Adverse Effects
Cancer
The use of fertility drugs is highly correlated with other ovarian cancer risk factors which complicates the direct contribution of the fertility drugs to ovarian cancer. Numerous studies indicate the risk of developing ovarian cancer as a result of fertility drugs is insignificant, but long-term exposure to fertility drugs may require further studies to determine their role in ovarian tumors and other health risks. In a review of fertility medications and cancer risk, they found that most studies conducted thus far have shown that fertility drugs also do not increase the risk of other gynecologic cancers ( cervical and endometrial) or other malignant cancers ( thyroid, colon, melanoma, breast). [1] [2] [3] [4] [5] [6] [7] However, the validity of these data may be affected by patient-reported biases, small subject numbers, and other confounding variables.
Estrogen antagonists and gonadotropins may stimulate multiple follicles and other ovarian hormones leading to
multiple birth and possible
ovarian hyperstimulation syndrome (OHSS). Development of OHSS is dependent on the administration of hCG and is mediated through
vascular endothelial growth factor (VEGF). OHSS is characterized as cystic enlargement of the ovaries. Multiple birth is especially deleterious due to compounding risks including premature delivery and low birthweight, pre-eclampisa, and increased risk of neonatal mortality. While triplet births have been declining in ART, multiple births remain over 50% of births from IVF. However, there are limitations to measure, as 4% to 8% IVF clinics to do not report their data to the CDC.
Gonadotropins
Main article: Gonadotropin preparations
Gonadotropins are protein hormones that stimulate the gonads (testes and ovaries). For medication, they can be extracted from urine or by genetic modification.
For example, the so-called menotropins consist of LH and FSH extracted from human urine from menopausal women. There are also recombinant variants which are created by inserting the DNA coding for it into bacteriae. The bacterial DNA is then called Recombinant DNA. Examples of recombinant FSH are Follistim and Gonal F, while Luveris is a recombinant LH.
FSH and recombinant FSH analogues are mainly used for controlled ovarian hyperstimulation as well as ovulation induction.
Gonadotropins
Main article: Gonadotropin preparations
Gonadotropins are protein hormones that stimulate the gonads (testes and ovaries). For medication, they can be extracted from urine in postmenopausal women or through genetic modification and bacterial recombination. Examples of recombinant FSH are Follistim and Gonal F, while Luveris is a recombinant LH.
There has been some controversy over the efficacy between extracted and recombinant FSH for ovulation induction; however, a meta-analysis of 14 trials among 1726 women found that there were no differences in clinical pregnancy or live birth outcomes. [8]
FSH and recombinant FSH analogues are mainly used for controlled ovarian hyperstimulation as well as ovulation induction.
 | This is a user sandbox of
L. Liu, Future UCSF Pharm.D.. You can use it for testing or practicing edits. This is not the sandbox where you should draft your assigned article for a dashboard.wikiedu.org course. To find the right sandbox for your assignment, visit your Dashboard course page and follow the Sandbox Draft link for your assigned article in the My Articles section. |
- ^ Venn, A.; Watson, L.; Bruinsma, F.; Giles, G.; Healy, D. (1999). "Risk of cancer after use of fertility drugs with in-vitro fertilisation". Lancet (London, England). 354 (9190): 1586–1590. doi: 10.1016/S0140-6736(99)05203-4. ISSN 0140-6736. PMID 10560672.
- ^ Modan, B.; Ron, E.; Lerner-Geva, L.; Blumstein, T.; Menczer, J.; Rabinovici, J.; Oelsner, G.; Freedman, L.; Mashiach, S.; Lunenfeld, B. (1998). "Cancer incidence in a cohort of infertile women". American Journal of Epidemiology. 147 (11): 1038–1042. doi: 10.1093/oxfordjournals.aje.a009397. ISSN 0002-9262. PMID 9620047.
- ^ Ricci, E.; Parazzini, F.; Negri, E.; Marsico, S.; La Vecchia, C. (1999). "Fertility drugs and the risk of breast cancer". Human Reproduction (Oxford, England). 14 (6): 1653–1655. doi: 10.1093/humrep/14.6.1653. ISSN 0268-1161. PMID 10357995.
- ^ Rossing, M. A.; Daling, J. R.; Weiss, N. S.; Moore, D. E.; Self, S. G. (1996). "Risk of breast cancer in a cohort of infertile women". Gynecologic Oncology. 60 (1): 3–7. doi: 10.1006/gyno.1996.0002. ISSN 0090-8258. PMID 8557223.
-
^ Doyle, Pat; Maconochie, Noreen; Beral, Valerie; Swerdlow, Anthony J.; Tan, S. L. (2002-08).
"Cancer incidence following treatment for infertility at a clinic in the UK". Human Reproduction (Oxford, England). 17 (8): 2209–2213.
doi:
10.1093/humrep/17.8.2209.
ISSN
0268-1161.
PMID
12151460.
{{ cite journal}}: Check date values in:|date=( help) - ^ Brinton, Louise A.; Scoccia, Bert; Moghissi, Kamran S.; Westhoff, Carolyn L.; Althuis, Michelle D.; Mabie, Jerome E.; Lamb, Emmet J. (2004). "Breast cancer risk associated with ovulation-stimulating drugs". Human Reproduction (Oxford, England). 19 (9): 2005–2013. doi: 10.1093/humrep/deh371. ISSN 0268-1161. PMID 15217997.
-
^ Gauthier, E.; Paoletti, X.; Clavel-Chapelon, F.; E3N group (2004).
"Breast cancer risk associated with being treated for infertility: results from the French E3N cohort study". Human Reproduction (Oxford, England). 19 (10): 2216–2221.
doi:
10.1093/humrep/deh422.
ISSN
0268-1161.
PMID
15271872.
{{ cite journal}}: CS1 maint: numeric names: authors list ( link) - ^ Weiss, Nienke S.; Nahuis, Marleen; Bayram, Neriman; Mol, Ben Willem J.; Van der Veen, Fulco; van Wely, Madelon (2015). "Gonadotrophins for ovulation induction in women with polycystic ovarian syndrome". The Cochrane Database of Systematic Reviews (9): CD010290. doi: 10.1002/14651858.CD010290.pub2. ISSN 1469-493X. PMID 26350625.
Adverse Effects
Cancer
The use of fertility drugs is highly correlated with other ovarian cancer risk factors which complicates the direct contribution of the fertility drugs to ovarian cancer. Numerous studies indicate the risk of developing ovarian cancer as a result of fertility drugs is insignificant, but long-term exposure to fertility drugs may require further studies to determine their role in ovarian tumors and other health risks. In a review of fertility medications and cancer risk, they found that most studies conducted thus far have shown that fertility drugs also do not increase the risk of other gynecologic cancers ( cervical and endometrial) or other malignant cancers ( thyroid, colon, melanoma, breast). [1] [2] [3] [4] [5] [6] [7] However, the validity of these data may be affected by patient-reported biases, small subject numbers, and other confounding variables.
Estrogen antagonists and gonadotropins may stimulate multiple follicles and other ovarian hormones leading to
multiple birth and possible
ovarian hyperstimulation syndrome (OHSS). Development of OHSS is dependent on the administration of hCG and is mediated through
vascular endothelial growth factor (VEGF). OHSS is characterized as cystic enlargement of the ovaries. Multiple birth is especially deleterious due to compounding risks including premature delivery and low birthweight, pre-eclampisa, and increased risk of neonatal mortality. While triplet births have been declining in ART, multiple births remain over 50% of births from IVF. However, there are limitations to measure, as 4% to 8% IVF clinics to do not report their data to the CDC.
Gonadotropins
Main article: Gonadotropin preparations
Gonadotropins are protein hormones that stimulate the gonads (testes and ovaries). For medication, they can be extracted from urine or by genetic modification.
For example, the so-called menotropins consist of LH and FSH extracted from human urine from menopausal women. There are also recombinant variants which are created by inserting the DNA coding for it into bacteriae. The bacterial DNA is then called Recombinant DNA. Examples of recombinant FSH are Follistim and Gonal F, while Luveris is a recombinant LH.
FSH and recombinant FSH analogues are mainly used for controlled ovarian hyperstimulation as well as ovulation induction.
Gonadotropins
Main article: Gonadotropin preparations
Gonadotropins are protein hormones that stimulate the gonads (testes and ovaries). For medication, they can be extracted from urine in postmenopausal women or through genetic modification and bacterial recombination. Examples of recombinant FSH are Follistim and Gonal F, while Luveris is a recombinant LH.
There has been some controversy over the efficacy between extracted and recombinant FSH for ovulation induction; however, a meta-analysis of 14 trials among 1726 women found that there were no differences in clinical pregnancy or live birth outcomes. [8]
FSH and recombinant FSH analogues are mainly used for controlled ovarian hyperstimulation as well as ovulation induction.
| This is a user sandbox of
L. Liu, Future UCSF Pharm.D.. You can use it for testing or practicing edits. This is not the sandbox where you should draft your assigned article for a dashboard.wikiedu.org course. To find the right sandbox for your assignment, visit your Dashboard course page and follow the Sandbox Draft link for your assigned article in the My Articles section. |
- ^ Venn, A.; Watson, L.; Bruinsma, F.; Giles, G.; Healy, D. (1999). "Risk of cancer after use of fertility drugs with in-vitro fertilisation". Lancet (London, England). 354 (9190): 1586–1590. doi: 10.1016/S0140-6736(99)05203-4. ISSN 0140-6736. PMID 10560672.
- ^ Modan, B.; Ron, E.; Lerner-Geva, L.; Blumstein, T.; Menczer, J.; Rabinovici, J.; Oelsner, G.; Freedman, L.; Mashiach, S.; Lunenfeld, B. (1998). "Cancer incidence in a cohort of infertile women". American Journal of Epidemiology. 147 (11): 1038–1042. doi: 10.1093/oxfordjournals.aje.a009397. ISSN 0002-9262. PMID 9620047.
- ^ Ricci, E.; Parazzini, F.; Negri, E.; Marsico, S.; La Vecchia, C. (1999). "Fertility drugs and the risk of breast cancer". Human Reproduction (Oxford, England). 14 (6): 1653–1655. doi: 10.1093/humrep/14.6.1653. ISSN 0268-1161. PMID 10357995.
- ^ Rossing, M. A.; Daling, J. R.; Weiss, N. S.; Moore, D. E.; Self, S. G. (1996). "Risk of breast cancer in a cohort of infertile women". Gynecologic Oncology. 60 (1): 3–7. doi: 10.1006/gyno.1996.0002. ISSN 0090-8258. PMID 8557223.
-
^ Doyle, Pat; Maconochie, Noreen; Beral, Valerie; Swerdlow, Anthony J.; Tan, S. L. (2002-08).
"Cancer incidence following treatment for infertility at a clinic in the UK". Human Reproduction (Oxford, England). 17 (8): 2209–2213.
doi:
10.1093/humrep/17.8.2209.
ISSN
0268-1161.
PMID
12151460.
{{ cite journal}}: Check date values in:|date=( help) - ^ Brinton, Louise A.; Scoccia, Bert; Moghissi, Kamran S.; Westhoff, Carolyn L.; Althuis, Michelle D.; Mabie, Jerome E.; Lamb, Emmet J. (2004). "Breast cancer risk associated with ovulation-stimulating drugs". Human Reproduction (Oxford, England). 19 (9): 2005–2013. doi: 10.1093/humrep/deh371. ISSN 0268-1161. PMID 15217997.
-
^ Gauthier, E.; Paoletti, X.; Clavel-Chapelon, F.; E3N group (2004).
"Breast cancer risk associated with being treated for infertility: results from the French E3N cohort study". Human Reproduction (Oxford, England). 19 (10): 2216–2221.
doi:
10.1093/humrep/deh422.
ISSN
0268-1161.
PMID
15271872.
{{ cite journal}}: CS1 maint: numeric names: authors list ( link) - ^ Weiss, Nienke S.; Nahuis, Marleen; Bayram, Neriman; Mol, Ben Willem J.; Van der Veen, Fulco; van Wely, Madelon (2015). "Gonadotrophins for ovulation induction in women with polycystic ovarian syndrome". The Cochrane Database of Systematic Reviews (9): CD010290. doi: 10.1002/14651858.CD010290.pub2. ISSN 1469-493X. PMID 26350625.