Every year, over six million women in the United States struggle to become or stay pregnant. However, struggling with infertility doesn’t mean you’ll never have a child. At West Coast Women’s Reproductive Center in Sherman Oaks, CA, we’d like you to know that you’re not alone. Together, we can find a safe, effective solution.
What Are Ovulation Pills?
Ovulation pills, sometimes known as fertility drugs, are prescription medications designed to regulate or stimulate ovulation. They are effective to treat female infertility caused by ovulation disorders. Most of them work like your body’s natural hormones to start ovulation.
Most women take these medications because they can’t ovulate or produce eggs. However, they may also be taken to produce more eggs or higher quality eggs. Some of the most common fertility drugs include:
Gonadotropins
Gonadotropins do not promote the release of extra hormones through pituitary gland stimulation. Rather, they are injected into the ovary directly to stimulate the production of multiple eggs. This treatment is recommended if clomiphene citrate has not resulted in pregnancy within the first six months.
Clomiphene Citrate
Clomiphene citrate is an oral ovulation medication that stimulates ovulation by prompting the pituitary gland to release higher levels of LH and FSH. In turn, this stimulates the ovarian follicle containing the egg to grow. You start by taking 50 milligrams daily for five days. We recommend our clients take their first pill three to five days after their period starts.
Seven days after taking your last dose, you should begin ovulating. If you don’t, we can increase your dose to 100 mg daily next month and 150 mg daily the month after that. Most pregnancies occur within the first three months of taking this medication. If you don’t get pregnant within six months it’s possible the cause of your infertility is unrelated to ovulation.
It is possible to take clomiphene citrate even if you don’t menstruate. Taking oral progestin for five to 12 days can induce menses in anovulatory (non-menstruating) women.
Metformin
When insulin resistance is the known or suspected cause of fertility issues, we often prescribe metformin. This is common in women who have been diagnosed with polycystic ovarian syndrome. Metformin works by increasing the chance of ovulating by treating the root cause. It achieves this through increasing your body’s resistance to insulin.
Letrozole
Letrozole, commonly sold under the brand name Femara, falls under a class of drugs known as aromatase inhibitors. It has been used for years to treat breast cancer caused by excess levels of estrogen. Like clomiphene, this ovulation pill works by treating pituitary gland disorders.
Bromocriptine
Bromocriptine, frequently sold as Cycloset, is a dopamine agonist that works by ceasing the excess production of prolactin. This condition is caused by an over-active pituitary gland and is known as hyperprolactinemia. High levels of prolactin are normal in the blood after childbirth to stimulate the production of breast milk. However, hyperprolactinemia before pregnancy can prevent the occurrence of ovulation.
Alternatives to Ovulation Pills
Ovulation pills and other forms of fertility drugs aren’t right for everyone. That’s why we’re proud to offer alternative reproductive assistance services.
Intrauterine Insemination
Intrauterine insemination, also known as IUI, is one of the most common methods of reproductive assistance. During this treatment, millions of healthy sperm are positioned inside the uterus near the time of ovulation.
Assisted Reproductive Technology
Assisted reproductive technology is another common method for helping a woman conceive. This involves harvesting a woman’s mature eggs, fertilizing them in a lab dish with a man’s sperm, and implanting the embryos into the uterus once they are fertilized.
IVF is the most effective method of assisted reproductive technology. This process has a high success rate but takes several weeks and requires daily injections of hormones and regular blood tests.
How Is Female Infertility Diagnosed?
If you have been unable to conceive after a year of trying, come in for an assessment of your reproductive health and infertility treatment. Female fertility tests may include:
Ovulation Testing
Over-the-counter ovulation prediction kits and smartphone apps aren’t very accurate. We have access to the most advanced, accurate ovulation tests. We can detect the surge in LH that signals ovulation is coming soon. We can run a blood test for progesterone to determine if you are currently ovulating. Finally, we can test for other blood levels of hormones, such as prolactin. If the level of prolactin in your blood is too high, you may be unable to ovulate.
Hysterosalpingography
Hysterosalpingography involves the injection if an X-ray contrast into your uterus. From there, our fertility experts can detect any abnormalities in your uterine cavity. This test is also used to determine if the fluid passes out of your uterus and spills out of your fallopian tubes. If there is an abnormality detected, a further evaluation will be necessary. In some cases, flushing out and opening the fallopian tubes is all that is required to improve fertility.
Ovarian Reserve Testing
Ovarian reserve testing is used to assess the quality and quantity of eggs available for ovulation. This exam is helpful for women at a higher risk of a diminished egg supply, such as women who are over the age of 35.
Other Hormone Testing
Some hormone tests run are used to assess the levels of ovulatory hormones. Moreover, they measure the levels of hormones produced by the pituitary and thyroid glands that control the reproductive processes.
Imaging Tests
A pelvic ultrasound may be ordered to search for a fallopian tube or uterine disease. If nothing can be seen on a traditional ultrasound, a sonohysterogram (saline infusion sonogram) may be used to provide more details from inside the uterus.
Less Common Female Infertility Tests
In rare cases, your doctor may decide that a hysteroscopy is necessary to look for a fallopian tube or uterine disease. Genetic testing may also be used to determine if there is a hereditary condition causing infertility.
Finally, laparoscopy is a minimally invasive surgery that involves the insertion of a cannula with a tiny camera at the end. Laparoscopy is helpful in identifying irregularities of the fallopian tubes, as well as scarring, blockages, and endometriosis. It can also be used to assess the condition of the uterus and ovaries.
Symptoms of Infertility
The most obvious symptom of female infertility is the inability to conceive. Signs you are not ovulating include irregular or absent menses, a menstrual cycle that is fewer than 21 days, or a menstrual cycle that is greater than 35 days. Besides your menstrual cycle and the inability to get pregnant, there may be no other outward signs that you are suffering from female infertility.
If menses and your menstrual cycle are normal, the cause of your infertility may be the quality of your partner’s sperm. Here’s when you should seek help from a medical professional for possible female infertility:
- Up to 35 – tried to conceive for a year
- 35 to 40 – tried to conceive for six months
- Over 40 – begin testing right away
You may also need immediate testing and treatment if you or your partner are aware of fertility problems, if you have a history of dysmenorrhea or irregular menses, or if you’ve had prior treatment for cancer, endometriosis or pelvic inflammatory disease.
Why Can’t I Get Pregnant?
To conceive, every step in the process has to go smoothly. First, you need to ovulate and your partner needs to have healthy sperm. You and your partner must copulate during your fertile time of the month, which is 12 to 14 days before your menstrual cycle. Moreover, your fallopian tubes must be open and your uterus must be healthy.
Common Ovulation Disorders
Ovulation disorders account for 25% of female infertility. These disorders cause you to ovulate infrequently if you ovulate at all. Ovulation disorders can be caused by problems in the ovary or the regulation of reproductive hormones by the pituitary gland or hypothalamus. Here are a few of the most common ovulation disorders:
PCOS
PCOS, or polycystic ovary syndrome, is a medical condition that causes a hormone imbalance that affects ovulation. It is strongly linked with obesity and insulin resistance (diabetes), acne and abnormal hair growth on the body or face. It is by far the most common cause of infertility in women.
Hypothalamic Dysfunction
The two hormones produced by the pituitary gland that are necessary for stimulating ovulation each month are FSH and LH. Excess emotional or physical stress, a very low or high body weight, or a recent significant fluctuation in body weight can affect the production of these hormones. As a result, ovulation can be delayed or prevented altogether. The most common sign of hypothalamic dysfunction is irregular or absent menses.
Premature Ovarian Failure
The premature release of eggs from your ovaries may cause premature ovarian failure or primary ovarian insufficiency. Risk factors include genetics and chemotherapy. Alternatively, autoimmune responses can trigger this condition. It affects women under the age of 40 who have a reduced level of estrogen production so that the ovary no longer produces eggs.
Excess Prolactin
Certain medications may cause too much prolactin in your blood. However, medical conditions affecting the pituitary gland are the most common cause. Excess prolactin in your bloodstream can reduce estrogen production, leading to the cessation of ovulation and the inability to become pregnant.
Tubal Infertility
Damaged or blocked fallopian tubes prevent pregnancy because sperm cannot reach the egg or the fertilized egg cannot enter the uterus. The most common cause of fallopian tube damage or blockage is pelvic inflammatory disease. This infection affects both the fallopian tubes and the uterus. Chlamydia, gonorrhea and other STIs are known to cause tubal infertility.
Prior abdominal or pelvic surgery can also block the fallopian tubes. If you’ve had surgery for ectopic pregnancy, you may now suffer from female infertility caused by tubal infertility. Pelvic tuberculosis is a common cause of tubal infertility outside of the United States but is rarer within the USA.
Endometriosis
Endometriosis is a medical condition characterised by tissue growing outside the uterus that normally grows inside the uterus. The surgical removal of this excess tissue growth, or the tissue itself, can cause scarring. This scarring may prevent the union of the egg and sperm.
In other cases, endometriosis affects the uterine lining, preventing the fertilized egg from implanting. Endometriosis can also damage any healthy eggs released by the ovaries.
Schedule Your Initial Consultation Today
Millions of women struggle with female infertility every year. Fertility drugs can help. To learn more about ovulation pills, how they work and if they are right for you, contact the dedicated fertility experts at West Coast Women’s Reproductive Center in Sherman Oaks, CA today to schedule your initial consultation. We promise you will feel safe and welcome in our friendly environment. Together, we will find a way!