You may have seen the recent coverage regarding Femara – a commonly prescribed medication in the fertility world – it induces ovulation.
3 in 10 women take the drug femara to increase their chances of getting pregnant. Femara is a medication that is FDA-approved for breast cancer prevention. Like many drugs, it may cause birth defects when taken in pregnancy. When taken pre-pregnancy, it does not increase one’s risk of birth defects.
It is not illegal for doctors to use medications “off-label.” I’ll give you an example of a medication that we use off-label all the time in medicine: birth control pills. Birth control pills are not FDA approved to decrease pain with periods – but we prescribe them all the time for this very reason. Birth control pills are also not FDA approved for decreasing acne – but we use them all the time for this indication.
Insurance companies do not want to be paying for a woman’s infertility treatment when she does not have infertility coverage and it is very difficult at the pharmacy level to figure out what a woman is using her femara prescription for. The recent news suggests that doctors use a medication to help women get pregnant knowing that it causes birth defects – it doesn’t. Femara is out of the blood stream before conception occurs. All fertility drugs if used in pregnancy may cause birth defects – femara is no different.
Femara may be better for some women than the FDA-approved drug for ovulation induction called Clomiphene Citrate (aka Clomid). It doesn’t have the mood side effects and it doesn’t increase one’s risk of miscarriage the way Clomid does. It’s all about money – Femara is 10 times more expensive than Clomid and the insurance companies don’t want to pay for it. The drug companies don’t want to be held responsible for a woman’s birth defects so they don’t want to be involved. There are lawyers who are trying to start a class-action lawsuit against doctors and the drug company who makes Femara. There are commercials out there stating, “If you’ve taken Femara and have a baby with a birth defect or have had a miscarriage you may have money coming your way.” This makes doctors who prescribe femara nervous – but ultimately we know that we are doing no harm.
So if your doc is recommending that you take Femara, make sure you feel comfortable that it has not been as well-studied as Clomid (clomid has been around for decades) and is being used off-label. If you’re nervous – use Clomid or another form of fertility enhancing medication.