KatCarney

THE MEDICAL FRONTIER OF CONCEPTION:
Doctors Using Non-Fertility Drugs to Treat Infertility



(November 14, 2002) According to the Society of Reproductive Medicine, infertility affects about 5.3 million Americans or nine percent of the reproductive age population. Eighty to ninety percent of these people are treated with common fertility drugs such as Clomid, Pergonal and Metrodin. Yet, experts are finding that increasing amounts of women are not responding to these drugs, and some of those that do, are experiencing adverse side effects. Dr. Randy Morris, Chicago-based reproductive endocrinologist and fertility expert, has been giving infertile women a new choice of medical therapy, using non-fertility drugs to treat infertility which has proven time and again to be quite successful.

Dr. Morris states, "For years the first line of drug treatment for infertility has been clomiphene citrate (also known as Clomid or Serophene) Yet, these days I see that more and more women are unresponsive to or have adverse effects from these drugs. Several drugs on the market today that have been approved by the FDA for other uses are proving to be highly successful in treating infertility." Commonly called off-label indications, the following drugs have been approved for medical use in treating breast cancer, prostate cancer and diabetes, but are allowed to be used by a physicians for anything he/she deems fit; in this case infertility.

Letrozole (Femara) Initially approved for treating breast cancer, Letrozole has recently been found to induce ovulation. An aromatase inhibitor (aromatase being the enzyme the body uses to form estrogen), Letrozole lowers the estrogen levels in the body to a very low point as to fool the pituitary gland into thinking there is a deficiency. At this point the pituitary gland releases more hormones that stimulate the ovaries to produce more eggs, in turn, enhancing a woman's chances of conceiving. Studies have shown that about twenty percent of patients taking Letrozole for infertility will become pregnant.

TZDs (Thiazolidinedione) More commonly known by their trade names Avandia and Actos, these drugs are FDA approved to treat diabetes resulting from insulin resistance. Insulin resistant women have an impaired ability to ovulate. Insulin resistance in women is commonly found in overweight women and women with a very common ovulation problem called polycystic ovary syndrome (PCOS). By using the aforementioned drugs, women are improving their ability to ovulate without the need for traditional fertility medications, hence increasing their odds of becoming pregnant and without the increased risk of multiple pregnancy. Experts have found that women with insulin resistance, who do not respond to Clomid, may respond better when treated with TZDs.

Lupron Used ninety-five percent of the time in in-vitro fertilization (IVF) patients, Lupron is very similar in structure to GnRH or gonadotropin releasing hormone, a naturally occurring hormone in the body produced by the hypothalamus in the brain. Originally approved by the FDA for prostate cancer and then for endometriosis, Lupron inhibits the hypothalamus, which in turn inhibits the pituitary gland from secreting LH and FSH hormones, primarily preventing pre-mature ovulation. Preventing ovulation allows doctors to retrieve eggs directly from the women's ovaries at the appropriate time of the IVF treatment.

All of the preceding drugs have been approved for medical use in the United States by the Food and Drug Administration. There has been some controversy over whether these drugs should be used for infertility as they have only been approved for specific uses pertaining to breast cancer, diabetes and prostate cancer. Dr. Randy Morris has used all three of these medications successfully to treat patients affected by infertility. In his ten years of practice, Dr. Morris has found that each patient's case is unique and requires a specific course of action. Not all approved fertility medications work for everyone. If given the option, why not try every possible treatment that would enhance a woman's chance of becoming a mother.

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