Injectable fertility medications can often help women ovulate when oral fertility medications fail.
When oral medications fail to induce ovulation, such as in Clomid-resistant PCOS patients, or when a more robust ovarian response is desired, injectable fertility medications are the next step.
All of these products contain FSH, follicle stimulating hormone.
Injectable fertility medications usually require close monitoring with ultrasounds and hormone levels, are more expensive, and are more infrequently stocked by local pharmacies. These hormones were traditionally extracted and purified from the urine of menopausal women, but today we have recombinant options entirely produced in the lab. Because the natural balance of the brain and the ovary is overcomed by the direct injection of FSH, these powerful medications often result in multi-follicular development and the release of several eggs, resulting in higher pregnancy rates (20-25%) but also higher multiples (20-30%). About 80% of the multiples are twins. The incidence of ovarian hyperstimulation (OHSS) is more frequent than with pills, but lower than that seen in IVF cycles.
Common brand names for FSH are Bravelle, Follistim and Gonal-f. Menopure contains LH in addition to FSH. Because of the high cost of these medications and the additional monitoring that they require, these cycles are expensive, ranging from $1300 – $2500.