If you are struggling to get pregnant, it can be a difficult time, especially if the reason for the issues prohibiting conception are uncertain. Even with natural pregnancy, there is only roughly a 20% chance that sexual reproduction between a fertile woman of reproductive age between roughly 14-42 (and not premenopausal) and fertile male between the age of 14 and 50, or a donor egg and sperm in IVF (test tube fertilisation or in vitro fertilisation), will lead to a successful conception.
In conception the egg, released from the female at day 14 of her mensural cycle in response to the fertility hormones Oestrogen and Follicle Stimulating Hormone (which causes the egg to develop in the female follicles) and a serge of LH (luteinising hormone), and sperm, released from the male penis in response to a serge of Testosterone, fuse together. LH triggers testosterone production, while FSH is responsible for making the sperm. Gonadotropin releasing hormone, or GnRH, triggers LH and FSH production.
The fertilised egg then travels down the female womb fallopian tubes to the womb where it is implanted in the womb. Progesterone hormone, which helps the womb lining mature and maintains it (unless the egg doesn’t meet a sperm, by which the lining is shed in menstruation), supports the womb development into the placenta. The placenta is the sack that surrounds the female egg and sperm as the egg develops into a zygote and then embryo and then child. Genetic material is copied (DNA/RNA) to make new cells in the developing child.
What Stops Pregnancy ?
There are a number of factors which can inhibit pregnancy, from maternal or paternal age (as a female and male age the DNA in their cells decreases in quality and their fertility hormone levels decrease, making it harder to conceive a child and increasing the chance of genetic diseases such as Down’s syndrome in the child), to parental birth weight (which affects the key fertility hormones), to fertility disorders like polycyclic ovarian syndrome (PCOS) and ovarian cysts.
Pregnancy can also be inhibited by high levels of the glucose monitoring hormone, Insulin in the blood. Insulin helps to decrease blood glucose but in conditions such as diabetes type 2, where there is far too much dietary glucose, Insulin resistance occurs. This is especially common in conditions such as obesity and PCOS which are closely linked to diet. Excess Prolactin can also cause fertility issues.
What Drugs Can You Take to Improve Fertility?
These medications target:
- Increased egg production- injected Gonadotropins. These injected treatments stimulate the ovary to produce multiple eggs. Gonadotropin medications include hCG which can be directly given as (Novarel, Ovidrel, Pregnyl, and Profasi) or Gonadotropin-releasing hormone, GnRH, (Factrel and Lutrepulse) or human menopausal gonadotropin or hMG (Menopur) and FSH (Gonal-F, Follistim AQ, Bravelle).
- Insulin reduction- Metformin. This drug is used when insulin resistance is a known or suspected cause of infertility, usually in women with a diagnosis of PCOS. Metformin (Fortamet) helps improve insulin resistance, which can improve the likelihood of ovulation and egg release.
- Increased LH and FSH in women- as well as directly being given FSH, the oral drug Clomiphene citrate, Tamoxifenor Letrozole (Femara). Letrozole is usually used in women 24- 39 to increase FSH and LH. It’s usually given to women who don’t have PCOS.
- Prolactin reduction: Dopamine agonists as used to reduce Prolactin which is also associated with low fertility, such as Bromocriptine (Cycloset, Parlodel).
Are There Any Risks?
As with egg freezing where artificial hormones are given to stimulate multiple egg release, there is a risk the ovaries may swell after artificial stimulation, and this may cause ovarian hyperstimulation syndrome (OHSS) which may make your ovaries painful and swollen and cause bloating and diarrhoea. The best solution in these circumstances is to take pain killers and rest and try to avoid foods and drinks which will exacerbate the bloating symptoms.
How Can GlobMed Help?
We believe every person deserves the right to create life. We are a team of highly specialised medical consultants, with experience in the NHS and private care. We understand the trials and tribulations involved in fertility problems, and we do what we can to help protect fertility. With access to the best teams from around the world, we tailor our offering to each clients needs and budget, to ensure that we help you find the most viable treatment option for your health and future. With so many options out there, we do our research so you don’t have to, working hard to find you the best option you deserve.