My IUI Medications

Intrauterine insemination (IUI), like most other fertility treatments, typically relies on medications to stimulate the production and release of eggs. Usually, Clomid (or its generic version clomiphene citrate) is the first drug prescribed to women who do not ovulate regularly. It is inexpensive and often effective. However, not everyone responds to it or can tolerate its side effects. In such cases, Clomid can be replaced with injectable medications to encourage the formation and ovulation of eggs.

Clomid (clomiphene citrate) is taken orally for 5 days, starting on day 3, 4, or 5 of a patient’s menstrual cycle. The usual starting dose is 50 mg but can be increased as needed (usually in increments of 50 mg) if ovulation fails to occur. Note that ovulation success rate is quoted to be as high as 60–80%, but the rate of successful pregnancy post ovulation is only half that.

Multiple treatment cycles with Clomid might be necessary to achieve pregnancy, and taking the medication for more than six months is not recommended. In such cases, your OB/GYN or reproductive endocrinologist will likely recommend an injectable medication.

The most common side effects of Clomid are mild and include mood swings, hot flashes, headache, nausea, and bloating. Severe side effects include ovarian hyperstimulation syndrome and certain vision problems (e.g., delayed images, blurred vision, sports, or flashes) that may not disappear after discontinuation of the drug. Since I experienced rare but severe vision impairment while taking Clomid (read more at “IUI #1: The Clomid Experience”), my reproductive endocrinologist suggested I switch to injections of Menopur.

Menopur and Sodium Chloride Vials

Unlike Clomid, which is a synthetic medication stimulating the ovaries by acting on the body’s own hormones, Menopur is a gonadotropin containing follicle stimulating hormone (FSH) and luteinizing hormone (LH), which are identical to the hormones produced by the pituitary gland. The medication comes in powder form and, mixed with sodium chloride, is administered via subcutaneous injection in the belly.

The side effects I experienced while on Menopur were bloating, constipation, weight gain, and mild pain at the sites of injection. Other reported side effects include headache, nausea, cramps, abdominal discomfort, and dizziness among others. Blood clots and ovarian hyperstimulation syndrome are also a possibility.

Despite the host of possible side effects, the pregnancy success rate of IUI cycles using Menopur are higher than when using Clomid due to the production of a greater number of eggs. With that, however, comes the risk of multiple pregnancy, which should not be discounted.

Immediately after IUI, and for a couple of more months in the event of a successful pregnancy, your reproductive endocrinologist might instruct you to take progesterone in order to maintain thick uterine lining and thus avoid a possible miscarriage. My doctor prescribed Endometrin for me. It comes as vaginal inserts that are to be applied twice or trice daily.

Sometimes it is difficult to distinguish which symptoms are to be attributed to pregnancy and which to Endometrin, but since I’ve used the vaginal inserts during four IUI cycles and have been pregnant only once, I can report that Endometrin (and not pregnancy) caused me to feel heightened fatigue, irritability, mood swings, insomnia, and bloating. Other possible mild side effects include headache, nausea, breast tenderness, stomach pain, and vaginal discomfort.

In general, as it is true with most medications, a doctor would not prescribe a drug unless he/she sees it as more beneficial than harmful. Furthermore, the side effects of IUI medications are dwarfed in severity when compared with the discomforts and body changes that women undergo during pregnancy. Thus, do not let the list of possible side effects prevent you from attempting an IUI. The aches and inconveniences are a small price to pay for a pregnancy.