Safety of Fertility Drugs

Global Courant

Fertility Drug Safety – Is It a Cause for Concern?

For millions of women struggling to conceive, fertility drugs are the first step

under treatment. Clomiphene works by stimulating the hormones in the brain that cause an egg (or several) to develop and be released from the ovaries. Gonadotropins directly stimulate ovaries to produce eggs. Women typically produce only one or two eggs per month. Human menopausal gonadotropin (hMG), urofollitropin, or recombinant FSH causes the ovaries to produce multiple eggs. One of these drugs is injected into the muscle or under the skin.

What are the risks of gonadotropin treatment?

• Multiple conception is the most common complication of gonadotropin treatment. Two-thirds of these pregnancies are twins and one-third are triplets.

• While many couples consider this a blessing, carrying multiples increases the risk of miscarriage and other complications.

• During stimulation for natural conception or IUI, if three or more follicles mature or if blood estrogen levels exceed a certain point, patients are asked to stop the injections to avoid a condition called hyperstimulation.

• Women taking gonadotropin occasionally develop ovarian hyperstimulation syndrome (OHSS). OHSS occurs when a woman produces too many eggs after taking the drug. The ovaries swell quickly and fluid accumulates in the abdomen, or around the heart or lungs. About 10 to 20 percent of gonadotrophin cycles result in a mild form of OHSS, which can cause sudden weight gain, nausea, vomiting, or diarrhea, but usually resolves on its own. In 1 to 2 percent of gonadotropin cycles, OHSS is severe enough to require hospitalization and can lead to blood clots, kidney problems, or, very rarely, death.

• Women may experience breast tenderness, skin rash or swelling at the injection site, a bloated abdomen or mood changes during fertility treatment.

Fertility treatment and cancer

During IVF treatment, drugs are given to stimulate the reproductive organs. As a result, women are exposed to high levels of estrogen, which is listed as a known carcinogen by the National Institute of Environmental Health Sciences. But based on current research, scientists say there’s little cause for concern.

As for ovarian cancer infertility, itself is associated with a higher risk. Compared to the general population, infertile women have a higher incidence of ovarian cancer, but not one caused by IVF. The drugs have recently been associated with a very small increased risk of non-invasive ovarian tumors. But experts don’t believe the dangers are great enough to warrant additional screenings for women who have taken fertility drugs in the past.

Fertility drugs do not increase the risk of breast cancer, although they may accelerate the growth of a pre-existing breast cancer. Therefore, it is mandatory to check for breast disorders before starting IVF treatment.

Fertility treatments increase hormone levels for a few days, which is much shorter than the increased hormonal exposure in nine months of pregnancy. Hence, the risks for cancer development are not a problem.

Safety of Fertility Drugs

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