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Drug Related Complications

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Stimulation protocols in IVF aim at ovarian stimulation in order to achieve maturation of multiple follicles and collection of oocytes from each patient during treatment cycle, thus increasing pregnancy rates.

Possible complications due to hormonal medications include allergic reactions, breast tenderness and body fluid retention. The most severe complication is ovarian hyperstimulation (OHSS), which occurs in 3-4 % of patients.

Ovarian hyperstimulation is characterized by severe ovarian enlargement, fluid accumulation inside the abdominal and chest cavity, abdominal pain, vomiting and shortness of breath.
Treatment is based on medical therapy, and in severe cases admission to hospital may be needed.
Choice of the correct stimulation protocol, depending on ovarian reserve, may help avoid this situation.

A major concern of couples undergoing infertility treatment is the possible association of the hormones with gynecologic cancer. In recent years, several studies have been published, attempting to find an association between the risk of gynecologic cancers and IVF medications. The weight of scientific evidence is that such treatments are unlikely to lead to breast or ovarian cancer.

One of the largest studies performed in Europe and the single largest one in Greece was completed at The Gynecologic Center for Reproduction and Genetics and was presented by Dr. Kapetanakis at the 1st Panhellenic Congress of IVF.

The study is a retrospective investigation involving 26,000 IVF cycles during the period between 1996 and 2006. The strength of this study and what makes it one of the most important worldwide, is the large number of women included in combination with the long follow-up period since the last treatment (over 20 years).

Overall, our results are reassuring and showed that the use of fertility drugs does not increase the risk of gynecologic cancers in this population of women compared to the general population.

According to the vast majority of studies published to date, there is little evidence that the use of conventional fertility hormones used for ovarian stimulation in the treatment of infertility increases the long-term risk of breast and gynecological cancers.

It is very important though that all the necessary screening tests are performed prior to starting treatment.