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There are so many different fertility medications out there that it is difficult to know what purpose they all serve. What are gonadotropins, and what are they used for?

What do gonadotropins do?

Gonadotropins are protein hormones, including hormones vital to fertility: Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), and human Chorionic gonadotropin (hCG). Artificially produced gonadotropins are used as fertility medications, and may be [prescribed to women who have a luteal phase defect, Polycystic Ovary Syndrome, or have unexplaned infertility. Women who do not ovulate, or do not ovulate regularly, are usually prescribed Clomid (clomiphene) to start with. Compared to Clomid, gonadotropins carry a larger risk of a condition called Ovarian Hyperstimulation Syndrome, and that is why Clomid is offered first. Gonadotropins may be used as an alternative treatment where Clomid was not successful, as well as in cycles of Intrauterine Insemination (IUI).

Ganodotropins are also used to stimulate as many follicles as possible for women who are about to undergo IVF treatment. These medications come in the form of injectable fluids, and they are self-administered by patients who use them after they receive instructions from their healthcare team. Usually, a combination of two gonadotropins are used FSH and hMG (human menopausal gonadotropin). Once the follicles are mature, something your healthcare team will be closely monitoring during the first half of your cycle, an injection of hCG usually induces ovulation within a day. These fertility medications can be used for three to six cycles in most cases, but the risks vs benefits should always be discussed with your fertility clinic.

Gonadotropins, their cost and side effects

Here's a quick list with the names of various gonadotopins:

  • Fertinex, Follistim, Gonal F, and Puregon are all FSH-only medications.
  • Novarel, Ovidre , Pregnyl and Profasi are hCG medications.
  • Menogon, Pergonal and Repronex are combanations medications containing FSH and luteinizing hormone.

The side effects of gonadotropin-containing medications differ depending on which particular drug you are using, as well as individually. They all have one thing in common, however injecting medications into yourself (or having your partner do it) is quite a scary process for many women. At first, they may experience difficulty with this. Along with giving yourself the shots, you will also require monitoring by your doctor or fertility clinic, making these fertility medications a very time-consuming process. Physically, bloating, fluid retention, weight gain and abdominal soreness are the top side effects.

There is also a slight risk of OHSS, Ovarian Hypertstimulation Syndrome. This is a much feared side effects, but OHSS is actually quite rare (happens in one percent of cases) and where it does occur the symptoms are not necessarily as heavy as you may expect. Discuss the risk of OHSS with your doctor before commencing treatment.

Gonadotropins also carry a slight risk of ectopic pregnancy, where the embryo implants outside of the uterus. In most cases, this means that the embryo would settle in one of the fallopian tubes. Ectopic pregnancies cannot be carried to term and often need to be removed surgically. Ovarian twisting, which is pretty much what it sounds like, is another possible side effect.

Another "risk factor" that comes with using gonadotropins is also a benefit for some couples who have been trying to get pregnant for a long time, and have had no success. These fertility medications increase your odds of having twins quite significantly by between 10 and 40 percent! Now for the scary stuff. There are some speculations that gonadotropins are linked to ovarian cancer.

At this point in time, research into the truth of this is ongoing. Should you let go of any worries just because science has not proven the theory that gonadotropins cause cancer? Only you can decide this. It is something you should certainly keep in mind and ask questions about, however. How about the cost of using gonadotropins? This does, of course, vary a lot depending on your country and your insurance policy. In the United States, the cost is between $2,000 and $5,000 per cycle of gonadotropins, but that does include all the monitoring visits. If you are lucky, your insurance will cover some of that.

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