Infertility Treatment and Migraines

Prescription infertility medications, in general, work to trigger ovulation during a woman’s cycle. Ovulation creates the development of an mature egg. The goal is for that mature egg to be fertilized and result in a healthy, successful pregnancy. However, in working to trigger ovulation, theses prescription infertility medications can trigger and worsen migraines due to the level of hormones that they contain. This is especially true for women who have a hormonal trigger to their migraine headaches.

Prescription Fertility Medications
There are many prescription medications that reproductive endocrinologists may prescribe to help their patients achieve a pregnancy. For example, infertility medications work like FSH and LH to trigger ovulation. In the case of Clomid, a commonly used infertility medication, it increases the production of FSH and LH from the pituitary gland. Pergonal, another commonly used infertility medication, directly stimulates the ovaries and has FSH and LH in it. It is considered a human menopausal gonadotropin (hMG). Repronex is another example of an hMG. Clomid is an oral medication in contrast to the hMG medications which are injectable. All infertility medications have the risk of increasing the occurrence of migraines in the patients who take them.

Possible Treatment Options
For those of who facing infertility treatment, what can you do? You should always discuss treatment options with your health care provider and your reproductive endocrinologist. Together, they should be able to find a preventive approach to your migraines during this vulnerable time. Non-pharmacologic treatment for prevention may include biofeedback; acupuncture; physical therapy; massage therapy and stress-reduction techniques. Taking Riboflavin (B2) and Magnesium (both 400 mg total daily dose on the average) may be helpful for prevention and in general, are considered safe for pregnancy. In some cases, taking a daily prescription preventive like a Beta-blocker (common ones include Propanolol and Labetalol) may be necessary for migraine prevention. Topamax, a commonly used migraine preventive, should be avoided as it has recently been linked to an increased risk of cleft palate and has been re-categorized by the FDA to Category D instead of its former Category C pregnancy risk.

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