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Fertility-drugs

Fertility and Fertility Drugs

Question:
what are the social aspects of artificial insemination and fertility drugs? I'm not sure what it
means by 'social aspects' but can you help?
Answer:
Social aspects here refer to what the impact would be on society. For example, a clearer
example might be this question: how has the sexual behaviour of people changed as a re-
sult of the availability of contraception? Before the pill, a woman would only have sex if she
wanted a baby – otherwise, sexual intercourse was a high-risk activity, and with a great
possibility it would lead to unwanted pregnancy . It also leads to smaller families, as couples
could then more or less reliably plan when to have their children. This had changed the
structure of society in the Western world completely, and had lead to the sexual liberation
of women.
Artificial insemination has not had similarly huge social affects – it simply affects too few
people to be statistically significant - but it has affected a small number of families with in-
fertility problems, and as a result, these families have been able to have children. The same
goes for fertility drugs. Not a lot of women use them, but it has enabled many women who
would otherwise have been infertile, to have children. As a result, it has lead to a number of
people getting greater value from their lives, as they wanted children, but without help we-
re unable to have them.
A question like this one is not really truly scientific, as it requires you to use your imaginati-
on. The questioner wants you to think about the possible psychological affect on people this
technology could have, both on them, and on the people around them. The psychological
affect then changes how the people relate to each other, and in society.
One social aspect of this therapy is the large number of twins and triplets that result from
this – but once again, this is statistically insignificant, and does not really have much of an
affect on society at large.
Fertility Drugs
Clomiphene Citrate
Type of medication: a non-steroidal antiestrogen
How it works: tricks brain/pituitary into "thinking" that there is less estrogen around
How given: oral, started on day 3-5 of cycle
Typical dosage: 50-250 mg/day
Indications: infrequent or rare ovulation, luteal phase deficiency, to increase the numbers of eggs
Multiple pregnancies: 8%
Side Effects: hot flashes, breast tenderness, mood swings, visual problems. thick cervical mucus,
luteal phase deficiency
Long-term safety: use for more than a year may increase the risk of ovarian cancer
Human Menopausal Gonadotropins (hMG)
Type of medication: pituitary peptide hormone, usually from the urine of menopausal women
How it works: directly stimulates the ovaries
How given: intramuscular injection (1-2 times per day), repronex can be give subcutaneously
Typical dosage: 75-600 IU/day (1-8 ampules)
Indications: problems of the hypothalamus, unexplained infertility, endometriosis, ovarian stimula-
tion for IVF/ZIFT/GIFT
Multiple pregnancies: 25-50%
Side Effects: mood swings,ovarian hyperstimulation
Long-term safety: potential risk of ovarian cancer is unclear
Urofollitropin (FSH)
Type of medication: pituitary peptide hormone, from urine or though recombinant DNA technology
How it works: directly stimulates the ovaries
How given: subcutaneous injection (1-2 times per day)
Typical dosage: 75-600 IU/day (1-8 ampules)
Indications: anovulation, unexplained infertility, endometriosis, ovarian stimulation for IVF/ZIFT/GIFT
Multiple pregnancies: 25-50%
Side Effects: mood swings,ovarian hyperstimulation
Long-term safety: potential risk of ovarian cancer is unclear
Human Chorionic Gonadotropin (hCG)
Type of medication: peptide hormone from urine of pregnant women
How it works: triggers ovulation
How given: intramuscular injection before ovulation
Typical dosage: 5,000-10,000 IU, less after ovulation
Indications: used in conjunction with hMG, FSH or clomiphene to force eggs to release
Multiple pregnancies: variable
Side Effects: cramping, hyperstimulation
Long-term safety: potential risk of ovarian cancer is unclear
Bromocriptine
Type of medication: a dopamine agonist (acts like a transmitting chemical in the brain)
How it works: suppresses prolactin hormone levels and allows return of menstrual function
How given: oral, vaginal
Typical dosage: 2.5 mg twice a day/ 0.5 mg twice a week
Indications: abnormal bleeding or infertility due to elevated prolactin levels
Multiple pregnancies: no increase
Side Effects: weakness on standing, nausea, nasal congestion
Long-term safety: appears safe, should be discontinued once pregnant
Progesterone

Type of medication: a steroid hormone produced by ovary and placenta
How it works: supplements levels of hormones naturally produced in last half of the menstrual cycle and in pregnancy
How given: oral (micronized), intramuscular (in oil), vaginal
Indications: luteal phase defficiency (defficiency in progesterone action), IVF/GIFT/ZIFT
Multiple pregnancies: no increase
Side Effects: breast tenderness, tiredness, bloating
Long-term safety: appears safe, other progestin hormones have been associated with birth defects

Type of medication: a hormone produced by the brain
How it works: replaces missing hormone and allows the pituitary gland to function
How given: infusion by pump with indwelling catheter
Indications: absent periods due improper function of the hypothalamus (part of the brain)
Multiple pregnancies: no increase
Side Effects: infection of the indwelling line
Long-term safety: appears safe
GnRH Agonist

Type of medication: an analog of GnRH produced by the brain
How it works: prevents premature release of eggs (daily form), turns off the pituitary gland (monthly form)
How given: daily injection or nasal spray, monthly injection or implant
Indications: to prevent premature release of eggs for IVF/GIFT or to induce a menopause-like state to suppress
endometriosis or fibroids
Side Effects: headaches, hot flashes, bone loss
Long-term safety: safe for less than 6-9 months use, longer if estrogen is supplemented

Source: http://www.ehrig-privat.de/ueg/downloads/fertility-drugs.pdf

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