MEDICATIONS USED IN THE TREATMENT OF INFERTILITY

• Clomiphene Citrate (Klomen, Gonaphene, Serophene): It binds to estrogen receptors, triggers the release of FSL and LH hormones (gonadotropins) that are secreted by the pituitary gland in the central nervous system and stimulates the ovaries. This allows the development of eggs in the ovary. It has been used for this purpose for many years. Its most negative effect known is the thinning of the endometrium.  Therefore its use has been decreased in recent years. It is in tablet form.

• Letrozole (Femera): It blocks the aromatase enzyme that plays a role in estrogen synthesis. Because of this feature, it has been used widely for medical treatment of breast cancer for many years. It contributes to the development of eggs with a mechanism similar to the above. It has no negative effect on endometrium. According to latest clinical trials it has been cited as first choice medication dor ovulation induction lately. 

• hMG (Human Menopausal Gonadotrophin) (Merional, Menogon, Fostimon, Menopur): In Menopausal women, FSH and LH hormone levels are high because ovarian functions are very low. hMG is obtained from the urine of menopausal women. It has been used in the treatment of infertility since the early 1960s.

• r-FSH (Gonal-f, Puregon): After 1995,  FSH hormone was synthetically produced in the laboratory. It is now widely used alone or  in conjunction with hMG.

• GnRH-Agonist (Lucrin): It is used to decrease( supress)  FSH and LH hormone levels secreted by the pituitary gland. While daily small doses are used in IVF treatment, monthly depot forms are used in the treatment or suppression of diseases such as endometriosis and fibroid. It may increase FSH and LH levels at the first doses of the application. For this reason in some cases it is also used in the IVF treatment to trigger ovulation.

• GnRH-Antagonist (Cetrotide, Orgalutran): Reduces LH and FSH levels with initial application. In the short protocol; In addition to gonadotropin treatment it is started around the 6th day. while the follicles getting bigger, to prevent early ovulation beyond our control.

• hCG (Pregnyl, Ovitrelle).:To trigger ovulation.

• Progesterone (Progestan, Crinone gel, Prolutex): After the embryo transfer, progesterone hormone support  is required for developing embryos. The oral use of natural progesterone is not effective. Intramusculer  administration is not preferred because of pain and local irritation in the long term. It is recommended to use as either vaginal tablet or gel. Lately subcutaneous injectable form has been manufactured and marketed.