Information Statement - Ovulation Induction Risks

Introduction

Medications can have side effects.

Even though the majority of people do not experience the side effects of medication, the following information is provided for people contemplating or undergoing Ovulation Induction.

Clomiphene Citrate (Clomid®)

Clomid® acts on the anterior pituitary gland in the brain and results in the release of hormones which stimulate ovulation.

Possible side effects include hot flushes, which are usually mild and disappear after you stop taking Clomid, and abdominal discomfort or bloating around the time of ovulation.
Less common side effects include nausea or vomiting, fatigue, dizziness or light headedness and headache.

There have also been concerns expressed that the use of Clomid® as an ovulatory stimulant may cause congenital malformations. This agent has been used for the past 30 or more years and there is no evidence that the children of mothers given Clomid have a higher incidence of congenital or pre-cancerous conditions.

Recombinant Follicle Stimulating Hormone (FSH)

Puregon® and Gonal-F® are laboratory produced products which are almost identical to FSH.

Possible side effects include nausea, abdominal cramps, bloating, breast tenderness and mood swings. These symptoms are normal.

hCG Chorionic Gonadotrophin (Pregnyl®)

Pregnyl® is used to mature the egg and promote ovulation, and also to stimulate progesterone production in the second half (luteal phase) of the cycle after ovulation has occurred. Pregnyl® can be self administered by subcutaneous injection.
Pregynyl can be associated with a rare condition called Ovarian Hyperstimulation Syndrome (see below).

Ovarian Hyperstimulation Syndrome ( OHSS )

Ovarian Hyperstimulation Syndrome (OHSS) occurs in some women who have an over response to the stimulating medication. It is a rare but potentially serious complication, so a great deal of care is taken to avoid it. The more severe symptoms of OHSS include severe abdominal pain, nausea or vomiting, decreased urinary frequency, dark-coloured urine and shortness of breath. Therefore, it is important that you notify Flinders Fertility if you experience any of these symptoms.

Fertility Drugs and Cancer

The Fertility Society of Australia together with the National Health and Medical Research Council, has conducted a detailed study to assess whether there are links between cancer and fertility drugs. Many reproductive centres throughout Australia (including Flinders Fertility) undertook the task of following up all patients attending their clinics.

Non identifying data on patients was analysed, looking at where they were treated, the type and duration of any treatment, and whether the woman had subsequently developed ovarian, uterine (cervical) or breast cancer.

The study (Venn et al, Lancet 354: 1586-90, 1999) took more than 4 years to complete, with the final report being released in November 1999. The study was based on more than 20,000 women in the “treated” group and 9,000 “untreated” women who were referred, but did not have treatment. The major finding was reassuring. No more cancers were found in the treated group than the general population, when considered over a 5-10 year period It is important to note that, as with any drugs, it is possible there may be effects or side-effects as yet unknown. It is therefore important for follow up studies to be performed.

You will be asked to consent to be contacted in the future if we have any further information for you.

Possible Complications

As with most medical procedures and fertility treatments, there are potential complications to consider with Ovulation Induction.

Risks to the Mother arising from multiple pregnancy, including:

  1. High blood pressure during pregnancy.
  2. Diabetes during pregnancy.
  3. More physical discomfort.
  4. Prolonged antenatal hospitalisation and surgical delivery.
  5. Post partum haemorrhage.

Potential risks for the baby, including:

  1. Low birth weight.
  2. Premature birth.
  3. Serious complications after birth.
  4. Higher risk of cerebral palsy.
  5. Increased development delays in speech and reading among “toddler” twins.

Potential social consequences, including:

  1. Social and economic difficulties.
  2. Psychological consequences.
  3. Fatigue and sleep deprivation.

Pregnancy Loss

As with natural conception, a pregnancy resulting from Ovulation Induction treatment is subject to a variety of outcomes including biochemical pregnancy, ectopic pregnancy or miscarriage.

Contact us

If you would like further information, please contact Flinders Fertility on 131 IVF (131 483) or by email enquire@flindersfertility.com.au

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