Like all medications, gonadotropins may have side effects. Severe ovarian enlargement, known as ovarian hyperstimulation syndrome, is uncommon and can usually be treated by bed rest at home. One of the reasons for the ultrasound and blood tests is to monitor your ovaries for abnormal enlargement. Signs of serious complications include vomiting, abdominal swelling and breathing difficulties. If these symptoms appear, do not wait for your next ultrasound but call our office immediately. Again, these are unusual and can be avoided with close monitoring. Before your hCG injection, if there are too many follicles or your estradiol is too high, the injection may be withheld or delayed. This reduces the risk of ovarian hyperstimulation. When your estradiol falls to a safer level, then the hCG injection can be given.
There is a risk of multiple pregnancies occurring as a result of gonadotropin ovulation induction. The rate is about 20% to 50% with the majority of cases involving twins. It is rare that a woman will become pregnant with three or more fetuses. Issues dealing with the consequences of carrying an unusually high number of fetuses should be discussed before treatment begins. The possibility of selectively reducing multiples of more than 3-4 should be discussed.
Possible Ovarian Cancer Risk
Recent reports have linked the use of fertility medications, such as gonadotropins and clomiphene citrate, with a possible increased risk of developing ovarian cancer later in life. The truth is that there are not enough studies to determine a definitive link between the use of fertility drugs and ovarian cancer. A woman who is on fertility treatments may have an increased risk over a woman who is not on fertility treatments. However, once a woman on fertility medications becomes pregnant, her risk factor drops to that of a woman who has become pregnant naturally. In any case, it is important to use fertility medications cautiously until more definitive data is obtained.
Home Remedies for Reactions to Injections
You may experience a sore bottom as a result of the injections. Warm baths or warm washcloths will help alleviate the discomfort. Some women have reported fatigue or headaches or both. You may take Tylenol if you get severe headaches, but do not take Advil or Motrin in that this may affect ovulation.