The effectiveness of fertility medications depends on their purpose and the condition being treated. Among the options available, gonadotropins like Gonal-F® and Menopur tend to have the highest success rates, particularly in assisted reproductive technology (ART) procedures like IVF.
Gonal-F® has shown superior efficacy compared to biosimilars in ovarian stimulation. Although the number of retrieved oocytes was similar between Gonal-F® and biosimilars (13.3 vs. 14.4), Gonal-F® demonstrated higher pregnancy rates (59.2% vs. 39.7%) and live birth rates (43% vs. 17.7%). Additionally, more women in the Gonal-f® group had good-quality embryos (83.3% vs. 69.5%), making it a preferred choice in IVF cycles.
Menopur, another gonadotropin, combines both FSH and LH, which can be beneficial for some women who need additional hormonal support for follicle maturation. Studies indicate that live birth rates with Menopur range between 50-54%, making it a strong contender in fertility treatments. While both Gonal-f® and Menopur are effective, the choice between them often depends on individual patient factors and treatment protocols.
For women who need ovulation induction without ART, Clomid (Clomiphene Citrate) and Letrozole (Femara) are the first-line treatments. Clomid has an ovulation success rate of 70-80%, particularly in PCOS patients, while Letrozole is often more effective in PCOS cases due to improved endometrial thickness. However, pregnancy rates with Clomid are lower than those seen with gonadotropins.
Other medications like Bromocriptine, used for high prolactin levels, and Estradiol and Progesterone, which help support pregnancy but do not induce ovulation, are effective in their respective roles but are not primary fertility treatments.
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Key Takeaways
Letrozole is often the most effective fertility pill, particularly for women with PCOS. It has shown higher pregnancy rates than Clomid in multiple studies. However, the best pill depends on the underlying cause of infertility, so a tailored treatment approach is ideal.
Progesterone and Estradiol support pregnancy but do not induce ovulation—these are essential for women with implantation or luteal phase issues.
Clomid is the go-to for unexplained infertility, providing a strong track record for ovulation induction. Studies have shown that clomiphene citrate has been known to increase the conception rate by 50% after 3 ovulations.
Best Fertility Pills to Get Pregnant
The following medications are oral tablets used to treat a variety of issues related to infertility:
1. Ovulation Induction (Best for Anovulatory Women, Especially PCOS)
These medications are the first-line treatments for women who do not ovulate regularly.
Medication | Best For | Effectiveness (Pregnancy Rate Increase) | Application Method |
PCOS, unexplained infertility | 30-40% pregnancy rate per cycle | Oral tablet | |
Letrozole (Femara) | PCOS, unexplained infertility | Can be more effective than Clomid for PCOS (27.5% pregnancy rate per cycle in PCOS patients) | Oral tablet |
Which is better?
Letrozole is often preferred over Clomid for PCOS patients because it has a higher ovulation rate and a slightly better pregnancy success rate.
Clomid is widely used and works well for many women, especially those with unexplained infertility.
Related: Clomid Cost (Guide)
2. Insulin-Sensitizing Agents (Best for PCOS with Insulin Resistance)
These help women with PCOS who struggle with insulin resistance.
Medication | Best For | Effectiveness (Pregnancy Rate Increase) | Application Method |
Metformin | PCOS with insulin resistance | Increases ovulation; improves pregnancy rates when combined with Clomid or Letrozole | Oral tablet |
Which is better?
Metformin alone does not significantly increase pregnancy rates, but when combined with Clomid or Letrozole, it improves ovulation and success rates.
3. Dopamine Agonists (Best for High Prolactin Levels)
These restore ovulation for women with hyperprolactinemia.
Medication | Best For | Effectiveness (Pregnancy Rate Increase) | Application Method |
Bromocriptine | Women with high prolactin levels | Restores ovulation and improves pregnancy chances | Oral tablet |
Related: IVF Medication Cost (Complete Guide)
4. Hormonal Support (Best for Luteal Phase Deficiency & IVF)
These medications help support pregnancy but do not induce ovulation.
Medication | Best For | Effectiveness (Pregnancy Rate Increase) | Application Method |
Progesterone (Prometrium, Endometrin, Crinone, etc.) | Luteal phase defect, IVF support | Supports early pregnancy; does not induce ovulation | Oral, vaginal, or injection |
Estradiol (Estrace, Divigel, etc.) | Thin uterine lining | Improves endometrial receptivity | Oral tablet or topical gel |
5. hCG Trigger Shots (Best for Inducing Ovulation in Timed Cycles)
These medications trigger ovulation after follicle development.
Medication | Best For | Effectiveness (Pregnancy Rate Increase) | Application Method |
Ovidrel (hCG - Human Chorionic Gonadotropin) | Timed intercourse, IUI, IVF | Ensures ovulation; does not increase pregnancy rates alone | Subcutaneous injection |
6. Best Fertility Pills for Specific Conditions
In terms of oral tablets for fertility, here is a short list of IVF-related medications based on specific condition:
Condition | Best Fertility Pill | Alternative |
PCOS | Letrozole | Clomid + Metformin |
Unexplained Infertility | Clomid | Letrozole |
Thin Uterine Lining | Estradiol | Progesterone |
High Prolactin (Hyperprolactinemia) | Bromocriptine | Cabergoline |
Luteal Phase Deficiency | Progesterone | hCG (Ovidrel) |
Ovulation Induction in IVF | Gonadotropins (FSH, Menopur) | Clomid + Injectables |
Overview of all IVF (In-vitro Fertilization) Medications and Efficacy
Treating infertility is not a “one-size-fits-all” approach. Patients may be suffering from a number of issues including PCOS or unexplained infertility, decreased ovulation, decreased endometrial receptivity, and much more. The following medications are usually prescribed to patients in a number of ways along their journey to pregnancy:
Ovulation Inducers (Selective Estrogen Receptor Modulators - SERMs)
Medication | Application Method | Estimated Pregnancy Rate Increase |
Clomid (Clomiphene Citrate) | Oral tablet | 30-40% cumulative pregnancy rate |
Letrozole | Oral tablet | Similar to Clomid; pregnancy rates vary, but can be slightly higher for PCOS |
More detail:
Clomid and Letrozole are commonly used for ovulation induction in anovulatory women (e.g., PCOS).
Letrozole is sometimes preferred over Clomid due to potentially higher ovulation rates and improved endometrial thickness.
Gonadotropins (Injectable Hormones to Stimulate Ovarian Follicles)
Medication | Application Method | Estimated Pregnancy Rate Increase |
Gonadotropins (FSH, hMG) | Subcutaneous injection | Used in IVF and IUI; pregnancy success depends on cycle type |
FSH (Follicle Stimulating Hormone) | Subcutaneous injection | Varies; higher success in controlled ovarian hyperstimulation |
Menopur (hMG - Human Menopausal Gonadotropin) | Subcutaneous injection | Used in IVF; pregnancy rates depend on cycle type |
Human Chorionic Gonadotropin (HCG) (e.g., Ovidrel, Pregnyl, Novarel) | Subcutaneous or intramuscular injection | Used as a trigger shot; does not directly increase pregnancy rates |
More detail:
These injectable medications stimulate follicular development.
Often used in combination with assisted reproductive technologies (ART) like IVF.
hCG (Ovidrel) is primarily used as a trigger shot to induce ovulation after follicular maturation.
Common injectables include Gonal-F® RFF Redi-Ject injectables. Studies have shown that Gonal-F® can have a reported higher pregnancy rate of 59.2% (compared to 39.7%) when studied in groups of women suffering from infertility.
Related: Gonal-F RFF Pen Price
Insulin-Sensitizing Agents (For PCOS-Related Infertility)
Medication | Application Method | Estimated Pregnancy Rate Increase |
Metformin | Oral tablet | Can improve ovulation in PCOS, increasing pregnancy rates 5-15% |
More detail:
Used to treat insulin resistance in PCOS patients, potentially improving ovulation.
Often combined with Clomid or Letrozole for better efficacy.
Dopamine Agonists (For Hyperprolactinemia-Induced Infertility)
Medication | Application Method | Estimated Pregnancy Rate Increase |
Bromocriptine | Oral tablet | Restores ovulation in hyperprolactinemia cases, increasing pregnancy rates |
More detail:
Used for women with high prolactin levels causing ovulatory dysfunction.
Can restore normal menstrual cycles and improve fertility.
GnRH Agonists (Used for Ovulation Suppression or Endometriosis)
Medication | Application Method | Estimated Pregnancy Rate Increase |
Leuprolide Acetate (Lupron) | Injection | Used to suppress ovulation in IVF; does not directly increase pregnancy rates |
More detail:
Used in IVF protocols to prevent premature ovulation.
Can also be used for conditions like endometriosis.
GnRH Antagonists (Prevent Premature Ovulation in IVF Cycles)
Medication | Application Method | Estimated Pregnancy Rate Increase |
Cetrotide (Gonadotropin-Releasing Hormone Antagonist) | Subcutaneous injection | Prevents early ovulation in IVF cycles |
More detail:
Used in controlled ovarian stimulation to ensure proper follicle development before egg retrieval.
Hormone Support (Luteal Phase Support and Uterine Lining Preparation)
Medication | Application Method | Estimated Pregnancy Rate Increase |
Estradiol (Estrogen - Estrace, Divigel, etc.) | Oral tablet, topical gel | Supports uterine lining; does not directly increase pregnancy rates |
Progesterone (Prometrium, Endometrin, Crinone, etc.) | Oral, vaginal suppository, or intramuscular injection | Essential for maintaining pregnancy; does not induce ovulation |
More detail:
Estradiol is used in medicated cycles to help build the uterine lining.
Progesterone is commonly used in IVF and other fertility treatments to support the luteal phase and early pregnancy.
Summary:
Ovulation Inducers (Clomid, Letrozole): First-line oral medications for ovulation induction.
Gonadotropins (FSH, hMG, HCG): Injectable hormones used in IUI and IVF.
Metformin & Bromocriptine: Address underlying hormonal imbalances that impact fertility.
GnRH Agonists & Antagonists (Leuprolide, Cetrotide): Used in IVF to control ovulation.
Hormone Support (Estradiol, Progesterone): Helps maintain the uterine environment for pregnancy.
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Sources
Comparative Analysis of Gonal-f® and Biosimilars in Ovarian Stimulation. National Center for Biotechnology Information. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10404022/. Accessed March 7, 2025.
Effects of Bromocriptine on Prolactin Levels and Ovulatory Function. National Library of Medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/628527/. Accessed March 7, 2025.
Clomid (Clomiphene Citrate) Prescribing Information. U.S. Food and Drug Administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020726s027lbl.pdf. Accessed March 7, 2025.
Estradiol Prescribing Information. National Institute of Allergy and Infectious Diseases. Available at: https://rsc.niaid.nih.gov/sites/default/files/1.14.2.2-package-insert-estradiol.pdf. Accessed March 7, 2025.
Bromocriptine (Parlodel) Prescribing Information. U.S. Food and Drug Administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/1998/20843lbl.pdf. Accessed March 7, 2025.
Progesterone (Prometrium) Prescribing Information. U.S. Food and Drug Administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/017962s065s068lbl.pdf. Accessed March 7, 2025.
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