From the Guidelines
Mounjaro is not a recommended first-line treatment for ovulation induction in women, and its use for this purpose is not supported by strong evidence. While Mounjaro (tirzepatide) may have indirect benefits for ovulation by improving insulin sensitivity and promoting weight loss, particularly in women with polycystic ovary syndrome (PCOS) or insulin resistance, the American College of Obstetricians and Gynecologists (ACOG) recommends clomiphene citrate as the primary medication for ovulation induction due to its effectiveness, with about 80 percent of women ovulating and one half of these patients conceiving 1.
- The ACOG guidelines suggest that treatment for women with PCOS who wish to conceive should begin with weight control and a regular exercise program, followed by medication if needed.
- Clomiphene citrate is the recommended medication for ovulation induction, with a high success rate in inducing ovulation and conception.
- Other medications like metformin and thiazolidinediones may improve ovulation frequency, but their effects on early pregnancy are not well understood, and their use is not recommended as a first-line treatment for ovulation induction 1.
- Mounjaro is primarily approved for type 2 diabetes management and chronic weight management, and its use for ovulation induction would be off-label.
- Women experiencing ovulation difficulties should consult with their healthcare provider to discuss the most appropriate treatment options, which may include clomiphene citrate, letrozole, or other medications specifically approved for ovulation induction.
From the Research
Mounjaro and Ovulation Induction
There is no direct evidence in the provided studies regarding the effectiveness of Mounjaro in helping women ovulate.
Alternative Treatments for Ovulation Induction
- Gonadotropins, such as follicle-stimulating hormone (FSH), are used as a second-line treatment for ovulation induction in women with polycystic ovary syndrome (PCOS) who do not ovulate or conceive on clomiphene citrate or letrozole 2.
- Letrozole has been proposed as an alternative to gonadotropins for ovulation induction, with some studies suggesting it may reduce the risk of multiple gestations while maintaining live birth rates 3, 4.
- Clomiphene citrate is also used for ovulation induction, but its anti-estrogenic effects can have negative effects on endometrial thickness and cervical mucus, potentially reducing pregnancy rates 5.
- A combination of letrozole and clomiphene citrate has been compared to gonadotropins for ovulation induction in infertile patients with clomiphene citrate-resistant PCOS, with no statistically significant difference in ovulation, pregnancy, twin foetuses, and miscarriage rates between the two groups 6.
Key Findings
- Recombinant FSH (rFSH) versus urinary-derived gonadotropins: there may be little or no difference in live birth rate, multiple pregnancy rate, clinical pregnancy rate, or miscarriage rate between rFSH and urinary-derived gonadotropins 2.
- Human menopausal gonadotropin (HMG) versus purified urinary FSH (uFSH): the certainty of the evidence is very low for all outcomes, and it is uncertain whether HMG improves or lowers rates of live birth, multiple pregnancy, clinical pregnancy, or miscarriage 2.
- Gonadotropins versus continued clomiphene citrate: gonadotropins probably result in more live births and clinical pregnancies than continued clomiphene citrate, without increasing multiple pregnancies 2.