Sex, Drugs, Rock and Roll....

Back in high school I was the well-behaved, straight A student, Eagle Scout, nice boy who would never do drugs or drink…so of course, no girl would give me the time of day. My wife believes that the real cause of my high school social isolation was the fact that I was a science fiction fan who went to science fiction conventions and had dinner with noted authors like Hal Clement (my high school chemistry teacher), Larry Niven, Isaac Asimov to name drop a bit… She reminds me that this part of my history was kept concealed along with the Monty Python memorization issue until well after we were married. Right now my old high school (Milton Academy) has been in the news because of a sex scandal involving hockey players, a young girl and well….you can guess the rest (or check out the book now available about the whole mess: www.washingtonpost.com). Needless to say this was not my experience at Milton Academy.

So are drugs always bad? Yes, as far as my teenage son is concerned but for fertility patients drugs can be very helpful. Although we can perform IVF without medications (Natural Cycle IVF) most programs use fertility medications to increase the odds of success. The same is true for cycles of IUI (intrauterine inseminaton). Here then is today’s Question of the Day from 100 Questions and Answers about Infertility the book that contains no information about the Milton Academy sex scandal.


42. Which fertility drugs are used with IUI, and why are they used if I already have normal periods?


IUI can produce fair success rates when combined with fertility drugs. Many studies show superior pregnancy rates when IUI is combined with either Clomid or injectable gonadotropins, as compared to using these medications alone. For this reason, most infertility experts will recommend IUI to their patients when treating them with fertility drugs. In women who fail to ovulate regularly, the goal of drug therapy is to induce the growth and release of a single mature egg. This treatment is known as ovulation induction. In contrast, the treatment goal for women with regular menstrual cycles is to induce the growth of multiple follicles with the subsequent release of multiple eggs. Hence the term superovulation (also called controlled ovarian hyperstimulation) is used to describe this situation. During a cycle of superovulation and IUI, the goal is to develop 3 to 5 mature follicles, whereas the goal in an IVF cycle is 10 to 15 mature eggs. Clomid is the fertility drug of first choice for both ovulation induction and superovulation with IUI. Women who fail to respond to Clomid or who fail to conceive may be candidates for treatment with injectable fertility medications (gonadotropins) combined with IUI. In some cases, it is best to skip the treatment with Clomid and instead proceed directly with gonadotropin therapy; this decision depends on the severity of the couple’s infertility situation. In women who have normal, regular ovulation and menstrual cycles, it would appear on the surface that IUI alone without fertility drugs would be as successful as IUI with fertility drugs. Unfortunately, this simply is not the case. Instead, the combination of IUI and fertility drugs to induce superovulation yields a synergistic benefit over either treatment alone.