Fertility Drug Safety
Fertility Drug Safety: Is It A Concern?
For millions of women struggling to conceive, fertility drugs are the first step
in treatment. Clomiphene works by stimulating hormones in the brain that trigger the development of an egg (or several) and its release from the ovaries. Gonadotropins directly stimulate the ovaries to produce eggs. Women usually produce only one or two eggs a month. Human menopausal gonadotropin (hMG), urofollitropin, or recombinant FSH induce 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?
• Conceiving multiples is the most common complication of gonadotropin treatment. Of these pregnancies, two-thirds are twins and one-third are triplets.
• Although many couples consider this a blessing, having multiple babies increases the risk of miscarriage and other complications.
• During natural conception stimulation or IUI, if three or more follicles are growing to maturity or if blood estrogen exceeds a certain point, patients are asked to stop injecting to prevent a condition called hyperstimulation.
• Women who take a gonadotropin occasionally develop ovarian hyperstimulation syndrome (OHSS). OHSS occurs when a woman produces too many eggs after taking the drug. The ovaries swell rapidly, and fluid builds up in the abdomen or around the heart or lungs. About 10 to 20 percent of gonadotropin cycles result in a mild form of OHSS, which can cause sudden weight gain, nausea, vomiting, or diarrhea, but usually goes away 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 notice breast tenderness, a rash or swelling at the injection site, a swollen abdomen, or mood swings during fertility treatment.
Fertility and cancer treatment
During IVF treatment, medications are given to stimulate the reproductive systems. As a result, women are exposed to high levels of estrogen, which the National Institute of Environmental Health Sciences lists as a known carcinogen. But based on current research, scientists say there is little cause for concern.
As for ovarian cancer infertility, it itself is associated with an increased risk. Compared to the general population, infertile women have a higher incidence of ovarian cancer, but not one caused by IVF. Medications have recently been linked to a very small risk of non-invasive ovarian tumors. But experts don’t think the dangers are significant enough to warrant additional testing for women who have taken fertility drugs in the past.
Fertility drugs do not increase the risk of breast cancer, although they can accelerate the growth of a pre-existing breast cancer. Therefore, before starting IVF treatment, it is mandatory to check for breast diseases.
Fertility treatments raise hormone levels in a matter of days, which is much less time than the highest hormonal exposure in nine months of pregnancy. Therefore, the risks for the development of cancer are not a concern.
