surrogacy medications side-effectsMedications and Potential Side Effects

The fertility medications that you will take during the ovum donation process are all very safe. All medicines have potential side effects, but many patients only experience little, if any, side effects. There are a few common side effects associated with the fertility treatments.

The medications can be grouped into the following categories:

  1. LUPRON: It is synthetically made and physicians use this medication to control your cycle to artificially simulate ovulation or control your ovulation. This medication is administered via subcutaneous injection (just below the skin).  You may experience:
    • Constipation
    • Dizziness
    • General body pain
    • Headaches
    • Hot flashes
    • Loss of appetite
    • Nausea or vomiting
    • A stuffy nose
    • Trouble sleeping and weakness.Occasionally, some women experience bone discomfort, but this is rare with short-term use. Irritation and redness may occur at the site of the injection. This is a GnRH agonist
  1. GONADOTROPINS (GONAL-F): These are the actual fertility hormones used to stimulate egg growth from your ovaries, resulting in multiple eggs. Gonadotropins are all very similar- they consist of the hormone FSH with some preparations containing the hormone LH. There are different trade names for these medications in Canada, the United States and Europe, include the following: Pergonal, Humegon, Fertinorm, Fertinex, Metrodin, Puregon, or Gonal-F. Some of the side effects may include:
    • Breast tenderness
    • Nausea or pelvic discomfort as the growing follicles
    • Which contain the eggs
    • Become larger towards the end of your cycle
    • Occasionally, women may experience flu-like symptoms when taking these medications
    • You may notice some redness or irritation at the injection site.Some women will feel stinging or burning with the injection itself. After ovulation, ovarian cysts may develop, and on rare occasion, women may develop ovarian hyperstimulation syndrome (OHSS).
  1. PROFASI/HCG OR PREGNYL: These medications are used to induce egg release (ovulation). They have the same side effects listed in the gonadotropins section above.

RISKS INVOLVED WITH TAKING FERTILITY MEDICATIONS

Potentially, the most serious complication that can occur from the use of fertility medications is Ovarian hyperstimulation syndrome (OHSS). Ovarian hyperstimulation syndrome is a condition that can typically be predicted before it happens, but it sometimes occurs when only minimal risk factors are present. Women with the following risk factors are at an increased risk for ovarian hyperstimulation syndrome:

  • Polycystic ovarian syndrome
  • High Estradiol (E2) levels (>5000 pmal/L) measured by blood tests especially when associated with numerous small follicles (<7.4 cm) on ultrasound.
  • A prior history of ovarian hyperstimulation

Doctors will perform daily blood monitoring of Estradiol (E2) and daily transvaginal ultrasounds near the time of ovulation in order to monitor the number and size of developing follicles in order to reduce the risk of OHSS.  Some women may be more resistant or sensitive to these fertility medications, but attentive daily monitoring is the key to prevention. Symptoms of ovarian hyperstimulation include:

  • Abdominal discomfort or pain
  • Abdominal distension
  • Dizziness
  • Nausea
  •  Increased thirst
  • Decreased urinary output
  • Shortness of breath.

Fortunately, this condition is extremely rare and almost never occurs in severe form unless a woman becomes pregnant. Therefore, the donor has little chance of developing this condition in the situation of egg donation. It is caused by enlargement of the ovaries after gonadotropin administration, which in turn causes abdominal pain and discomfort, abdominal swelling and bloating, shortness of breath, weight gain, and decreased urinary output.

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