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Fertility treatments - how safe are they?

Written by Nirmalya Dutta |Updated : September 3, 2013 12:19 PM IST

ART-sideeffectsWhen anAamir Khan and Kiran Rao have a child via in-vitro fertilization or a Bollywood movie like Vicky Donor centres on sperm donation, people sit up and notice it. Having offspring is seen as the natural way of life and people are willing to go to any lengths to have their own and when they can't naturally they turn to Artificial Reproduction Techniques (ART). And it's not only Indians that are obsessed with children the fertility industry is a major part of India's medical tourism industry and India is fast becoming the surrogacy capital of the world. Experts say that the fertility business is worth a whopping Rs 13,033 crore. This has led to fertility clinics mushrooming up in all parts of the country which completely disregard all the Indian Council Of Medical Research (ICMR) rules, regulations and protocols of Artificial Reproduction Techniques.

Fertility quacks are not beyond giving heavy doses of hormones to a woman to make her ovulate (be it the conventional mother-to-be or the surrogate). Such is the social stigma attached to infertility in our society that women (there seems to be no ART for infertile men) are willing to go to any lengths to conceive. But first what is infertility? The medical definition of infertility is the failure to conceive following twelve months of unprotected intercourse. Infertility treatment looks to undo this.

If you indeed are looking to conceive using any of the ART methods be aware of the treatment you're being given and its side-effects. We've tried to list some of the drugs used and their side-effects:

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  1. Drugs which act by suppressing the natural menstrual cycle (Lucrin, Synarel, etc.) can have side-effects similar to menopause. You could experience hot flushes and mood swings.
  2. Gonadotrophin (Puregon/Gonalf/Humegon) is a hormone that stimulates the ovaries to produce more eggs. Side-effects may include weariness, mood swings, nausea and headache. Since the ovaries swell up some patients complain of additional pelvic pressure. In rare cases, the ovary may rotate and twist leading to bleeding and requires surgery. These conditions usually continue for the second half of the cycle and may last up to three months if pregnancy is successful.
  3. Human Chorionic Gonadotrophin (HCG/PROFASI/PREGNYL) facilitates the final maturing of the oocyte (oocyte is a cell that goes on to become the ovum or the egg and is more uncomfortable than other injections. It's often called the 'trigger' injection.
  4. Another drug which is used is Clomiphene (Clomid/Serophene) which looks to stimulate the pituitary to produce extra oocytes. Here too the side-effects include headaches, weariness, occasional visual disturbance and hot flushes.
  5. Some drugs like doxycycline and progesterone don't actually help produce oocytes but help in other ways by protecting the embryo or thickening the uterine walls. Side-effects of doxycycline include nausea, vomiting, diarrhoea, skin rashes and photosensitivity whereas progesterone can cause perianal pain, headaches, nausea and drowsiness.

Ovarian Hyper Stimulation Syndrome

A more specific problem which occurs in about 1-2% of patients who undergo super-ovulation induction is a problem called Ovarian Hyper-stimulation syndrome (OHSS).

Essentially fluid from the bloodstream leaks into the abdominal cavity causing it to swell. Several symptoms include respiratory issues, kidney failure and arterial and venous thrombosis. Rarely cases could see a lack of blood supply to the brain and other vital organs. Patients who suffer severe OHSS must be hospitalised and treated. This treatment would involve the infusion of intravenous fluids and the fluid in the abdomen may need draining off.

The ICMR guidelines dictate that it's the doctor's the duty to tell their patients about all the side-effects of the treatments. It's imperative to know them before going for any procedure. Women who suffer from health issues, particularly cardiovascular or blood pressure issues have to be even more careful. Having children may seem like the most important thing in the world, but conceiving shouldn't be at the cost of your partner's, wife's or even an unknown surrogate's health and well-being.

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