Side Effects caused by Injectable Fertility Drugs (Gonadotropins)

HMG Injections

What are gonadotropins?

Gonadotropins are fertility inducing drugs. It is administered by injection and contain follicle-stimulating hormone (FSH). The hormone FSH is either injected alone or sometimes along with luteinizing hormone (LH). During a regularly occurring menstrual cycle, the pituitary gland in the brain is responsible for stimulating FSH and LH to produce an egg in ovary. When FSH (alone or with LH) is injected, it stimulates the ovary to make multiple follicles (cysts containing eggs). There are other fertility drugs as well such as clomiphene citrate, which work in tandem with the brain in order to coax the ovaries to produce egg.

How are these medications used?

Gonadotropins are employed by doctors during fertility treatments, generally during intrauterine insemination (IUI) or in vitro fertilization (IVF). Injections of gonadotropins are given in the beginning of the menstrual cycle to encourage production of multiple healthy eggs. Human chorionic gonadotropin (hCG) is then injected to stimulate the ovary to release the egg once it reaches maturity.  During the treatment, doctors monitor the patients closely using ultrasound to prevent side effects and risks.

What are some of the potential side effects of gonadotropins?

Ovarian Hyper stimulation Syndrome (OHSS)

OHSS refers to the condition in which the ovaries become large and fluid accumulates in the abdomen. Around 10% to 20% of patients complain of discomfort but the symptoms usually go away in due course of time. However, more severe complications can occur in approximately 1% of the cases marked by nausea, vomiting, fast weight gain, dehydration, blood clots, kidney dysfunction, twisting of an ovary (torsion), fluid collections in the chest and abdomen, and, in rare conditions even death.

Using injectable gonadotropins enhances the probability of multiple implantations (twins or more), by as much as 30 % which in normal pregnancy occur in 1% to 2% of women. There is 5% chance of triplets as well.  Being pregnant with twins or triplets puts a woman at risk by enhancing the threat of miscarriage, premature delivery, abnormalities in the new born baby, pregnancy-induced hypertension, bleeding, along with other pregnancy related complications.