Fertility Medications

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1. What are the side effects of IVF medications on babies?
   
   Most of the medication used for IVF are commenced and completed prior to the embryos being transferred. The main medications that are continued after the embryos are transferred to the uterus include natural estrogen and progesterone which should not carry any increased fetal risk having been used now for many years and also because we try to keep these hormones within the physiological range. Patients with additional medical problems especially those patients with abnormal immunology may also require to be on heparin which does not cross the placenta and therefore does not affect the baby. They may also need to be taking a very low dose of one baby aspirin a day and possibly monthly intravenous gamma globulin until the end of the first trimester. None of these medications are known to cause fetal abnormalities remembering that between 3% to 4% of pregnancies may be complicated by an abnormality discovered at birth even when no additional medications or technologies are required for conception.
2. What are the side effects of medications used in IVF on patients?
   
   This is a very large topic mainly because of the large number of medications that are used in generating an IVF cycle and supporting the pregnancy thereafter. In general, the IVF medications used to prepare the uterus and to stimulate the ovaries are not known to carry any long-term risks of cancer of the ovary unless there is a family history of ovarian cancer. The commonest side effect would be some abdominal discomfort and bloating as the follicles increase in size especially if there are a large number of follicles. The commonest serious side effect would be ovarian hyperstimulation syndrome (OHSS) which should be entirely preventable with prolonged coasting (See OHSS question above).