Safety of fertility drugs – Is it a cause of concern?
For millions of women struggling to conceive, fertility drugs are the first step
in treatment. Clomiphene works by stimulating the hormones in brain that trigger an egg (or several) to develop and be released from ovaries. Gonadotropins stimulate ovaries directly to produce eggs. Women typically produce only one or two eggs a month. Human menopausal gonadotropin (hMG), urofollitropin, or recombinant FSH prompts the ovaries to produce several 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.
• Though many couples consider this a blessing, carrying multiples increases risk of miscarriage and other complications.
• During stimulation for natural conception or IUI if three or more follicles are growing to maturity or if blood estrogen exceeds a certain point patients are asked to stop the injections in order to prevent a condition called hyper stimulation.
• Women who take a gonadotropin occasionally develop ovarian hyper stimulation syndrome (OHSS). OHSS happens when a woman produces too many eggs after taking the drug. The ovaries rapidly swell and fluid accumulates 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 diarrhoea, 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, rash or swelling at the injection site, bloated abdomen, or mood swings during fertility treatment.
Fertility treatment and cancer
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’s little cause for concern.
As for ovarian cancer infertility, itself is associated with a higher risk. When compared to the general population infertile women have a higher incidence of ovarian cancer, but not one that is caused by IVF. The drugs have recently been linked to a very small increased risk for non-invasive ovarian tumours. But experts don’t believe the dangers are significant enough to warrant extra screenings for women who have taken fertility drugs in the past.
Fertility medications don’t raise risk of breast cancer, though they may accelerate the growth of a pre-existing breast cancer. Hence before starting IVF treatment it is mandatory to check for breast diseases.
Fertility treatments raise hormone levels for a matter of days which is far less time than the heightened hormonal exposure in nine months of pregnancy. Hence the risks for cancer development is not a concern.