At Advanced Fertility Care, almost all IUI treatment cycles are done in conjunction with fertility drugs called ovulation induction medication. These medications are utilized in many situations and, in general, help a women to ovulate more than one egg and usually better quality eggs. There are 2 types of these drugs:
- Oral (Clomiphene Citrate Clomid® and Letrizole Femara®): oral tablets which function as estrogen antagonists (i.e. compete with estrogen for receptor sites). Use of this medication can lead to monthly ovulation for those women who normally do not ovulate on their own, ovulation of more than one egg for those women who do ovulate on their own, and better synchronization of the uterine lining.
- Note about the use of Letrizole (Femara®): We are often asked about the use of Letrizole or Femara® which works similarly to Clomid and was originally manufactured for the use in breast cancer patients. Many Ob/Gyn practitioners and some fertility specialists have chosen to prescribe this medication as first line treatment for ALL patients, rather than Clomid due to reports of fewer side effects. While it is Drs. Zoneraich and Larsen’s belief that Femara® is an excellent medication and may have some benefits over Clomid, there are some potential issues with its use. A scientific study which was performed in Canada several years ago concluded that the use of Femara® while trying to achieve pregnancy may result in an increased incidence of congenital anomalies (birth defects) in the fetus in those women who are unknowingly pregnant while taking the medication. Accordingly, the manufacturer of Femara® issued a statement to all fertility specialists across the world that the use of the medication Femara® is contraindicated when trying to conceive a pregnancy.However, in a large scale study published in, The New England Journal of Medicine in 2014, Femara was found to be a superior fertility treatment over Clomid specifically for those patients being treated for Polycystic Ovarian Syndrome (PCOS). Based on this new scientific information, at Advanced Fertility Care, we have now implemented the use of Femara as a first line treatment for those with PCOS as well as in certain other situations where Clomid may not be a suitable alternative. In order to minimize the risks of Femara’s use by our patients, and due to mainly medical-legal reasons, Advanced Fertility Care will require that patients for whom this treatment is offered, and who voluntarily agree to use this medication despite the manufacturer’s warnings, will be required to undergo a serum or urine pregnancy test on the day the medication is prescribed and will also need to read and sign specific written consent for the use of this medication which will outline its risks and potential adverse side effects.
- Injectable (Follistim®, Gonal-F®, Menopur®, Bravelle®): highly purified preparations of follicle stimulating hormone (FSH) and/or luteinizing hormone (LH) which are taken as subcutaneous or intramuscular injections. These medications provide for a much more potent stimulation than the oral ovulation medications, and as such require much more frequent monitoring.