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Many women rely on in vitro fertilization in the hope of conceiving. But often they are unaware of the fact that the high doses of hormones used in the procedure can lead to several side effects which not only affect them but may also affect their babies.
Ever since in vitro fertilization technique was successfully employed for the first time in 1978, many women have resorted to it when other low cost fertility treatments have failed. It is true that IVF has come as a ray of hope for many such childless women. However, the procedure is not without its share of side effects. This is especially true in cases where high dose of hormones are used in the procedure.

Normally, one egg is produced from the ovaries in each cycle. During in vitro fertilization, the ovaries are stimulated by hormones to produce more number of eggs per cycle. The number of eggs produced is dependent upon the dose of hormones used. While ovarian stimulation by low dose of hormone results in the production of around ten eggs per cycle, this number may increase to 20 to 30 eggs with higher dose of hormones.
Fertility clinics in favor of using high dose of hormones say that the increased number of eggs produced in every cycle increases the success rate of in vitro fertilization. As the treatment is costly, it is better if the woman gets pregnant within one or two cycles of treatment. With the number of fertility clinics mushrooming at a rapid rate, the level of competition is stiff. Fertility clinics like to boast about their high success rates. Therefore, they generally resort to high doses of hormones for ovarian stimulation. However, when these fertility clinics boast about their success rates, they forget to mention about the alarming number of patients who suffer from the side effects of these high doses of hormones.

As per the statistics provided by the National Institutes of Health, ovarian stimulation by high doses of hormones can lead to the development of a condition called as ovarian hyper-stimulation syndrome (OHSS) in 10% of patients undergoing IVF. The condition is characterized by fluid accumulation in the ovaries, which may eventually leak into the chest and abdominal cavities. The condition has the potential of turning life threatening. In fact, a recent study found that OHSS is the leading cause of maternal deaths in women who underwent high dose IVF in England and New South Wales. Another recently conducted study has linked high dose IVF to lower birth weights of babies.

Apart from developing OHSS, many side effects of hormones used during IVF can be attributed to Lupron. This is the medicine used to suppress the ovaries prior to their stimulation by hormones like the follicle stimulating hormone (FSH) and the Luteinizing hormone (LH). Though used commonly, readers would be surprised to know that Lupron has not been approved by the FDA for use in IVF. The drug has been associated with deleterious effects like liver disorders, joint aches, pain in bones, muscle and bone loss and even memory loss in certain cases.

Low Dose Form Of IVF Is Safer

Many fertility clinics across Europe and Japan now employ low dose forms of IVF, According to the proponents of this technique, the low dose form of IVF is much safer compared to the high dose form of therapy. In this form of IVF, the ovaries are not suppressed at the beginning of the cycle and the hormone used for stimulating the ovaries are in low dose. Although the number of eggs released is much less compared to high dose IVF, the patient experiences fewer side effects.

ivf1.jpgThe critics of low dose IVF say that the procedure takes a longer time to get the results, but proponents of this form of therapy say that the cost of treatment per cycle is less than one-thirds of that incurred in high dose IVF. And as there are fewer side effects, patients do not require hospitalization for them, cutting down the expenditure further. Moreover, mild stimulation of the ovaries results in the production of healthier eggs which in turn leads to a higher birth rate. As the dose of hormones used is low, the women experience lesser physical and emotional discomfort.

In vitro fertilization is a form of assisted reproductive technology which normally involves five steps:

  • Stimulation of the ovaries by means of fertility drugs so that ovaries produces more than one egg per cycle. During this step, the woman is made to undergo repeated trans-vaginal ultrasounds so observe the ovaries.
  • Retrieval of the eggs from the follicles. This is an ultrasound guided technique wherein eggs are sucked out from their follicles. The process is carried out as an outpatient procedure under mild sedation.
  • Insemination and fertilization of the eggs, wherein the eggs are kept with sperms in laboratory conditions till the time they are successfully fertilized. If the fertilization does not take place spontaneously, then the eggs are injected with sperms, a process called as intra-cytoplasmic sperm injection (ICSI).
  • Embryo culture is the step wherein the fertilized egg is watched judiciously in environmentally controlled conditions till the time it starts dividing. The fertilized eggs may be screened for hereditary diseases, a process called as pre-implantation genetic diagnosis (PGD). This procedure helps the parents and the physicians to decide which embryos are most suitable for implantation. However, this procedure is not carried out in all the fertility clinics.
  • Embryo transfer is the process wherein the fertilized embryo which has begun dividing, is placed back into the woman’s womb. It is normally done 4 to 5 days after fertilization has taken place. Once the embryo has been successfully implanted into the woman’s womb, it grows there and the IVF procedure is deemed successful. The unused embryos can be frozen and used at a later date.
Although IVF has given hope to a number of childless couples, the risks associated with the procedure must also be kept in mind. Life threatening OHSS can develop in 0.5 – 1 % of all IVF cycles. Moreover, the cost of a single cycle of high dose IVF can cost as much as $12,000 - $17,000. Most of the times, the expenses involved in IVF are not covered by the insurance companies. Keeping all these factors in mind, women opting for an IVF procedure must make an informed decision.
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  • “High Doses of Hormones Faulted in Fertility Care”, by Jacqueline Mroz, published in the July 16, 2012 issue of the New York Times, accessed on Aug 5, 2012.
  • “In vitro Fertilization”, published in the Times Health Guide, accessed on August 5, 2012.
  • “Risks and Complications of Assisted Fertilization”, by Richard Kennedy, published by the British Fertility Society, accessed on August 5, 2012.
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