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Medical conditions and treatments that impact on fertility

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are some of the most common medications used by women for headaches, menstrual cramps, arthritis, etc. Some examples of these medications include Aleve®, Advil®, and Naprosyn®. Use of these medications has been associated with a reduction in fertility due to a condition called luteinized unruptured follicle (LUF) syndrome (failure of the follicles to release an egg).

Valproate

Valproate is a medication used for epilepsy, a disorder characterized by seizures. Reproductive disorders tend to occur more frequently in women with epilepsy, however treatment with valproate is also associated with a negative effect on fertility. In one study of 238 women undergoing treatment for epilepsy, 45% of those taking valproate alone had menstrual irregularities. Furthermore, 43% of the women taking valproate had polycystic ovaries, and 17% had elevated levels of testosterone. Therefore, if you are currently taking valproate and are having difficulty getting pregnant, talk to your doctor about other options available to control your seizures. Do not discontinue the valproate on your own – this can be very dangerous.

Chemotherapy

Chemotherapy refers to medications used for cancer treatment. Chemotherapy can interfere with the normal functioning of both the male and female reproductive system. In women, chemotherapy can damage the ovaries or decrease the amount of hormones necessary to control the cycle. Some women who undergo chemotherapy consequently experience irregular or absent periods. This does not happen in every woman – in some cases the cycle is unaffected during chemotherapy.

Does normal reproductive function recur after chemotherapy is discontinued? The answer depends on the type of medication used, dosage, and numerous other factors. Before undergoing chemotherapy, every woman who plans to have children should discuss the impact of the specific chemotherapy drugs on their future fertility. In the future, modern advances such as ovarian tissue transplants, may offer hope for women who may lose their ovarian function due to chemotherapy.

Dopamine Agonists (metoclopramide, methyldopa, cimetidine, haloperidol)

Metoclopramide (Reglan®), methyldopa (Aldomet®), cimetidine (Tagamet®), and haloperidol (Haldol®) may interfere with fertility by causing increased levels of prolactin in the body. Too much prolactin can interfere with the normal function of the menstrual cycle by suppressing the controlled release of GnRH (gonadotropin-releasing hormone) from the brain. The result can be absent or inconsistent ovulation. If you are taking one of these medications and are having difficulty with increasing fertility and achieving a pregnancy, talk to your doctor. He/she may be able to recommend an alternative treatment or a medication that reduces the level of prolactin in your body.