For some women, pregnancy is far from the biggest issue in their lives. It’s getting the egg fertalized that is the hard part. There are oodles of reasons that it might be difficult for a woman to become expectant.
For women who wait it’s age that hinders them. Female fertility starts to decline by age 25, by the time a woman is 31, her fertility drops by 3 percent annually. There's a group of women who might have a depleted egg reserve, other times it’s a thin uterine lining.
Sometimes, it might even be male factor infertility — which accounts for 30 percent of all infertility cases.
Fortunately, many causes of infertility can be diagnosed. Technology has become advanced enough that we can actually fertilize embryos outside of the human body and place them into the womb hoping for a positive outcome. Parents who have struggled with infertility — or keeping the pregnancy— are grateful for these interventions.
Still, there are risks with every turn when it comes to infertility and the treatments that come with it. Adding synthetic chemicals to the body does pose risks. There are risks to the pregnancy, to the baby, to the mother, and to the father. The likelihood of a miscarriage is higher with fertility treatments, as well.
Other outcomes may not happen so suddenly. Instead, the treatments used for couples facing infertility may predispose them to a greater likelihood of trouble down the road, like birth defects or chronic conditions that may develop in the mother and impact her for the rest of her life.
As important as it is to many couples to have a baby, these factors should be considered at the same time — especially if fertility measures don’t prove to be effective the first few rounds.
15 Clomiphene Complications
Also known as Clomid or Serophene, this drug is used routinely throughout fertility clinics to boost ovulation. Normally, the body produces luteinizing hormones and follicle stimulating hormones leading up to ovulation. These hormones stimulate the ovaries.
During a typical cycle, FSH would stimulate follicles to develop and estrogen then directs the pituitary gland to stop making FSH so that only LH is left producing. This causes the ovary to release the egg.
When Clomid is used, receptors are turned off so that estrogen continues to be produced. This way more follicles develop. The goal is to have more than one egg release so that the chances of pregnancy are greater.
The risks involved with Clomid may trump the benefits for some women. The pros and cons should be weighed individually. Some side effects include: mood swings, hot flashes, abnormal bleeding, and more. It can also cause a miscarriage to occur and ectopic pregnancy.
14 Cysts In The Uterine Lining
For some women, cysts are caused by a condition known as Polycystic Ovarian Syndrome. For others, they occur as a result of hormonal imbalance. In both cases, fertility measures could exacerbate the culprit. For some women with PCOS, they actually find fertility drugs, like Clomid, to be helpful with their symptoms.
For others, it causes their cysts to grow.
This is a common side effect because fertility drugs often flood the body with natural or synthetic estrogen, and it's the extra estrogen that causes cysts to become larger in many cases. For some women, they will develop cysts directly as a result of going through fertility treatments. It's the off-and-on relationship with the drugs they're given that causes this.
When a woman undergoes treatment with fertility drugs, they cause an imbalance of hormones in her body. Usually she will become estrogen dominant and will need progesterone following insemination or implantation to balance her out.
As the body shifts back from having so much estrogen in it to not, it can form follicles that don’t rupture, but instead turn into cysts. For some women, these cysts will continue to be recurrent even after they stop using fertility treatment drugs.
13 Progesterone Problems
Progesterone can be problematic to different women for different reasons. Many women are intolerant to this hormone altogether and don’t make the connection until they have to be on it for the purposes of becoming with child or sustaining a pregnancy.
The most prominent symptom of this is generally pretty intense mood swings that make them very irritable and hard to get along with. They may feel overly annoyed with everyone and everything around them.
Outside of progesterone intolerance — which can be managed by avoiding progesterone products — this hormone can cause an onslaught of other issues.
Women are often told that the synthetic hormone has only minor side effects, like bloating and nausea, and that these issues go away after they stop using the hormone. This is true for some, but not all.
Progesterone use has been linked to contributing to heart disease, as well as dementia. It can also cause permanent hyperpigmentation of the skin known as melisma.
While science routinely argues that there is no link between infertility and hormonal birth control — which contains progesterone too — there is enough anecdotal evidence for many to worry that could be links. In addition, the evidence used to counter that there isn’t a link is often a result of studies produced by organizations with financial ties to the pharmaceutical industry.
12 Possible Miscarriage
No one wants to endure a miscarriage, no matter how they came to be expectant. For those who do conceive without interventions, the rate of miscarriage is around 10 to 15 percent.
When infertility treatments are involved, many couples expect that they may be safer somehow or more protected from this potential pitfall. Unfortunately, that’s not the case.
Miscarriage is more probable in women who produce fewer eggs during invitro fertilization treatments. Around one-fifth of women who became expectant after a cycle of IVF that produced fewer than four eggs ended up miscarrying.
The use of synthetic hormones over time may also contribute to the likelihood of miscarriage. When estrogen is depleted, the uterine lining may become too thin. This makes it difficult for a fertilized embryo to implant successfully.
Repeated use of infertility treatment drugs can potentially lead to a more hostile uterus that is less likely to be a hospitable home to an embryo.
11 Having Multiples
Around 29.1 percent of women under the age of 36 were carrying twins or more following IVF with the use of fertility drugs in one study. This might not sound like a risk factor to everyone. Some couples would be delighted to be parents to twins — especially those who have been trying with no success to have a baby.
Having two or three or more at once would solve a lot of their problems, ideally. But multiple pregnancies come with their own concerns.
One problem occurs before IVF and IUI (intrauterine insemination) can ever be undertaken. If there are too many developing eggs, then the procedure isn’t carried out. Women who become expectant with more than twins are often faced with the decision of having to selectively reduce the number of pregnancies, too.
In cases where they refuse, it is far less likely any of the babies will survive.
In addition, carrying multiples to term isn’t generally possible, but per-term birth is also more common. Multiples are often born under weight and prematurly. Many end up having to spend time in the Neonatal Intensive Care Unit. Pre-eclampsia is also more likely to occur in multiple pregnancies, too.
Gestational diabetes and placental abruption are other more common issues with twins or greater. Around 10 to 15 percent of twins will develop a disorder known as twin-to-twin transfusion syndrome where blood flows from one baby to the other via the placenta. This requires surgery to repair.
Pre-eclampsia is a condition that develops during pregnancy. Women who have been treated for infertility are 25 percent more likely to develop it. There doesn’t appear to be many straightforward warning signs that pre-eclampsia will develop. Instead, it usually comes on suddenly.
For the expectant mother, it can cause a lot of grief and upset. Sometimes, mommies-to-be will develop swelling in their legs and arms, headaches or blurred vision that alerts them to something being wrong. However, this doesn’t always happen.
Often, the diagnosis comes following an appointment that shows the expectant mother has high blood pressure and protein in her urine. These are trademark signs of pre-eclampsia. This condition affects 8 to 10 percent of expectant moms.
It can cause hearing and vision problems in the baby, as well as cerebral palsy, epilepsy and learning disabilities. This occurs as the blood pressure rises and oxygen that is carried to the developing baby becomes depleted . Expectant moms with pre-eclampsia can also suffer from heart failure, stroke, seizure and more.
Delivery of the baby is a must where pre-eclampsia is concerned.
9 Ovarian Hyperstimulation Syndrome
This syndrome occurs as a byproduct of using fertility drugs like Clomid during fertility treatments. However, injectable medications are far more likely to cause OHSS than oral medications. Human Chorionic Gonadotropin — HCG — also contributes to the development of OHSS.
When the trigger shot of HCG is given, OHSS may develop in the following week and will bring with it symptoms like sudden weight gain, abdominal pain, vomiting and diarrhea, tenderness in the ovarian region of the body, and more.
In some cases, OHSS is severe enough that a woman will suddenly pack on as many as 45 lbs. in a matter of days. This is due to fluid that builds up in the abdominal cavity around the ovaries. It can also lead to blood clots in the legs and shortness of breath.
Even mild swelling of the stomach or abdomen and minor symptoms should be reported to a doctor if they occur, because OHSS can escalate quickly.
8 Cancer Risks
Cancer might be the scariest thing for most people on this list. There’s been a lot of debate over the years about whether or not synthetic hormones can contribute to the development of tumors or cancer. Some have said, "Yes, without a doubt." Others have claimed there is no link.
Many doctors push patients to get screened for cancer after they undergo infertility treatments because it has become so commonplace.
Still, science shows that women who undergo IVF are 37 percent more likely to develop ovarian cancer. While conditions that preclude them from fertilizing the egg and caused them to need IVF may contribute to the development of cancer on their own, the contributing factors underlying infertility drugs cannot be ruled out.
The American Cancer Society reports low malignant tumors of the ovary appear to be more common in women who use fertility drugs.
7 Birth Defects
Birth defects are a fact of life for a small percentage of babies born each year. Annually, 1 in 33 babies are born with some kind of defect. Babies conceived with the use of fertility drugs, like Clomid or Femara, are more likely to develop birth defects than children who are conceived naturally.
These birth defects include heart, skeletal and muscular defects. While around 4.4 percent of babies who are conceived naturally will incur such defects, 6.2 percent of babies conceived through IVF will be more likely to have these issues.
While the incidence of birth defects among these babies is not high enough to deter most couples from moving forward with infertility treatment measures, it’s important that couples have all the facts up front before they make a decision. That includes information that doctors are not required to relay to patients.
For example, during clinical trials of Clomid, many side effects were reported including congenital heart lesions, Down’s syndrome, microencephaly, club foot, cleft palate, hypospadias, hernias, spina bifida, still birth and more.
6 Neurodevelopmental Disorders
Conditions like Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder are common enough that most parents worry about their children developing them.
They have every right to be concerned. Autism now impacts 1 in 45 children. Overall, 1 in 6 have a developmental disability. It leads parents and medical professionals alike down the path of wondering just where all these issues are coming from in a world where they once barely existed.
Sure, diagnostic criteria and better awareness account for some of these cases. But doctors being more aware of the signs of an illness don’t account for how Autism went from 1 in 10,000 in the 1980s to 1in 45 the way it has now. Fertility drugs are indeed in part to blame.
Children born to women who use fertility drugs are almost twice as likely to develop one of these disorders as those who are conceived naturally. Mental disorders are also more likely in children born to mothers who used drugs like Clomid to augment ovulation or conceive.
Children conceived with the use of these drugs were up to 11 times more likely to develop conditions like ADHD and depression, per one study.
5 Preterm Birth
Every year, around 15 million babies are born prematurely around the world. The causes of this are numerous. Sometimes, it’s an incompetent cervix that causes a mother to go into labor before the baby is ready.
Other times, it might be her bag of waters breaking too early or an antenatal hemorrhage. Sometimes disorders during pregnancy cause preterm birth to take place, too.
Of course, in some instances it won’t be known what caused a pre-term birth. A percentage of these cases may be attributed to fertility drugs if the babies were conceived using them. Part of the catalyst with pre-term births and drugs like Clomid is the influence that the drugs have on the likelihood of multiples. That's what leads to pre-term birth.
So, this isn’t necessarily a direct cause, but an indirect one that still wouldn’t be as likely to occur had the fertility drugs not been used.
4 Ectopic Pregnancies
An ectopic pregnancy occurs when an embryo implants outside of the uterus. While this can happen anywhere in the abdominal cavity, it is most commonly seen inside the fallopian tubes. Around 98 percent of them implant there.
Interestingly, while ectopic pregnancies account for just 1 to 2 percent of all live births in developed nations, they account for as many as 4 percent among pregnancies that involved fertility interventions.
Ectopic pregnancy isn’t the only issue in early pregnancy for women who need reproductive technology. In fact, almost all early pregnancy complications appear to be more common in women who need assistance to conceive.
High levels of estrogen and multiple oocytes induced by using drugs like clomiphene produce a four-fold increased risk of ectopic pregnancy for women using these drugs. In women who have already had an ectopic pregnancy, they are also more likely to have another than those who’ve never had one.
3 Ovarian Torsion
This condition is another common side effect of drugs like Clomid. Ovarian torsion occurs when the ligaments attached to an ovary twist. This twisting causes the blood supply to be lost to the ovary and often can result in loss of the organ entirely.
That means other conditions often stem from ovarian torsion, like Post Tubal Ligation Syndrome and Premenstrual Dysphoric Disorder. Women may also have reduced chances of conception after the loss of one ovary, too.
Ovarian torsion presents with remarkable pain. It's not a condition that goes unnoticed, but still it can present quickly enough that the organ cannot be recovered. Sometimes this occurs because of cysts that grow on the ovary.
As these cysts grow larger, they can cause the ovary to topple over from the weight of it. Cysts are a common occurrence during fertility treatments with ovulation-inducing drugs, such as Clomid. In addition, ovarian torsion may also occur as a result of using Clomid or Femara.
These drugs commonly cause the ovaries to swell and the same toppling effect can take place.
2 Thyroid Disorders
Hormones are fickle things. You mess with them just a little here and there, and they can go haywire — permanently. Many women find this out after years of using birth control. The same kind of complications can stem from the use of infertility drugs.
When the gender hormone cycle that is naturally present in the body is disturbed, it can cause a cascade of other issues to be set into motion.
Consequently, thyroid diseases like Hypothyroidism or Grave’s disease can also cause fertility problems. So, women who were using fertility measures to bolster their chances of conception due to male factor infertility may be at an even greater disadvantage afterward if fertility drugs cause issues with her thyroid.
Around 20 million Americans live with some form of thyroid disorder. There is also an increased risk of thyroid cancer in women who use fertility drugs, per the Journal of Human Reproduction.
1 Financial Health
Just when you thought fertility treatments were going to be an onslaught of issues that mom can end up dealing with, keep in mind that both parties are affected when it comes to the cost of said treatments.
Obviously, hopeful moms and dads-to-be aren’t often so worried about the cost of having a baby that they will typically forego having one, but this matter should be somewhere looming in most of their minds. It costs a lot of money just to have a baby the old-fashioned way!
What to Expect notes an uncomplicated pregnancy and vaginal birth can cost as much as $30,000. Add fertility treatments to the mix and you’re looking at bills in the range of $11,000 to $12,000 just for IVF.
This is an important factor to consider because for some couples, it won’t simply be one round of IUI or IVF and done. In fact, there is a 65.3 percent rate of success after six rounds of fertility treatments for IVF.
Still, many doctors are leery of letting patients use fertility drugs for more than five or six cycles due to the risks they pose, some of which we’ve discussed here.