Who needs fertility medications?

Infertility is the inability of a couple to conceive after 12 months of regular intercourse without the use of contraception in women under the age of 35, or after six months of regular intercourse without contraception in women under 35 years. Around 10% of women in the United States struggle with infertility, which comes to about 6 million people. So the obvious answer to “who needs fertility medications?” is “lots of people.” When a couple is having fertility issues, about ⅓ of the time it’s because of female infertility factors, about ⅓ of the time it’s male factors, and the rest of the time it’s both people or unknown. So, who are the people who can benefit from fertility medications?

Women with PCOS

Polycystic ovary syndrome, or PCOS, is a hormonal endocrine disorder that affects 5-10% of women of childbearing age. There isn’t one test for PCOS, and symptoms vary between women, so it’s believed that only 50% of women with PCOS are diagnosed. Women with PCOS experience an excess in leutenizing hormone and insulin-resistant hyperinsulinism, all of which cause the symptoms of PCOS. Ovulation often doesn’t occur, cysts form, and the menstrual cycle disappears or becomes irregular.

To treat PCOS-related fertility issues, your healthcare provider might recommend Clomid (clomiphene citrate), Metformin (a diabetes medication), gonadotropins, or a combination of medications to help regulate ovulation.

Men with low sperm count or motility

If infertility comes from the male side of the equation, it’s likely because of low sperm count or low motility. Either there aren’t enough sperm, or the sperm are moving too slowly. Sometimes these problems can’t be fixed and fertility solutions like IVF or IUI are used, but there are some medications that can help.

If sperm issues are coming from a hormonal deficiency, a healthcare provider might prescribe hormones to balance out levels in the body and hopefully improve fertility. Clomid may offer some benefit in the right male patient, but large-scale clinical trials have yet to provide sufficient evidence for routine use among infertile men.

Women with endometriosis

Endometriosis is a disorder where tissue that’s supposed to be lining the uterus grows outside of the uterus. Because of the tissue growth, endometriosis can block fallopian tubes and prevent eggs from traveling through the tubes to meet sperm. Endometriosis can also get worse with age, making it increasingly difficult to get pregnant as you get older.

For many, it’s possible to conceive naturally with endometriosis, but success rates are high with IVF, which usually comes with its own round of fertility medications to stimulate ovulation.

Cancer survivors

In men, treatments for prostate cancer can sometimes alter the hormone production in testes, which can damage sperm. Some men and women choose to freeze sperm or eggs prior to undergoing cancer treatments. If chemotherapy or radiation do impact your fertility, your healthcare provider might recommend IVF and fertility medications for ovulation. Men might have testicular sperm extraction done to take healthy sperm from the testicles to use for insemination.

The bottom line

More than 30% of the time, the cause of a couple’s fertility issues is unknown or a combination of male and female factors. Sometimes people need fertility medications and don’t fall into any of these categories, and sometimes they fall into more than one. If you think you might need fertility medications, you can work with your healthcare provider to see what treatment might be right for you.

  • Mayo Clinic Staff. “Infertility: Symptoms and Causes.” Mayo Clinic. Mayo Clinic, August 2, 2016. Web.
  • Mayo Clinic Staff. “Endometriosis: Overview.” Mayo Clinic. Mayo Clinic, August 20, 2016. Web.
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