Some couples struggle to conceive, and hormone therapy is sometimes necessary especially after a long period of failed attempts at having a baby. Given the advantages that hormone therapy can provide, this is a relatively common and preferable treatment option, even in the Philippine setting.
The medicine used to treat infertility is contingent on the phase of infertility treatment cycle a patient is undergoing. The treatments applied for patients undergoing ovulation induction are different from what is appropriate for those undergoing assistive reproductive technology.
During the first thirteen days of the menstrual cycle, women are in the follicular phase. At this time, the ovarian follicles produce a single mature egg to be released at ovulation. If warranted, a woman can be prescribed follicle-stimulating hormone (FSH) for injection, which helps to stimulate follicular development.
The interplay between a woman’s hormones during the follicular phase is a delicate balance. Another hormone, estradiol is also released during this time, and can trigger a premature surge in luteinizing hormone (LH), causing early ovulation. Timing is of the essence, so an injection of cetrorelix acetate may be indicated to delay the LH surge until the follicles have matured.
Around the eleventh day of her menstrual cycle, a woman who has problems related to ovulation may receive a single treatment of chorionic gonadotropin alfa injection, to mimic an LH surge, resulting in the final step of follicular maturation and subsequent ovulation.
Once ovulation has been triggered, insemination must now take place. Patients who do not require in-vitro fertilization but need assistance can rely on intrauterine insemination, a common form of artificial insemination used in the Philippines and around the world.
During the luteal phase of the menstrual cycle, which follows the follicular phase, the woman’s body begins releasing progesterone. Once an embryo has been successfully created, the mother’s uterus must be prepared to receive and maintain a developing fetus. This is the primary function of progesterone.
For women with low progesterone levels, their uterine endometrium may be inadequate to sustain a pregnancy, so progesterone supplements may be indicated. For patients undergoing IVF, supplements may continue after embryo transfer until the placenta has developed sufficiently and is able to produce progesterone on its own.
As an adjunct to in-vitro fertilization, medical advances in hormone therapy have increased IVF success in the Philippines. For women who may have lost hope, they now have something to look forward to.