3.3 Potential Risks and Side Effects

While gentle protocols like Mini-IVF™ offer significantly lower risks and fewer side effects when compared to conventional IVF, any prescribed medications may have side effects and can pose a risk to your health. To best manage these risks, it helps to be informed. Please carefully review the potential risks and medication side effects below and discuss any questions or concerns with your personal care team.

Potential Risks

Ovarian Hyper Stimulation Syndrome (OHSS)

Ovarian Hyper Stimulation Syndrome is the most common risk associated with conventional IVF, although very uncommon, it can also occur in minimal stimulation cycles. During ovarian stimulation, the maturation of a large number of follicles within the ovary can cause the ovary to swell. As the follicles grow, the eggs inside are surrounded by fluid. When many eggs are retrieved, fluid can accumulate in the abdomen or the chest, requiring hospitalization. Vomiting, diarrhea and shortness of breath are symptoms of severe OHSS, but discomfort and ovarian tenderness are also indicators. If you experience any of these symptoms, contact your doctor immediately.

Multiple Births

Multiple embryo transfers can result in a high-order pregnancy and the health risks to the mother and child are significant. Additionally, the chances of premature delivery increase with higher-order multiples. We advocate single embryo transfer to eliminate the risk of multiple births.

Potential Medication Side Effects

If you experience any of the symptoms or side effects listed below, please contact your doctor immediately.

Birth Control Pills
(drospirenone and ethinyl estradiol)
Use: Birth control pills are used for suppression of FSH and LH.
How it works: Birth control pills suppress the production of FSH and LH, which preventing the formation of a follicle and release of an egg.
Side effects: Headaches, nausea, bloating, spotting between periods and breast tenderness.
Clomid
(clomiphene citrate)
Use: Clomid is used to stimulate the production of follicle stimulating hormone (FSH) and luteinizing hormone (LH), needed for ovulation induction and with continued use, premature ovulation suppression.
How it works: Clomid causes the body to think estrogen levels are low, which results in the release of FSH and LH. These hormones ultimately stimulate production of follicles and the release of mature eggs. With extended use, Clomid acts to block the production of LH, which helps prevent premature ovulation.
Side effects: Abdominal or pelvic discomfort, bloating, nausea, vomiting, breast tenderness, hot flashes, blurred vision, headache and irregular spotting. While Clomid is generally well tolerated, patients may experience mild side effects such as hot flashes, headaches, bloating and breast tenderness.
Estrace
(estradiol)
Use: Estrace is a form of estrogen used to encourage growth of the uterine lining.
How it works: Estrace mimics the effects of estrogen normally produced by the ovaries. It increases secretions from the cervix and promotes endometrial lining growth.
Side effects: Nausea, vomiting, appetite loss, swollen breasts, acne or skin color changes, decreased sex drive or difficulty achieving orgasm, migraines, dizziness, chest pain, vaginal pain, dryness or discomfort, swelling of the ankles or feet, depression, changes in menstrual periods and irregular spotting.
Femara
(letrozole)
Use: Femara is used for the stimulation of follicles and ovulation induction.
How it works: Femara blocks the production of estrogen, causing the release of FSH and LH.
Side effects: Side effects: Hot flashes, headache, loss of appetite, weight gain, general body discomfort, weakness, fatigue, nausea and diarrhea.
Ganirelix/Cetrotide
(ganirelix acetate/cetrorelix acetate)
Use: Ganirelix and Centrotide are forms of a protein used to reduce the amounts of certain hormones to suppress premature ovulation.
How it works: Ganirelix and Cetrotide are injectable gonadotropin-releasing hormone (GnRH) antagonists that suppress the production and activity of LH and FSH. The amount of estrogen present is reduced.
Side effects: Headache, nausea, pain, redness, irritation and itching at injection site, abdominal swelling, pain or cramping.
hCG
(human chorionic gonadotropin)
Use: An hCG injection is used to induce ovulation.
How it works: hCG mimics the action of the LH surge and triggers ovulation approximately 36-48 hours after its initial use. Egg retrievals can be timed as close to ovulation as possible to increase the chance of retrieving a mature egg.
Side effects: Headache, hot flashes, mood swings, muscle pain, nasal irritation and runny nose.
Ibuprofen
Use: This drug reduces inflammation to make follicles less sensible to rupture.
How it works: As a nonsteroidal anti-inflammatory drug, ibuprofen reduces hormones that cause inflammation and pain in the body. As the follicle is less inflamed, it is less likely to rupture prematurely.
Side effects: Heartburn, diarrhea, constipation, bloating, gas, dizziness, drowsiness, rash and headache.
Menopur and Repronex
(menotropins)
Use: Menopur and Repronex are an equal mixture of the naturally occurring follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the form of a subcutaneous injectable. They are more commonly used in women with a low FSH baseline.
How it works: Menopur and Repronex are a combination of FSH and LH hormones that stimulate ovaries to produce follicles.
Side effects: Abdominal pain, back pain, breast enlargement, chills, nausea, dizziness, fever, flu-like symptoms, flushing, general body discomfort, headache, menstrual changes, muscle or joint pain and pain or rash at the injection site.
Synarel
(nafarelin acetate)
Use: Synarel is a nasal spray used to induce ovulation and cause final follicular maturation.
How it works: Synarel causes an LH surge, which triggers ovulation approximately 36-48 hours after its initial use. Egg retrievals can be timed as close to ovulation as possible to increase the chance of retrieving a mature egg.
Side effects: Headache, hot flashes, mood swings, muscle pain, nasal irritation and runny nose.