Fertility medication to induce ovulation will cause an increase in a woman’s estrogen production by her ovaries. This results in increased symptoms that mimic ‘pre-ovulatory’ feelings such as abdominal bloating, breast tenderness and nausea. The most common risk of any medicine that induces follicle development for egg production is a multiple pregnancy. Using clomiphene citrate tablets, the risk of a multifetal pregnancy is estimated at 5-10% of pregnancies. This risk increases significantly when a patient uses gonadotropin injectable medication, approximately 15-20% of pregnancies with a 5% risk of triplets.
Although most patients believe IVF increases the multiple pregnancy rate, this is not necessarily accurate. The percentage of multiple births from infertility treatments in this country is essentially the same when IUI is compared to IVF. Actually, the risk can be lower with IVF when responsible decision making and education is applied. At Fertility CARE we counsel couples extensively about ways to reduce the risk of multiple births including offering a single embryo transfer for good prognosis patients and this can provide above average pregnancy rates.
Other risks of fertility medications are even more rare. These include the risk of:
- Ectopic pregnancy – A potentially life-threatening pregnancy occurring outside the uterus,usually in the fallopian tube. This situation can be treated medically in the early stages, but may require surgery if severe.
- Ovarian torsion – An ovary containing cysts that gets twisted on its blood supply, possibly requiring surgery. In very rare cases, an ovary must be removed.
- Ovarian hyperstimulation syndrome – This is a rare but potentially fatal condition resulting from excessive cyst production by the ovaries in response to fertility medication, causing fluid accumulation in the abdomen but, at the same time, severe dehydration. In serious conditions, patients require hospitalization. Fortunately most cases resolve within one to two weeks.
- Ovarian cancer – A major study in the journal of Obstetrics and Gynecology, April 2004, demonstrated NO association and a possible reduction of risk after women were exposed to fertility medication compared to infertile patients never receiving these medications.
Side effects will certainly vary among patients and most tolerate the medicine very well.