For patients and medical practitioners alike, the sheer quest to surmount infertility is an obsessive one entailing not only a struggle on the physical dimension but also a struggle on the emotional and spiritual front.
Each month without signs of pregnancy engineer another round of frustrating and emotive questions among couples, which soon develops into feelings of resentment, finger-pointing and blame-apportioning. Documented research demonstrates that these negative outcomes have, in more than one occasion, led to marriage breakups in the absence of proper intervention measures such as counseling or medical intervention (Cooper & Glazer 38).
Indeed, the panorama associated with conceiving, giving birth, and starting a family may be so momentous that it obliges couples, especially women, to consider every avenue of reinstating fertility, from the simplest to the most bizarre. Pushed to the limits, most individuals opt for fertility drugs. It is the purpose of this paper to critically evaluate the functions and side-effects of fertility-enhancing drugs with a view to demonstrate that their benefits outweigh social and health costs.
Fertility drugs, also called ovulation-inducing drugs (OIDs), are medications that are mainly used to influence the biological process of ovulation.
According to Ayhan et al., “ovulation-inducing drugs have been widely used for various types of infertility since the beginning of 1960s and their use increases day by day parallel to the success achieved in fertility treatment”[1] (1104). Al-Shawaf et al. asserts that the development and dissemination of OIDs generated the opportunity for a vast proportion of the unproductive population to create children (513).
These drugs work by enhancing ovulation by arousing or stimulating the victim’s brain to get an egg ready and discharge it from her ovaries every month (Pendzich para. 9). Some of the most commonly used fertility drugs include Clomiphene Citrate, Human Menopausal Gonadotrophin, Recombinant Gonadotrophin, Repronex, and Bromocriptine (Chavis para 3; Singer 45).
One of the most basic uses of fertility drugs is to restore the reproductive capacities of infertile individuals. Clomiphene functions to achieve this purpose by stimulating the pituitary gland to generate adequate follicle-stimulating hormones, which are the hormones that are primarily responsible for triggering ovulation (Mix 89). The medication, taken in pill form daily, triggers the ovaries to prepare some eggs for ovulation.
Immediately therapy is discontinued, the hypothalamus gland discharges a luteinizing hormone which responsively triggers the ovaries to discharge a ready egg to the section where fertilization takes pace – the fallopian tubes. According to Pendzich, “…about 70 to 90 percent of women who take Clomiphene will ovulate, and of those who ovulate, 20 to 60 percent will get pregnant”[2] (para. 10).
Another commonly used fertility drug is Human Menopausal Gonadotropin (hMG). This drug, according to Pendzich, “…consists of purified follicle stimulating hormone (FSH)…” which occasions a woman to develop egg follicles after being injected with the drug (para. 11).
Immediately after completion of the injections, the woman is then injected with another hormone named human chorionic gonadotropin, which functions to arouse the ovaries to discharge the mature eggs that ostensibly develops after weeks of receiving hMG.
This drug is normally given to estrogen-deficient women or those who fail to respond to first-line treatment drugs such as Clomiphene. According to Pendzich, “…the rate of multiple births [for women using the drug] is close to 20 percent…About 70 to 90 percent of women who take hGM will ovulate, and of those who ovulate, 20 to 60 percent will get pregnant”[3] (para. 11).
Lastly, this paper will discuss Bromocriptine – a fertility-enhancing drug that can either be taken orally or applied as a vaginal gel (Pendzich para. 12; Mix 92).
The drug has the potent efficacy of inhibiting the pituitary’s production and release of prolactin, a hormone that is closely associated with reduced estrogen levels, hence inhibiting ovulation.
This way, the ovaries are given the opportunity to produce the desired eggs. Available statistics suggests that “…90 percent of the women who take Bromocriptine will ovulate as long as they continue taking the drug…Of the women who ovulate, 65 to 85 percent will get pregnant”[4] (Pendzich para. 12).
Having discussed how various fertility drugs functions, it is imperative to note at this stage that many of these drugs compliment each other in the quest to restore fertility, and no single drug has ever proven to be the wonder drug (Jensen et al 132).
As such, personalized leads may have to be pursued from all likely angles, and personalized problem-solving approaches may have to be attempted again and again before an appropriate diagnosis is achieved, reproductive health restored, and a tangible pregnancy attained (Cooper & Glazer 23).
The side-effects of fertility drugs range from mild to serious, and sometimes, life-threatening. It is the object of this paper to divide the side-effects into two – mild and serious – for purposes of evaluating possible social and health costs.
According to Al-Shawaj et al., some of the mild side-effects occasioned by fertility drugs include: mood swings, headaches, abdominal tenderness, dizziness, dry cervical mucus, simple cyst development, weight gain, mild ovarian enlargement, nausea, vomiting, stomach pain, menopausal problems, allergic reactions, ovarian hyper-stimulation syndrome, immune reaction, and low blood pressure (515-523).
Parazzini et al argues that these side-effects are drug-specific, and some side-effects caused by specific drugs are more serious than others (1373). This argument reinforces the fact that the operational mode of fertility-enhancing drugs is interestingly divergent, thus the need for individualized attention (“The Need For” para. 1).
The above notwithstanding, fertility drugs have the capacity to occasion life-threatening side-effects. Although it has never been authentically proved, scientists and medical practitioners believe there is a close correlation between fertility-enhancing drugs and ovarian cancer (Parazzini et al 1372).
According to Al-Shawaj et al., “…ovarian cancer is the second most commonly diagnosed gynecological malignancy, the deadliest gynecological malignancy and the fourth leading cause of cancer-related deaths in women in the U.S.”[5] (518).
Fertility inducing agents have also been closely associated with breast cancer – the most common cancer affecting women globally. Indeed, concerns have been raised that women with an ovulatory infertility are at increased risk of suffering from breast cancer, but scientists are yet to offer concrete evidence linking breast cancer to fertility drugs (Al-Shawaj et al 519).
Other seminal studies have also demonstrated that infertile women, in general, bears no excess risk of suffering from breast cancer compared with their fertile counterparts in the general population (Venn et al 1574). In equal measure, the risk of cancerous tumors in children conceived following the use of fertility medications has been reassuringly low as found out in a recent cohort study involving Danish women (Jensen et al 134).
Taking the above into consideration, it can safely be argued that many of the perceived serious consequences ostensibly caused by fertility drugs so far remains a specter of imagination for lack of adequate substantiation.
It is indeed true that ovulation-stimulating drugs increases the rate of pregnancy loss (Singer 102), not mentioning the fact that they also increase the chances of conceiving multiple pregnancies and autism spectrum disorder (Keller para. 1).
These risks, however, cannot be equated with the joy of having children, the method of conceiving notwithstanding. Fertility drugs, just like other prescriptions, are used to treat a medical condition that affects and distresses one in six couples[6] – infertility.
The therapy of these drugs carries complications and impediments as does any other medical therapy and it needs to be scrutinized and evaluated in this broad perspective. As such, it is prudent to postulate that fertility drugs are useful since their benefits far outweigh the perceived risks.
End Notes
- Ayhan, A., Salman, M.C., Celik, H., Dursun, P., & Ozyungu, O., & Gulteknm, M. Association between Fertility Drugs and Gynecological Cancers, Breast Cancer, and Childhood Cancers. Acta Obstetricia et Gynecologica Sc and Inavica 83.12 (2004): 1104-1111.
- Pendzich, M. Fertility Drugs: Are they worth it? 2008.
- Pendzich 2008.
- Pendzich 2008.
- Al-Shawaj, T., Zosmer, A., Dirnfeld, M., & Grudzinskas, G. Safety of Drugs Used in Assisted Reproduction Techniques. Drug Safety 28.6 (2005): 513-528.
- Al-Shawaj et al 2005.
Works Cited
Al-Shawaj, T., Zosmer, A., Dirnfeld, M., & Grudzinskas, G. Safety of Drugs Used in Assisted Reproduction Techniques. Drug Safety 28.6 (2005): 513-528.
Ayhan, A., Salman, M.C., Celik, H., Dursun, P., & Ozyungu, O., & Gulteknm, M. Association between Fertility Drugs and Gynecological Cancers, Breast Cancer, and Childhood Cancers. Acta Obstetricia et Gynecologica Sc and Inavica 83.12 (2004): 1104-1111.
Chavis, J. Types of Fertility Drugs. 2010. Web.
Cooper, S.L., & Glazer, E.S. (1994). Beyond Infertility: The New Paths to Parenthood. London: Lexington Books.
Jensen, A., Sharif, H., Svare, E.I., Frederiksen, K., & Kjaer, S.K. Risk of Breast Cancer after Exposure to Fertility Drugs: Results from a Large Danish Cohort Study. Cancer Epidemiology, Biomarkers & Prevention 16.3 (2007): 132-145.
Keller, D.M. Study suggests Infertility and Use of Fertility Drugs Increases Risk for Autism. Web.
Mix, T. The Price of Ovulation. The Truth about Fertility Drugs and Birth Defects and a Solution to the Problem. Boston, MA: Tendrill Press. 2005.
Parazzini, F., Pelucchi, C., Negri, E., Francesclus, S., Talamini, R., Mentella, M., & Vechia, C.L. Use of Fertility Drugs and Risk of Ovarian Cancer. Human Reproduction 16.7 (2001): 1372-1375.
Pendzich, M. Fertility Drugs: Are they worth it? 2008. Web.
Singer, K. The Garden of Fertility: A Guide to Charting your Fertility Signals to Prevent or Achieve Pregnancy – Naturally – and to Gauge your Reproductive Health. New York: Penguin Books.
The need for an Individualized Approach to COH. (n.d.). Web.
Venn, A., Watson, L., Bruinsmi, F., Giles, G., & Healy, D. Risk of Cancer after use of Fertility Drugs with In-Vitro Fertilization. Lancet 6.354 (1999): 1573-1584.