We understand that the decision to proceed with fertility treatment is one of the toughest choices a couple can face. It seems that there is an overwhelming amount of information, and people usually have lots of questions as they sort though it all. This online fertility library was created to give you an overview about the latest infertility treatment options. Once you get an insight on the various fertility treatments, you will get a better understanding of the treatment guides at San Diego Fertility Center.

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Miscarriage and the Successful Pregnancy

Fertility Drug Gonadotropin

There are many types of gonadotropins used alone or in combination for ovulation induction. They include hMG (human menopausal gonadotropin, Repronex and Menopur), FSH (follicle stimulating hormone, Follistim, FSH-Bravelle, or Gonal-F), and recombinant LH (Luveris). During the use of these drugs, careful monitoring is required to minimize the side effects, discussed below.

Side Effects Of Gonadotropins

Ovarian Hyperstimulation (OHS)

Occurring in 1 to 5 percent of cycles, the chance of OHS is increased in women with polycystic ovarian syndrome and in conception cycles. When severe, it can result in blood clots, kidney damage, ovarian twisting (torsion), and chest and abdominal fluid collections. In severe cases, hospitalization is required for monitoring, but the condition is transient, lasting only a week or so. Occasionally, drawing fluid out of the chest or abdominal cavity helps. The best prevention is to not give hCG to induce ovulation at the end of an overly vigorous stimulation cycle.

Multiple Gestations

Up to 20 percent of pregnancies resulting from gonadotropins are multiple, in contrast to a rate of 1 to 2 percent in the general population. While most of these pregnancies are twins, a percentage are triplets or higher. High-order multiple gestation pregnancy is associated with increased risk of pregnancy loss, premature delivery, infant abnormalities, handicap due to the consequences of very premature delivery, pregnancy induced hypertension, hemorrhage, and other significant maternal complications. Read more on multiple gestation ...

Ectopic (Tubal) Pregnancies

While ectopic pregnancies occur 1 to 2 percent of the time, in gonadotropin cycles the rate is slightly increased at 1 to 3 percent. These can be treated with medicine or surgery. Combined tubal and intrauterine pregnancies (heterotropic pregnancies) occasionally occur with hMG and need to be treated with surgery.

Birth Defects

The rate of birth defects after gonadotropin cycles is not higher than in the general population, at 2 to 3 percent. Furthermore, these children are developmentally no different than their peers.

Adnexal Torsion (Ovarian Twisting)

Less than 1 percent of the time, the stimulated ovary can twist on itself, cutting off its own blood supply. Surgery is required to untwist or even remove the ovary.

Gonadotropins and Ovarian Cancer

The risk of ovarian cancer seems in part related to the number of times a woman ovulates. Infertility increases this risk; birth control pill use decreases it. Controversial data exists that associates ovulation stimulation drugs like gonadotropins with the risk of future ovarian cancer. While research is underway to help clarify this issue, the careful use of gonadotropins is still reasonable, especially considering that pregnancy and breast-feeding reduce cancer risk. More information about ovarian cancer in a 2004 published article by the American College of Obstetricians and Gynecologists , Adobe Acrobat Reader required.

Last updated: February 7, 2006
Authors: Dr. William Hummel and Dr. Michael Kettel