Medications and Potential Side Effects

The fertility medications which you will be taking are all extremely safe. However, women do experience some common minor side effects.

These medications can be classified into the following groups:

1. LUPRON: Doctors use this medication to control your cycle to artificially stimulate ovulation or control when ovulation occurs. It is administered as a subcutaneous shot (just under the skin). You may experience some hot flashes or headaches. Occasionally, some women experience bone discomfort, but this is quite rare with short-term use. Some redness or irritation may occur at the injection site.
    
2. GONADOTROPINS: These are the true fertility hormones used to stimulate multiple egg growth from your ovaries. These medications are all basically the same, consisting of the hormone FSH with some preparations containing the hormone LH. These medications have different trade names in Canada, Europe and the United States. You may be using the following: Pergonal, Humegon, Fertinorm, Fertinex, Metrodin, Puregon, or Gonal-F. You may notice some nausea, breast tenderness or pelvic discomfort as the growing follicles (containing the eggs) become larger in the latter part of your cycle. Occasionally, women may get flu-like symptoms when taking these medications, and you may experience some redness or irritation at the injection site. Some women experience stinging or burning with the injection itself. Ovarian cysts may develop after ovulation, and rarely, women may develop ovarian hyperstimulation syndrome (OHSS).
    
3. PROFASI/HCG OR PREGNYL: These medications are used to induce ovulation (egg release). They carry the same side effects as the gonadotropins above.

RISKS INVOLVED IN TAKING FERTILITY MEDICATION

Ovarian hyperstimulation syndrome (OHSS) is potentially the most serious complication that can arise from the use of fertility medications. Ovarian hyperstimulation syndrome is a condition that can usually be predicted before it occurs, but it sometimes occurs when only minimal risk factors exist. The following risk factors increase the risk for ovarian hyperstimulation syndrome:

• Women with polycystic ovarian syndrome.
• Women with high Estradiol (E2) levels (>5000 pmal/L) measured by blood tests especially when associated with numerous small follicles (<7.4 cm) on ultrasound.
• A previous history of ovarian hyperstimulation.

In order to reduce the risk of OHSS, daily blood monitoring of Estradiol (E2) and daily transvaginal ultrasounds near the time of ovulation are done to monitor the number and size of developing follicles. Some women may be more sensitive or resistant to these fertility medications, but careful daily monitoring is the key to prevention. Symptoms of ovarian hyperstimulation include abdominal pain or discomfort, abdominal distension, nausea, dizziness, increased thirst, decreased urinary output, or shortness of breath. Fortunately, this condition is extremely rare and almost never occurs in severe form unless a woman becomes pregnant. Therefore, in the situation of oocyte donation, the donor has little chance of developing this condition. It is caused by enlargement of the ovaries following gonadotropin administration, which in turn causes abdominal discomfort and pain, abdominal swelling and bloating, shortness of breath, decreased urinary output, and weight gain.