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Doctor insights on: Methotrexate And Fertility

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Methotrexate (Definition)

Methotrexate was originally used in the early 1950's as a treatment for cancer but was also found to be effective in many other diseases including rheumatoid arthritis and psoriasis. It has anti inflammatory and immunosuppressive properties which make it an excellent first line therapy for RA ...Read more


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Can adding hCG shots while taking femara (letrozole) for infertility improve the chances of conceiving?

Can adding hCG shots while taking femara (letrozole) for infertility improve the chances of conceiving?

Sometimes: A properly-timed HCG shot can be used as a 'trigger' for ovulation. Women who develop a dominant follicle with Femara (letrozole) but don't ovulate appropriately (or at all) can be triggered with hcg. ...Read more

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Better to be on methotrexate and hydroxychloroquine or methotrexate and a biologic when treating jra? Methotrexate only doesn't help

Better to be on methotrexate and hydroxychloroquine or methotrexate and a biologic when treating jra? Methotrexate only doesn't help

Depends on severity: Since you have already been on Methotrexate and its not helping you get complete relief from symptoms, further addition of therapies will depend on severity of your current symptoms. Hydroxychloroquine is milder in efficacy as compared to biologics & both have different side effect profiles. Talk to a rheumatologist who can assess your clinical course & treatment needs & then advise accordingly. ...Read more

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3rd iui with clomid (clomiphene) and ovidrel and unexplained infertility, wife is 34. Low chance of success? Losing hope and ashamed.

3rd iui with clomid (clomiphene) and ovidrel and unexplained infertility, wife is 34.   Low chance of success?  Losing hope and ashamed.

Don't lose hope...: pregnancy only occurs in 20% of IUI cycles, have faith and keep on trying! Try speaking with your doctor or their nurse for encouragement if needed, infertility is tough mentally and most couples can use some extra emotional support! ...Read more

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How would x-rays and chemotherapy affect male fertility?

How would x-rays and chemotherapy affect male fertility?

Dose-dependent: Regardless of dose, all male patients even considering fathering children in the future should ask about fertility preservation (such as sperm cryopreservation) before any treatment with radiation or chemotherapy. This is an extremely important point that all patients and multi-disciplinary physician teams should be proactive about so that fertility options are explored prior to treatment. ...Read more

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Im 30 We are trying to convince,can clochecine and allopurinol for my gout treatment effects sperms and fertility?

Im 30 We are trying to convince,can clochecine and allopurinol for my gout treatment  effects sperms and fertility?

Life Altering ?: There has been evidence to support that, However, the sperm count returns after stopping the gout medication. Best to ask your doctor for all the nitty gritty. ...Read more

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Very Low sperm count situation Can I take clomid (clomiphene) and proxeed plus together

Very Low sperm count situation 
Can I take clomid (clomiphene) and proxeed plus together

Yes: Yes, you can take those together. If your sperm count has not improved after 3 months on Clomid (clomiphene) then I would see a urologist for an evaluation. Sometimes medications just do not work and you have to rely on medical techniques to improve your chances for conception. Intrauterine insemination (IUI) and IVF may be your best options. ...Read more

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Taking allpurinol for gout trying to conceive can I take omega 3 and coenzyme q10 ? Can allpurinol effects fertility?

Taking allpurinol for gout trying to conceive can I take omega 3 and coenzyme q10 ? Can allpurinol effects fertility?

Consult your doctor: Allopurinol classified as category C-evidence of birth defects in animal studies at high doses, no human studies exist, decision to stay on allopurinol is based on risk versus benefit. Omega-3 supplementation has documented benefit in pregnancy specifically 1.6 g of EPA and 1.1 g of DHA beginning at week 25 for pregnancy until 3rd month of breast-feeding- less food allergy&eczema. coq10 not safe. ...Read more

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Does taking hCG affect fertility in all cycles?

Does taking hCG affect fertility in all cycles?

Not in all cycles: Hcg, the pregnancy hormone, can be used as a trigger to ovulation. Structurally similar to luteinizing hormone, but longer lasting, HCG helps the follicle release the egg and switch from making estrogen to making progesterone, called luteinization. Hcg is also occasionally used to help the follicles mature. ...Read more

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Can having been on fertlity drugs the month prior (clomid (clomiphene) and hCG trigger shot) effect day 3 labs? For example, make the values higher?

Can having been on fertlity drugs the month prior (clomid (clomiphene) and hCG trigger shot) effect day 3 labs? For example, make the values higher?

They Can: Most often they do not, however, if you have a funcitonal ovarian cyst left over from the month before this can cause your body to make higher levels of estrogen. This may cause your day3 Estradiol level to be elevated, but also consequently lowers your fsh. Recent prior cycles would not however explain an elevated fsh. This is most likely relatd to ovarian aging. ...Read more

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Should Clomid (clomiphene) be combined with IUI in couples with unexplained infertility? Or is it okay to initiallly go with Clomid (clomiphene) on its own?

Studies suggest...: Clomid (clomiphene) ovulation induction is combined with IUI based on evidence from older studies showing statistical improvement in success unexplained infertility. Nowadays, unexplained infertility should be a rare disagnosis indeed, but the cc/iui combination is still prudent and evidence-based. Newer studies emphasize the proven success of ivf for unexplained. ...Read more

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Does metformin also help with fertility like clomid (clomiphene)?

Not the same: Clomid (clomiphene) is a nonsteroidal medication that causes the pituitary glands to stimulate ovulation. Metformin suppresses glucose production from the liver. Metformin is used for pcos pts that have irregular menses often with insulin resistance. Metformin can help some weight loss and regulate menses to help regular ovulation. ...Read more

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Humira losing its effectiveness with RA. Unable to tolerate MTX or Plaquenil. Any Rheumotologists think Remicade (infliximab) would be a good option?

Humira losing its effectiveness with RA. Unable to tolerate MTX or Plaquenil. Any Rheumotologists think Remicade (infliximab) would be a good option?

Can't hurt to try: I'm a family doctor, not a rheumatologist, but I do have RA patients who are on Remicaid who are responding very well with it. I don't know what that's worth to you, but I thought I would share. I think it's being used a lot more and does have FDA indication for RA. ...Read more

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What are my chances of getting liver disease while taking arava (leflunomide) and methotrexate together?

What are my chances of getting liver disease while taking arava (leflunomide) and methotrexate together?

See details: Studies of this combination have shown increased risk of liver disease over taking just one of these meds alone. The exact risk is open to debate. I personally never prescribe this combination of meds although other rheumatologists do. ...Read more

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What are treatment options for high testosterone. I'm trying to conceive and I have pcos caused by high testosterone. Clomid (clomiphene) and metformin failed.

What are treatment options for high testosterone. I'm trying to conceive and I have pcos caused by high testosterone. Clomid (clomiphene) and metformin failed.

Here are some ...: With thus far in your care for PCOS, it would not most logical and beneficial to bring this Q to the treating doctor so timely modification of care could be given. At this time, further online inquiry tends to cause more unnecessary confusion and anxiety. So, contact your treating doc who should be in line of today's knowledge and options of care. Worst, seeking second opinion is still easier &... ...Read more

Dr. Khurram Rehman
1,661 doctors shared insights

Fertility (Definition)

Fertility refers to the ability of a woman to conceive a child, or to the ability of a man to ...Read more


Dr. Robert Lowe
344 doctors shared insights

Rheumatrex (Definition)

Rheumatrex ...Read more