Fertility Agents
TERM
□ clomiphene (Clomid)
QUICK LOOK AT THE CHAPTER AHEAD
Fertility agents are also called ovulation stimulants. Fertility agents stimulate follicle development and ovulation in functioning ovaries and are combined with human chorionic gonadotropin to maintain the follicles once ovulation has occurred.1 Gonadorelin (Factrel), a synthetic gonadotropin-releasing hormone, is a diagnostic agent used to diagnose hypogonadism in men and women. It is administered SC or IV. Chorionic gonadotropin alpha (Ovidrel) and chorionic gonadotropin (Chorex, Pregnyl) are drugs that stimulate ovulation. Clomiphene (Clomid), an ovulation stimulant, and follitropin beta (Follistim), follitropin alfa (Gonal-F), menotropins (Pergonal), lutropin alfa (Luveris), urofollitropin (Metrodin), and urofollitropin purified (Bravelle) are human pituitary gonadotropins that promote follicular maturation. Cetrorelix (Cetrotide) and ganirelix (Antagon) are gonadotropin-releasing hormone (GnRH) antagonists used to prevent premature ovulation.2
Table 60-1 Fertility Agents | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
FERTILITY AGENTS CLIENT TEACHING
Continue follow-up care with health care provider if being treated for infertility.
Teach client to monitor for therapeutic and adverse effects.
Take exactly as prescribed and follow all directions carefully.
Follow health care provider’s instructions on timing and frequency of coitus during therapy.
Keep a journal to note physical or emotional changes or related symptoms; take and record basal body temperature.
Monitor and report rapid increases in weight.
Contact health care provider if pregnancy is suspected.
Contact health care provider if experiencing abdominal pain as this could be a sign of an ovarian cyst.
Advise client that fertility agents when taken for infertility can result in multiple births.
Continue follow-up care with health care provider if being treated for infertility.
Contact healthcare provider if experiencing abdominal pain as this could be a sign of an ovarian cyst.Clomiphene (Clomid)
If a dose is missed, take as soon as remembered, or if close to next dose, double the dose.
If more than one dose is missed, contact the health care provider.
Report visual changes to health care provider.
Report visual changes to health care provider.
ACTIONNonpituitary Chorionic Gonadotropins
Chorionic Gonadotropin
Similar to luteinizing hormone (LH) in the anterior pituitary gland and acts on the ovary to induce ovulation2
Human Pituitary Gonadotropins
Menotropins (Pergonal), urofollitropin (Metrodin), and urofollitropin purified (Bravelle) are equal to the effects produced by follicle stimulating hormones (FSH) and LH and are obtained from the urine of postmenopausal women.2
Follitropin beta (Follistim) and follitropin alfa (Gonal-F) have FSH effects and are produced by recombinant DNA technology.3
Lutropin alfa (Luveris) has LH effects and is produced by recombinant DNA technology.3
Gonaditropin-Releasing Hormone (GnRH) Antagonists
GnRH antagonists block the endogenous release of LH, which prevents premature ovulation.2
Ovulation Stimulants
Clomiphene (Clomid)
Increases the release of FSH and LH from the anterior pituitary gland, which stimulates ovulation, increases maturation of ovarian follicle, and the development of the corpus luteum.
USENonpituitary Chorionic Gonadotropin
Hypogonadism, nonobstructive cryptorchidism, and stimulation of ovulation
Human Pituitary Gonadotropins
Spermatogenesis in men in combination with chorionic gonadotropin, and promotion of follicular stimulation
GnRH Antagonists
Prevention of premature ovulation
Ovulation Stimulants
Clomiphene (Clomid)
Treatment of infertility
ADVERSE EFFECTS AND SIDE EFFECTS
Fertility Agents are Pregnancy Category X, except gonadorelin (Factrel) is Pregnancy Category B, and chorionic gonadotropin alpha (Ovidrel), chorionic gonadotropin (Chorex, Pregnyl) are Pregnancy Category C.
Fluid retention, flushing, gynecomastia, headache, abdominal pain, nausea, vomiting multiple pregnancies, ovarian hyperstimulation
INTERACTIONSAll Fertility Agents
Few interactions
CONTRAINDICATIONS
