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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Infertility Agents - LiverTox - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]">
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<meta name="citation_title" content="Infertility Agents">
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<meta name="citation_publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases">
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<meta name="citation_date" content="2017/07/19">
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<meta name="description" content="Infertility affects at least 10% of couples and the rate may be increasing as women in developed countries delay childbearing until later in life. The source of the infertility is primarily the woman in one-third, the man in one-third, and both in one-third of couples. Management and treatment of infertility usually begins with diagnosis of the cause. In some instances, infertility is not correctable, but in many, fertility can be corrected or improved in part by hormonal or antihormonal therapies and assisted reproductive techniques.">
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yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK548308_"><span class="title" itemprop="name">Infertility Agents</span></h1><p class="fm-aai"><a href="#_NBK548308_pubdet_">Publication Details</a></p></div></div><div class="body-content whole_rhythm" itemprop="text"><div id="InfertilityAgents.OVERVIEW"><h2 id="_InfertilityAgents_OVERVIEW_">OVERVIEW</h2><p>Infertility affects at least 10% of couples and the rate may be increasing as women in developed countries delay childbearing until later in life. The source of the infertility is primarily the woman in one-third, the man in one-third, and both in one-third of couples. Management and treatment of infertility usually begins with diagnosis of the cause. In some instances, infertility is not correctable, but in many, fertility can be corrected or improved in part by hormonal or antihormonal therapies and assisted reproductive techniques.</p><p>Anovulation in women is perhaps the single most common cause of infertility in women and can be modulated by pharmaceutical approaches. Induction of ovulation can be stimulated by antiestrogens (clomiphene, tamoxifen) or by administration or stimulation of follicle stimulating hormone (FSH) with or without luteinizing hormone (LH) and human chorionic gonadotropin (hCG). Drugs for infertility are very rare causes of drug induced liver injury, but may be associated with liver abnormalities as a part of the ovarian hyperstimulation syndrome (OHSS). The following agents are discussed in LiverTox:</p><ul><li class="half_rhythm"><div>Antiestrogens</div><ul><li class="half_rhythm"><div>
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<a href="/books/n/livertox/Clomiphene/?report=reader">Clomiphene</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/livertox/Letrozole/?report=reader">Letrozole</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/livertox/Tamoxifen/?report=reader">Tamoxifen</a>
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</div></li></ul></li><li class="half_rhythm"><div><a href="/books/n/livertox/Gonadotropins/?report=reader">Gonadotropins</a>
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<ul><li class="half_rhythm"><div><a href="/books/n/livertox/Gonadotropins/?report=reader">Human Chorionic Gonadotropin (hCG)</a></div></li><li class="half_rhythm"><div><a href="/books/n/livertox/Gonadotropins/?report=reader">Follicle Stimulating Hormone (FSH)</a></div></li><li class="half_rhythm"><div><a href="/books/n/livertox/Gonadotropins/?report=reader">Luteinizing Hormone (LH)</a></div></li><li class="half_rhythm"><div><a href="/books/n/livertox/Gonadotropins/?report=reader">Gonadotropin Releasing Hormone (GnRH)</a></div></li></ul></div></li></ul></div><div id="InfertilityAgents.ANNOTATED_BIBLIOGRAPHY"><h2 id="_InfertilityAgents_ANNOTATED_BIBLIOGRAPHY_">ANNOTATED BIBLIOGRAPHY</h2><p>References updated: 19 July 2017</p><ul class="first-line-outdent"><li><div class="bk_ref" id="InfertilityAgents.R1">Zimmerman HJ. Hormonal derivatives and related drugs. In, Zimmerman, HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999: pp. 555-88.<div><i>(Textbook of hepatotoxicity published in 1999 mentions that clomiphene has been linked unconvincingly to one case of hepatoblastoma [in a child born to a woman who received clomiphene] and one adenoma; gonadotropins and fertility agents are not discussed).</i></div></div></li><li><div class="bk_ref" id="InfertilityAgents.R2">Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013.<div><i>(Textbook on hepatotoxicity; gonadotropins and fertility agents are not discussed).</i></div></div></li><li><div class="bk_ref" id="InfertilityAgents.R3">Schimmer BP, Parker KL. Contraception and pharmacotherapy of obstetrical and gynecological disorders. In, Brunton LL, Chabner BA, Knollman BC, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill, 2011, pp. 1833-52.<div><i>(Textbook of pharmacology and therapeutics).</i></div></div></li><li><div class="bk_ref" id="InfertilityAgents.R4">Levin ER, Hammes SR. Estrogens and progestins. In, Brunton LL, Chabner BA, Knollman BC, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill, 2011, pp. 1163-94.<div><i>(Textbook of pharmacology and therapeutics).</i></div></div></li><li><div class="bk_ref" id="InfertilityAgents.R5">Drugs for ovulation induction. Med Lett Drugs Ther 2011; 53 (1376): 86-8.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/22033212" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22033212</span></a>]<div><i>(Concise review of the efficacy and safety of drugs used for ovarian induction mentions that common side effects of clomiphene are hot flushes, gastrointestinal upset, headache, breast discomfort and uterine bleeding. Side effects of FSH, LH and hCG include injection site reactions, headache, abdominal pain and nausea; in addition, clomiphene, FSH and LH have been linked to the ovarian hyperstimulation syndrome [OHSS] which can be severe and even fatal; no mention of ALT elevations or hepatotoxicity).</i></div></div></li></ul></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK548308_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Update: <span itemprop="dateModified">July 19, 2017</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div></div><h3>Publisher</h3><p><a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Infertility Agents. [Updated 2017 Jul 19].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/livertox/Inebilizumab/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/livertox/Infigratinib/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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