There are various factors that can influence both male and female fertility. These include nutrition, weight, lifestyle and age. Emotional factors can also play a part, as stress can be detrimental to fertility.
If a change in diet and lifestyle is not sufficient to enhance fertility, there are certain medications that may help.
Male fertility drugs
There are two main types of male fertility drug, which are human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG). These are both injectable hormones. They are used when men are not producing sperm due to a condition called primary hypogonadotropic hypogonadism.
This condition means that the testicles are not receiving the signals to make sperm, as the brain is not producing enough of the correct hormones. Treatment with gonadotropins causes the testicles to produce sperm and male sexual hormones directly, bypassing the brain.
The treatment may last for as long as six months, with two or three injections required each week.Men with fertility problems can also be treated with pulsatile gonadotropin-releasing hormones (GnRH) or the follicle stimulating hormone (FSH).
Non hormonal drugs can also be used to treat certain fertility problems in men. There is a condition called retrograde ejaculation, which causes sperm to be released into the bladder instead of the penis.
This can be caused by surgery, diabetes or medication. Imipramine can be used to close the neck of the bladder.Although fertility treatment cannot guarantee a pregnancy, the drugs used can help to increase the sperm count to 20 million or more. One study has shown that 40 per cent of couples achieved at least one pregnancy after the treatment. There may be certain side effects caused by fertility drugs. Gonadotropins can cause acne, weight gain, fluid retention and breast enlargement. The side effects will disappear after the treatment has stopped.
Female fertility drugs
Fertility drugs may be helpful for women who do not ovulate regularly. There are several drugs available, but which is the most suitable will depend on the reason for the ovulation problem.
Metformin hydrochloride is used to treat diabetes, but it can also be used to treat ovulation problems in women with polycystic ovary syndrome (PCOS). This drug can lower the blood sugar control hormone levels in the body, which can lower male sexual hormones and help the body to ovulate. Gonadotropins can also be used to treat female fertility problems. FSH and LH can stimulate the ovaries into ripening and producing eggs. They can be used by women with PCOS who have not responded to other treatment, or by women who are undergoing In Vitro Fertilisation (IVF). The FSH and LH is injected over the course of approximately twelve days, followed by an injection of hCG.
Another medication that can be used is bromocriptine. This can correct a hormonal imbalance that could prevent ovulation from occurring each month. This treatment may benefit women who have too much of the prolactin hormone, as this can reduce the levels of oestrogen. The medication is usually in the form of pills or capsules that need to be inserted into the vagina.
The success rates achieved by these drugs can vary, depending on factors such as the age of the woman and the quality of the sperm. In patients who are taking bromocriptine, figures show that between 65 per cent and 85 per cent of women become pregnant.
Some methods produce conception rates of approximately 40 per cent, and gonadotropins have a conception rate of 20 per cent to 60 per cent. There can be side effects to the treatments, such as fatigue, headaches and weight gain. Fertility treatment also increase the chances of multiple births. Studies have found that 30 per cent of pregnancies achieved with gonadotropins result in multiple births, compared to 1 to 2 per cent with natural conception.
Fertility problems are not uncommon, with one in seven couples in the UK experiencing issues. There is advice available, so anyone who is experiencing problems should consult a medical professional to discuss the options.