Fertility Medication Questions

Can Depo-Provera cause infertility?

Depo-Provera only reduces your fertility if your periods don’t come back for a while after stopping it. It sounds like your periods started back right away, so your fertility should be back to normal. Most couples get pregnant in the first year of trying (about 85%) and it can still happen naturally in the second year, but this is a good time to see a Fertility specialist (Reproductive Endocrinology and Infertility or REI MD) to help you to get pregnant.

How long it takes depends on many factors, including your age. We can check for hormonal problems, low egg supply (diminished ovarian reserve), blocked tubes, problems inside the uterus like polyps or fibroids, or sperm problems. 40-50% of couples who aren’t getting pregnant easily have a sperm problem – this can be the only issue, or occur along with other problems on your side. After testing for fertility issues, your doctor can come up with individualized treatment options to help you get pregnant.

Does taking the birth control pill affect your tolerance for alcohol?

Current research (in contrast to some older studies) suggests that birth control pills and even changes in natural hormones over the menstrual cycle have very little to no effect on alcohol metabolism.

Different people having different responses to drinking alcohol can be due genetic variations in two enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). A fast ADH enzyme or a slow ALDH enzyme can cause toxic acetaldehyde to build up in the body, creating dangerous and unpleasant effects. These variations may affect a person’s risk for alcoholism, though there are many other factors.

You probably have enzyme variants that give you more unpleasant effects than ‘average’. You don’t need to get your liver enzymes tested unless you drink heavily.

Stay on the birth control pills and stay safe. A lot of the harmful effects of alcohol are not diseases like liver cirrhosis or pancreatitis but social – the man who drinks and perpetrates domestic violence, the person who should have taken a cab but thought they were OK to drive. There is no shame in being a light drinker, but if you’re with friends who aren’t please look out for them.

Can certain drugs or medications cause infertility?

It’s possible. For men testosterone treatment, anabolic steroids, narcotic painkillers, SSRI antidepressants like sertraline or venlafaxine, sulfasalazine, smoking, heavy alcohol, and marijuana can all affect fertility. Sperm numbers and quality are relatively easy to measure compared to female fertility.

In women we know less about the long-term effects of medicines on fertility or ovarian reserve (egg supply). Medications that raise prolactin hormone levels can affect ovulation and reduce fertility – chlorpromazine, prochlorperazine, haloperidol, risperidone, metoclopramide, methyldopa, cimetidine, some older antidepressants like amitriptyline, SSRI antidepressants like sertraline or fluoxetine, and many others. Immunosuppressants such as cyclophosphamide can cause reduced ovarian reserve. Drugs that may affect the ovaries but have not been well studied long-term include newer immunosuppressants like tacrolimus and sirolimus, and antirheumatic drugs like hydroxychloroquine or methotrexate.

Can I give myself intramuscular injections for my fertility medications?

It’s easy to give subcutaneous injections (under the skin on your belly) yourself. Intramuscular (IM) shots are harder to give yourself, especially progesterone in oil. Most IM shots are less painful given into the gluteus muscle in the upper outer part of either butt cheek, which is hard to do yourself. Some women do the shots themselves, looking in a mirror. Ask a Nurse or Medical Assistant to ‘mark the spot’ for you.