Abstract
Over 2 million women age 15–44 years are estimated to have taken fertility drugs in the United States. This number will continue to increase as more women seek treatment for infertility, and many undergo treatment with ovulation induction agents. Thus it is important to be aware of the possible complications associated with superovulation so we can adequately counsel, diagnose, and treat our patients appropriately. We discuss here several iatrogenic complications associated with the use of ovulation induction agents, including ovarian hyperstimulation syndrome, multifetal gestations, preterm delivery, heterotopic/ectopic pregnancy, spontaneous abortion, and the theoretic risk of a possible increase in the incidence of ovarian cancer.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
Suggested Reading
Antsaklis AJ, Drakakis P, Vlazakis GP, et al. Reduction of multifetal pregnancies to twins does not increase obstetric or perinatal risks. Hum Reprod 1999; 14: 1338–1340.
ASRM Practice Committee Report. Guidelines on Number of Embryos Transferred, November 1999.
ASRM Practice Committee Report. Multiple Pregnancy Associated with Infertility Therapy, November 2000.
Bohrer M, Kemmann E. Risk factors for spontaneous abortion in menotropin-treated women. Fertil Steril 1987;48:571–575.
Bristow RE, Karlan BY. Ovulation induction, infertility, and ovarian cancer risk. Fertil Steril 1996;66:499–507.
Bristow RE, Karlan BY. The risk of ovarian cancer after treatment for infertility. Curr Opin Obstet Gynecol 1996;8:32–37.
Fisch JD, Milki AA, Behr B. Sibling embryo blastocyst development correlates with the in vitro fertilization day 3 embryo transfer pregnancy rate in patients under age 40. Fertil Steril 1999;71:750–752.
Fluker MR, Copeland JE, Yuzpe AA. An ounce of prevention: outpatient management of the ovarian hyper-stimulation syndrome. Fertil Steril 2000;73:821–824.
Gross TP, Schlesselman JJ. The estimated effect of oral contraceptive use on the cumulative risk of epithelial ovarian cancer. Obstet Gynecol vol. 83 p. 619–626, 1996.
Haning RV Jr, Canick JA, Goldsmith LT, et al. The effect of ovulation induction on the concentration of maternal serum relaxin in twin pregnancies. Am J Obstet Gynecol 1996;174:227–232.
Hartge P, Schiffman MH, Hoover R, et al. A case control study of epithelial ovarian cancer. Am J Obstet Gynecol 1989;161:10–16.
Helzlsouer KJ, Alberg AJ, Gordon GB, et al. Serum gonadotropins and steroid hormones and the development of ovarian cancer. JAMA 1995;274:1926–1930.
Hock DL, Scifer DB. Ovarian hyperStimulation syndrome. Infertil Reprod Med Clin North Am 2000; 11:399.
Houmard BS, Scifer DB. Infertility treatment and informed consent: current practices of reproductive endocrinologists. Obstet Gynecol 1999;93:252–257.
Krasnow JS, Berga SL, Guzick DS, Zeleznik AJ, Yeo K-T. Vascular permeability factor and vascular endothelial growth factor in ovarian hyperstimulation syndrome: a preliminary report. Fertil Steril 1996;65: 552–555.
Lyons CA, Wheeler CA, Frishman GN, et al. Early and late presentation of the ovarian hyperstimulation syndrome: two distinct entities with different risk factors. Hum Reprod 1994;9:792–799.
Mathur RS, Akande AV, Keay SD, et al. Distinction between early and late ovarian hyperstimulation syndrome. Fertil Steril 2000;73:901–907.
McElhinney B, McClure N. Ovarian hyperstimulation syndrome. Baillieres Best Pract Res Clin Obstet Gynaecol 2000; 14:103–122.
Ron EL, Lunenfeld B, Menczer J, et al. Cancer incidence in a cohort of infertile women. Am J Epidemiol 1987; 125:780–790.
Rossing MA, Daling JR, Weiss NS, et al. Ovarian tumors in a cohort of infertile women. N Engl J Med 1994; 331:771–776.
Schenker, et al. Complications of assisted reproductive techniques. Fertil Steril 1994;61:411–422.
Schildkraut JM, Schwingt PJ, Bastos E, Evanoff A, Hughes C. Epithelial ovarian cancer risk among women with polycystic ovary syndrome. Obstet Gynecol 1996; 88:554–559.
Sherwood OD. Relaxin. In: Knobil E, Neill (eds) The Physiology of Reproduction. New York: Raven, 1988: 585–673.
Shu XO, Brinton LA, et al. Population-based case-control study of ovarian cancer in Shanghai. Cancer Res 1989;49:3670–3674.
Spirtas R, Kaufman SC, Alexander NJ. Fertility drugs and ovarian cancer: red alert or red herring? Fertil Steril 1993;59:291–293.
Strandell A, Thorburn J, Hamberger L. Risk factors for ectopic pregnancy in assisted reproduction. Fertil Steril 1999;71:282–286.
Tal J, Haddad S, Gordon N, Timor-Tritsch I. Heterotopic pregnancy after ovulation induction and assisted reproductive technologies: a literature review from 1971 to 1993. Fertil Steril 1996;66:1–12.
Venn A, Watson L, Lumley J, et al. Breast and ovarian cancer incidence after infertility and in vitro fertilization. Lancet 1995;346:995–1000.
Weiss G, Goldsmith LT, Sachdev R, et al. Elevated firsttrimester serum relaxin concentrations in pregnant women following ovarian stimulation predict prematurity and preterm delivery. Obstet Gynecol 1993;82: 821–828.
Whelan J III, Vlahos N. The ovarian hyperstimulation syndrome. Fertil Steril 2000;73:883.
Whittemore AS, Harris R, Itnyre J, et al. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. Part II. Am J Epidemiol 1992;136:1184–1203.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer-Verlag New York, Inc.
About this chapter
Cite this chapter
Fonslick, J.A., Seifer, D.B. (2002). Complications of Ovulation Induction. In: Seifer, D.B., Collins, R.L. (eds) Office-Based Infertility Practice. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-87690-5_19
Download citation
DOI: https://doi.org/10.1007/978-3-642-87690-5_19
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-87692-9
Online ISBN: 978-3-642-87690-5
eBook Packages: Springer Book Archive