Medicines to Help Conceive: A Global and Updated Analysis for Fertility Success

Difficulty conceiving is a worldwide challenge affecting about 1 in every 6 people of reproductive age, as recently highlighted by the World Health Organization (WHO). This multifactorial problem requires effective and personalized treatments, where medicines to help conceive play a fundamental role. Although medications are widely used, their efficacy, safety, and protocols vary globally and deserve critical analysis. Furthermore, the COVID-19 pandemic brought challenges and adaptations in fertility management in 2025.

1. Global Overview of Infertility and the Role of Medicines

Infertility affects men and women across all cultures and countries, with diverse causes including genetic, environmental, lifestyle, and pathological factors. According to WHO data, approximately 16.7% of people worldwide are affected by infertility. The use of medications to induce ovulation and improve fertility is one of the most common strategies to treat female causes, especially ovulatory dysfunction, reflecting protocols used in Brazil, the United States, Europe, Asia, and Oceania.

2. Main Medicines to Help Conceive: Review and Evidence

2.1 Clomiphene (Clomid, Serophene)

This oral medication is the most prescribed worldwide to induce ovulation in women with anovulation or polycystic ovary syndrome (PCOS). Clinical studies from countries such as Brazil, the United States, and Italy confirm ovulation rates of up to 80% and pregnancy rates of 40-45% in treated cases.

2.2 Letrozole (Femara)

Originally a cancer treatment, letrozole gained recognition in countries like the United States and Canada for effectively inducing ovulation with a lower risk of multiple pregnancies in women with PCOS. Systematic reviews show that letrozole outperforms clomiphene in some subgroups, particularly by increasing live birth rates.

2.3 Gonadotropins

Used for ovarian stimulation in advanced protocols such as in vitro fertilization (IVF), gonadotropins (FSH, LH, hCG) are common in Europe, Asia, and the Americas. Controlled use is essential to prevent complications like ovarian hyperstimulation syndrome.

2.4 Metformin

Originally prescribed for type 2 diabetes, metformin is used globally as a complementary therapy for women with insulin resistance typical in PCOS. Reviews indicate that metformin alone can increase ovulation by 50% compared to placebo, and when combined with clomiphene, it significantly raises ovulation and pregnancy chances.

2.5 Other Medicines

Drugs to normalize hormone levels, such as bromocriptine and cabergoline, are indicated for hyperprolactinemia — a less common cause of infertility. Heparin, although used in cases of thrombophilia, lacks sufficient evidence to improve pregnancy rates in women without coagulation disorders.

3. International Guidelines for Using Fertility Medicines

Countries such as Brazil, the United States, the United Kingdom, Australia, and Japan adopt protocols emphasizing detailed evaluation before starting medication treatment, including:

• Clinical and laboratory assessment of the reproductive health of the couple.

• Ultrasound monitoring of follicles.

• Strict medical supervision to avoid multiple pregnancies and adverse effects.

The common international recommendation is to wait up to 12 months of natural attempts for women under 35 years old but to reduce this period to 6 months or less for older women or in specific cases.

4. Impact of the COVID-19 Pandemic on Fertility Treatments in 2025

The pandemic strongly influenced fertility treatment protocols worldwide, delaying elective procedures and requiring COVID-19 testing before treatments. Many centers kept services open only for priority cases, such as fertility preservation in oncology patients and women with compromised ovarian reserve.

5. Side Effects and Precautions in Using Medicines to Help Conceive

The most common adverse effects include hot flashes, abdominal pain, hormonal alterations, and mainly an increased risk of multiple pregnancies, which necessitates close medical follow-up.

6. Cultural, Dietary, and Lifestyle Factors

Studies from the United States, Europe, and Latin America emphasize that combining medical treatments with lifestyle changes — such as balanced nutrition, physical activity, quitting smoking, and reducing alcohol — significantly increases the chances of conception success.

7. Complementary Therapies Used Worldwide

Many countries incorporate complementary therapies such as acupuncture (China, Japan), herbal medicine (regions of Latin America and Europe), and manual therapies (osteopathy in Europe) to assist in hormonal balance and stress reduction, thus improving outcomes of conventional treatments.

8. Future Perspectives and Innovation in Fertility Medicines

Advanced research across continents investigates new molecules and protocols, as well as personalized pharmacogenetics to optimize dosages and reduce side effects, offering promising prospects for the next decade.

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