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Fertility Drugs

Fertility Drugs and Artificial Insemination

Fertility drugs that stimulate ovulation are often used with intrauterine insemination, a procedure in which millions of sperm are inserted into a woman's uterus around the time of ovulation to increase the chance of pregnancy. A partner's sperm or donor sperm may be used.

Side Effects of Fertility Drugs

Among the most common bothersome side effects of clomiphene are hot flashes, which occur in 10 percent of women. Abdominal discomfort and bloating are seen in less than 5 percent. Less common side effects with this fertility drug are nausea, vomiting, and breast discomfort, which occur in 2 percent of women.
Gonadotropins can cause side effects similar to clomiphene. The most common serious adverse event with these types of fertility drugs is ovarian hyperstimulation syndrome. This causes ovarian enlargement and pain, as well as an accumulation of fluid in the abdomen that is potentially dangerous. This results in pain in the pelvic area.
The occurrence of ovarian hyperstimulation syndrome varies with the gonadotropin used, but with most gonadotropins, hyperstimulation occurs in 5 to 7 percent of women, with severe cases affecting less than 2 percent of patients. Mild cases may result in the development of ovarian cysts. In severe cases, patients may need to be hospitalized for lung, kidney, and liver problems. Although death has also been reported, it is a rare occurrence.
People who experience bothersome side effects while taking fertility drugs should see their doctor.

Multiple Pregnancies

The incidence of multiple pregnancies with clomiphene is about 8 percent, and the incidence of multiple pregnancies with gonadotropins is up to 20 percent. In contrast, the rate of multiple infant births is 3 percent in the general U.S. population.
Most of the cases of multiple pregnancies due to fertility drugs result in twins, but up to 5 percent result in triplets or a higher number of babies.
A multiple pregnancy significantly raises the risk of preterm labor, pregnancy complications for the mother, and low birth weight and long-term disability in babies.
Last reviewed by: Arthur Schoenstadt, MD
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