI treatment. Because of this, they aren’t usually used first or as often as clomiphene citrate.
Gonadotropins
Gonadotropins are a slightly more intensive type of fertility medication. For IUI treatment, women get daily injections of gonadotropins for 8-14 days. Once her body is ready, the woman gets an injection to stimulate ovulation. This therapy is highly effective for women who don’t ovulate, but it requires more monitoring by a provider and is usually more expensive. It also stimulates the production of more eggs than does clomiphene citrate, so it carries a higher risk of a multiple pregnancy. This treatment can be expensive, as well – it starts at about $50-75 a cycle – so this is something women should think about when they consider potential medication options.
Fertility drugs can be incredibly helpful, and may improve the chances of success for somebody undergoing IUI. They do carry some risks, however, and it’s important to remember that they’re not safe for everyone. If you’re considering IUI or taking fertility drugs with IUI, ask your provider to tell you more about how they would impact your health and fertility.
Sources
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Mayo Clinic Staff. “Female infertility: treatments and drugs.” MayoClinic. Mayo Foundation for Medical Education and Research, Jul 16, 2013. Web.
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“IUI Success Rates – Success with Intrauterine Insemination.” AdvancedFertility. Advanced Fertility Center of Chicago, 2016. Web.
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“Unexplained infertility.” FertilityAuthority. Progyny, Inc., 2016. Web.
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Richard Sherbahn. “Clomid Fertility Drug Treatment for Women.” AdvancedFertility. Advanced Fertility Center of Chicago, 2016. Web.
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Burtt Littman. “Drugs Used in the Treatment of Infertility.” MarylandCRM. The Center for Reproductive Medicine, 2016. Web.
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Sujata Kar. “Current evidence supporting “letrozole” for ovulation induction.” Journal of Human Reproductive Sciences. 6(2): 93–98. Apr-Jun 2013. Web.
