15.07 Drugs for infertility

The first drug used to treat female infertility is usually clomiphene. The exact mechanism of action of clomiphene is not known, but it has anti-oestrogenic activity at the oestrogen receptors in the hypothalamus, which leads to reduced levels of follicle stimulating hormone and luteinizing hormone. In turn, this leads to ovarian stimulation, maturation of the ovarian follicle, ovulation and development of the corpus luteum. About 70% of women ovulate and 30% conceive after clomiphene treatment.

If clomiphene is unsuccessful in promoting fertility, a combination of hormones or drugs that mimic the effects of hormones, are used in sequence to promote the production of ovum for in-vitro fertilization, IVF (Figure 15.2).

Figure 15.2 Sequence of drugs used to produce ova for in-vitro fertilisation (Copyright QUT, Sheila Doggrell)