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Safety of High-Dose IVF Treatments Questioned

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A growing number of fertility specialists are questioning the practice of using high doses of hormone medications to help women become pregnant, calling instead for low-dose cycles of in-vitro fertilization that carry less of a risk of potentially serious side effects.  The New York Times reports:

[Ovarian Hyperstimulation Syndrome (OHSS)] is a little-known complication of fertility treatments that rely on high doses of hormones, which are standard in the United States and the United Kingdom; the syndrome is not the only health problem to be linked to in vitro fertilization. Fertility clinics in Europe and Japan have turned to a safer, low-dose form of IVF, but clinics here have largely resisted on the grounds that the success rates for low-dose IVF are not as high.

"Pregnancy rates are lower, and more cycles of IVF are necessary" with low-dose IVF, said Dr. Glenn L. Schattman, a fertility doctor at NewYork-Presbyterian/Weill Cornell Medical Center and president of the Society for Assisted Reproductive Technology.

But some critics are urging the industry to reconsider.

"Mild stimulation is clearly much healthier for women," said Francine Coeytaux, founder of the Pacific Institute for Women's Health, a nonprofit organization based in Los Angeles. "The reason hyper-stimulation happened is because these fertility clinics compete against each other by posting their success rates."

In high-dose IVF, a woman is first given injections of a drug, often Lupron, to suppress her ovaries, causing temporary menopausal symptoms. Then the ovaries are stimulated with hormones, such as follicle-stimulating hormone and luteinizing hormone, in order to produce more eggs. The duration of stimulation is longer, and the hormone dose significantly higher, than in the low-dose programs common overseas.

Women normally generate one egg per cycle, but high-dose stimulation can help women produce 20 to 30 eggs, or even more. By contrast, women receiving mild, low-dose IVF produce 8 to 10 eggs. The ovaries are not suppressed at the outset, and there is no manipulation of the patient's cycle.

Image: IVF shots, via Shutterstock.

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