From: cha@cha.cha   
      
   >  Fertility drugs work by promoting ovulation by stimulating hormones in a   
   woman's brain to get an egg (or several) ready and release it from her ovaries   
   each month. Many fertility drugs have been used safely and successfully for   
   more than 30 years.    
   Unlike many other infertility solutions, such as in vitro fertilization,   
   fertility drugs won't increase the chance of multiple births beyond 5 to 15   
   percent. The most common fertility drugs include Clomiphene, Human Menopausal   
   Gonadotrophin, and    
   Bromocriptine.   
   >   
   > Clomiphene, taken in pill form daily, stimulates the pituitary gland to   
   produce follicle-stimulating hormones, which are the hormones that trigger   
   ovulation. It prompts the ovaries to prepare a number of eggs for ovulation.   
   Once the drug cycle is    
   finished, the hypothalamus gland releases a lutenizing hormone, which   
   instructs the ovaries to release a mature egg from its follicle to the   
   Fallopian Tubes. Women who ovulate irregularly or not at all commonly use   
   Clomiphene. Clomiphene can cause a wide    
   range of side effects, including mood swings, dry cervical mucus, mild ovarian   
   enlargement, stomach pain, breast and ovarian cancer. About 70 to 90 percent   
   of women who take Clomiphene will ovulate, and of those who ovulate, 20 to 60   
   percent will get    
   pregnant. (1, 2).   
   >   
   > Human Menopausal Gonadotropin (hMG) consists of purified follicle   
   stimulating hormone (FSH). When injected into the body, FSH causes a woman to   
   develop egg follicles. After seven to twelve days of shots, the woman receives   
   an injection of human    
   chorionic gonadotropin that stimulates the ovaries to release the egg or eggs   
   that it has just developed. HMG is most often given to women with low estrogen   
   levels who have not responded to Clomiphene. Possible side effects from hMG   
   include abdominal    
   tenderness and weight gain. In rare cases, less than 5 percent of the time,   
   women develop hyperstimulated ovaries, a potentially fatal condition signaled   
   by sudden onset of severe pelvic pain, nausea, vomiting, or weight gain. Due   
   to an excessive number    
   of eggs, the ovaries rapidly swell to several times their size and may leak   
   fluid into the abdominal cavity. Even with careful monitoring, multiple   
   pregnancies and ovarian hyperstimulation can occur. The rate of multiple   
   births is close t   
   o 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. (1).   
   >   
   > Bromocriptine, which can be taken orally or as a vaginal pill, reduces the   
   pituitary gland's production of the hormone prolactin. Excess prolactin   
   reduces estrogen levels and inhibits ovulation. Women who take Bromocriptine   
   suffer from    
   hyperprolactinemic amenorrhea, which is a condition where ovulation problems   
   are caused by a pituitary adenoma (a benign tumor). Side effects from   
   Bromocriptine include nausea, dizziness, low blood pressure, and headaches.   
   Patients who take the drug    
   vaginally often report fewer side effects. 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. (1).   
   >   
   > Are Fertility Drugs Safe?   
   >   
   > One major concern surrounding fertility drugs are the instances of multiple   
   births that arise from their use. Multiple births occur in about 50 percent of   
   cases, especially among women in their early 30s or younger. In most cases,   
   risks can be lowered    
   through careful monitoring and controlling dosages of medications. For IVF, if   
   a high number of eggs are seen developing on the ultrasound, doctors are able   
   to remove them and place back two or three embryos. However, as Dr. Valerie   
   Baker states, "in the    
   case of normal or artificial insemination, we have no control. So if we see   
   too many eggs, we may advise the couple to not attempt to get pregnant. But   
   couples sometimes are hesitant to cancel the cycle because they have so much   
   invested in it, both    
   financially and emotionally". In addition, if the couple does not cancel the   
   cycle and four or more embryos implant, the newborn babies have a high risk of   
   neurological complications if they survive. (3).   
   >   
   > Multiple births are also risky because they can result in the birth of   
   sickly, premature babies. Premature babies face serious complications,   
   including lung problems and bleeding the head, which can cause long-term   
   physical and mental impairment. (4).   
   >   
   > Fertility drugs are often fingered as a risk factor for ovarian cancer.   
   There are several factors that may increase a woman's risk of ovarian cancer.   
   One factor is that an increased number of uninterrupted ovulations in a   
   woman's lifetime increases her    
   chance of developing ovarian cancer. This may explain why events that   
   interrupt the constant cycle of ovulations, such as pregnancy, breastfeeding,   
   and oral contraceptive use, are associated with a decreased risk of ovarian   
   cancer. Another factor is that    
   increased levels of certain hormones associated with ovulation, such as human   
   chorionic gonadotropin, increase the risk of ovarian cancer. Fertility drugs   
   can increase both the number of ovulations and the levels of hormones   
   associated with ovulation. (5,   
    6).   
   >   
   > A conflicting study states that women who take ovulation-inducing drugs in   
   conjunction with IVF are not are increased risk of developing breast, ovarian,   
   or uterine cancer. However, women who seek treatment but do not take fertility   
   drugs have more    
   than twice the expected incidence of uterine cancer, and women with   
   unexplained infertility have elevated rates of uterine an ovarian cancer. This   
   study was based on date on 29, 700 women who registered for treatment at 10   
   IVF clinics in Australia. This    
   study, however, only refers to increasing the risk of cancers when fertility   
   drugs are taken in conjuncture with IVF, and not the risk of cancer when drugs   
   are taken by themselves. (7).   
   >   
   > While multiple children may seem like a good alternative to remaining   
   childless for many couples, each couple must weigh the risks and benefits of   
   using fertility drugs or ARTs to have these children. Fertility drugs and ARTs   
   may cause serious physical    
   damage and have long-term effects on the mother and the child. Consequently,   
   each couple must consult their doctor and follow his/her recommendations to   
   ensure that the use of a fertility drug is safe for the parents and the child.   
   Childlessness can also    
   be resolved by a method that is physically safe for all parties: adoption.   
   >   
      
   [continued in next message]   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)