Brand names
- Repronex, Menopur: Human menopausal gonadotropin (hMG), a mixture of luteinizing hormone (LH) and follicle stimulating hormone (FSH)
- Follistim, Gonal-F, Bravelle: Urofollitropin or recombinant FSH, pure FSH
- Pregnyl, Novarel, Ovidrel: Human chorionic gonadotropin (hCG), a "recombinant" hCG drug, engineered differently from the others
Are gonadotropins for me?
A gonadotropin can help you ovulate if you tried taking the fertility drug clomiphene, but your body didn't respond to it. A doctor might also prescribe a gonadotropin if you don't produce enough FSH and LH – the hormones needed for ovulation.
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If you're undergoing intrauterine insemination (IUI) or an assisted reproductive technology (ART) treatment, such as in vitro fertilization (IVF), a gonadotropin can help you produce several eggs for the procedure.
Do gonadotropins work for men?
A gonadotropin can help men who have a hormonal imbalance linked to a low sperm count, or poor sperm quality or motility (how well sperm move).
Read more about fertility drugs for men.
What's gonadotropin treatment like?
Gonadotropin treatment can be emotionally intense for some women if they worry about their body's response to the medication. Also, women getting gonadotropin treatment go to the doctor's office for frequent monitoring. Here's what the treatment entails:
- Produce the eggs. Human menopausal gonadotropin (hMG), urofollitropin, or recombinant FSH prompts the ovaries to produce several eggs. (You typically produce only one egg a month.) One of these drugs is injected into the muscle or under the skin. The doctor or nurse tells you which type of injection to use and how to minimize side effects, and you or your partner gives the shot. The shot is given daily, most likely starting on day two or three of your period. Most women take the injections for seven to 12 days, though if your ovaries are slow to respond, your doctor may increase your dose or have you take the shot for longer.
- Monitor the follicles. The fluid-filled sacs where eggs mature are called the ovarian follicles, and are monitored by frequent blood tests and ultrasounds. You make three or four visits to the doctor's office.
- Release the eggs. Once the follicles are big enough, the injections stop and you get a shot of hCG. This "trigger" shot tells the follicles to release the mature eggs into your fallopian tubes, which usually happens about 36 hours later.
- Time the conception. To conceive, you have sex 12 to 36 hours after the trigger shot. (If you have IUI, the procedure usually is scheduled around 24 to 36 hours after the trigger shot.) Then, if an egg hooks up with a healthy sperm on its way to your uterus, there's a chance you'll become pregnant.
How long does gonadotropin treatment take?
If you use a gonadotropin followed by intercourse or IUI, you'll give yourself shots and visit the doctor's office for frequent blood tests and ultrasounds for about two weeks before having sex or an IUI procedure.
If you take gonadotropins and have an ART treatment (such as IVF), the entire process is between three and six weeks.
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Most women go through three to six gonadotropin cycles, with or without a procedure like IUI, before moving on to IVF. Success rates don't improve the longer you take the drugs, so if you try three or more times and don't get pregnant, your doctor may increase the dose, try a different drug, or suggest another kind of treatment.
What are the risks of gonadotropin treatment?
- Conceiving multiples is the most common complication of gonadotropin treatment, even when you're monitored closely. You have up to a 30 percent chance of conceiving twins or more with gonadotropins. Of these pregnancies, two-thirds are twins and one-third are triplets. Though many couples consider this a blessing, carrying multiples increases your risk of miscarriage and other complications. If you pair timed intercourse with a gonadotropin, you may be asked to stop the injections if three or more follicles are growing to maturity or if your blood estrogen exceeds a certain point.
- Women who take a gonadotropin occasionally develop ovarian hyperstimulation syndrome (OHSS). OHSS happens when a woman produces too many eggs after taking the drug. The ovaries rapidly swell and fluid accumulates in the abdomen, or around the heart or lungs. About 10 to 20 percent of gonadotropin cycles result in a mild form of OHSS, which can cause sudden weight gain, nausea, vomiting, or diarrhea, but usually goes away on its own. In 1 to 2 percent of gonadotropin cycles, OHSS is severe enough to require hospitalization and can lead to blood clots, kidney problems, or very rarely, death.
- You may notice breast tenderness, rash or swelling at the injection site, bloated abdomen, or mood swings.
On the bright side: Contrary to what some researchers thought years ago, recent studies have found that taking fertility drugs such as gonadotropins doesn't increase your risk of ovarian cancer.
What's the success rate of gonadotropins?
The pregnancy rate for gonadotropins with timed intercourse is 15 percent per cycle. If you do get pregnant, you have a 30 percent chance of conceiving twins or more. Your individual chance of delivering a baby depends on several factors, including your age and the quantity and quality of your partner's sperm.
How much do gonadotropins cost?
In the United States, expect to spend $1,000 to $5,000 per treatment cycle of gonadotropin, depending on your dosage and how long you need to take the shots. (This estimate doesn't include the office visits, blood tests, or ultrasounds.) If your insurance doesn't cover this treatment, you may have to pay the cost up front.
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Learn more about handling the cost of fertility treatment.
See therapists' top 10 tips for coping with a fertility problem. Also, visit the BabyCenter Community to discuss gonadotropins and other fertility drugs.
