Success/Risk

Fertility Drugs | Typical Cycle | Success/Risk

The success of using gonadotropins (injectible fertility drugs) varies with several parameters, including age of the patient, underlying reasons for infertility, and the quality of the semen. Certainly, not all infertile patients are candidates for ovulation induction and intrauterine insemination; however, where there is unexplained infertility, ovulation dysfunction, or endometriosis, gonadotropins and intrauterine insemination may be the most cost-effective alternative.

In general, controlled ovarian hyperstimulation (COH) and intrauterine insemination (IUI) yield a per-cycle pregnancy rate of approximately 25% in the 21-35 year old age group and a 10% chance in the 36-40 year old age group. After 40, a 3-5% chance per cycle pregnancy rate is usually quoted.

According to diagnostic category, success also varies with the highest success being in patients who have cervical factor or unexplained infertility, followed by endometriosis, male factor, and pelvic adhesions. In short, it is only after consultation with one of the physicians at the Center for Reproductive Medicine that an estimate of a particular patient’s pregnancy chances can be given.

Risks of gonadotropins include ovarian hyperstimulation syndrome (OHSS) seen in approximately 3-5% of patients using these medications, and multiple gestation which occurs in approximately 15-20% of cycles.

With respect to OHSS, symptoms may include abdominal pain and distention, dizziness, weakness or lightheadedness, nausea, vomiting, and others. Patients affected by this syndrome may require hospitalization for closer observation and/or IV fluid management.

Multiple gestation occurs in approximately one in five patients. Of these patients, most will have twin gestations with a small number of patients having triplet or higher order gestations. As a practice, we are very conservative in the induction of ovulation with the extremely rare patient developing a pregnancy with greater than twins. Certainly, however, with respect to these risks, no guarantee may be given or implied.