FAQ - Medications
Because the use of many over the counter medications has not been studied with fertility treatments, we recommend you take Extra Strength Tylenol, per the package instructions, for pain. If you experience any pain that is not controlled, you will want to alert our office immediately and/or be seen locally in an urgent care or ER.
Medications for the stimulation portion of the process are taken usually for 10-12 days before a trigger injection. Retrieval is typically 35 hours after your trigger.
Other medications will be taken through different parts of the process and will be stopped at different weeks of pregnancy, per your individualized treatment plan.Intralipids are a liquid emulsion of fat. It is mainly composed of soybean oil and egg fats. Intralipids can be used along with conventional fertility treatments. Researchers believe it acts to suppress the body’s Natural Killer Cells. These cells may attack the sperm or egg and possibly the cells of the developing fetus. This is an IV infusion that is performed in our office and generally takes approximately 20-30 minutes. The recommendation is to infuse Intralipids before IUI / Egg Retrieval / Embryo Transfer and weekly thereafter to 12-14 weeks gestation.
Intralipids need to be used with extreme caution in patients who have diseases that may affect the function of the liver or kidneys. These may include but are not limited to; diabetes, liver failure, hepatitis, cirrhosis, kidney disease, sepsis or metabolic disorders. People who have an allergy to soybeans or eggs are unable to receive Intralipid therapy.
As with any medication, there are side effects that may be experienced. The side effects are often related to the rate of infusion and will lessen if the infusion is stopped. The possible side effects may include; fever, chills, nausea, vomiting, headache, back pain, chest pain or difficulty breathing. If you experience any of these side effects during or after your infusion please let the nurses know. There is also the potential of an allergic reaction. Should this occur the infusion will be stopped immediately and the necessary actions will be taken to treat the reaction.
LDN is a therapy that has shown promise in a variety of health issues including infertility and other symptoms associated with PCOS. LDN boosts the immune system, the mechanism for which we do not entirely understand. LDN makes the immune system begin working at optimum levels again which includes the correction of the many imbalances which plague out body. Studies have also helped to uncover some relationships between the immune system, the hormonal imbalance of the body and the problems experienced by women with PCOS.
LDN therapy requires taking 4.5mg by mouth at bedtime. The medication will cause a blockage of endorphin receptors throughout the body, and decreases hyperfunction of microglial cells, which are supporting cells in the nervous system that regulate immune and inflammatory response. The brief blockage every night appears to be enough to effect a prolonged change in many aspects of the immune system and increases the body’s ability to heal itself.
Although LDN is noted for being side-effect free because it stimulates the body’s own mechanisms, there are clients for whom it is not well-suited especially those being treated for addictions.
LDN is ONLY available at a specialty compounding pharmacy and will not be available at your local pharmacy.
Inflammation and immune issues can be contributing factors in infertility. Dr. Kiltz always recommends adding our full immune protocol which may include Low Dose Naltrexone (considered a “miracle drug” that simply reduces inflammation,) Intralipid Infusions, Neupogen, Lovenox injections, oral prednisone, low-dose aspirin, Prograf, Plaquinil, PRP (platelet-rich plasma), and HCG washes to your cycles. Additional potential immune treatments like Humira, IVIG, and cannabinoid oil (CBD) may also be recommended.
One of the scariest parts of this process for some is the injections. While some people elect to give themselves the injections, others work together with their partner, a friend, or a family member to assist. Our nurses will provide instruction on how to self-administer injections and there are many online resources as well.
Medications used for IVF may include: Gonal-F/Follistim (FSH), Menopur (HMG), HCG-LH Supplement, Cetrotide/Ganirelix, Letrozole, Low Dose Naltrexone (LDN), Z-Pak, Prednisone, Omnitrope (HGH), Lupron Acetate Trigger, HCG Trigger, and prenatal vitamins.
Medications used for embryo transfer may include: Estrace, Z-Pak, LDN, Prednisone, low-dose aspirin, Prograf, Endometrin, Progesterone in Oil, and prenatal vitamins.
After your initial consult, medications will be prescribed for you typically within 7-14 days to whichever the least expensive self-pay fertility pharmacy is at the time. These medications can be reviewed in your patient portal. Because New York State prohibits the release of paper prescriptions, should you elect to fill any of these medications elsewhere, we request that you call the pharmacy where they were initially ordered and request they be forwarded electronically to the pharmacy of your choice. This helps to reduce duplicate medication orders which cause confusion for you, CNY, and the respective pharmacies. You will need to ensure you receive all your medications prior to calling to notify us you have started your period.
For constipation, we recommend Citrucel, Colace, Peri-Colace, FiberCon or Milk of Magnesia. We also encourage increasing your water intake.