Dr. Linda Helps - You’ll do most anything when you are desperate to have a baby. When doctors recommend you take fertility drugs, you take them. Infertility clinics have been full of women willing to pump potent medications into their systems in order to increase their chances for a baby.

In the 1980s, few people talked about the long-term effects of taking all those fertility drugs. I talked with several women in infertility clinics during that decade -- a woman on her 12th IVF attempt, another who had taken Clomid for three years, another who felt ill most of the time but was willing to endure her constant state of fatigue and nausea for the possibility of a child. The sentiment of most women in the clinics was similar -- they would do whatever was available to attain the goal -- pregnancy.

I often wondered how prolonged use of these drugs would affect their future health. Few seemed to be concerned about their future health. The focus was on the moment.

Since I was on the faculty of a medical school, I asked for studies. I was told data was being collected. Hundreds of women were using the drugs but we had to wait and see.

In addition, fertility drugs can have some nasty side-effects -- moods swings, irritability, depression, hot flashes, swelling of the ovaries, weight gain, water retention and in rare cases, stroke (related to hyperstimulation). Taking the drugs cycles after cycle for prolonged periods was and is a concern. If these women were successful in achieving live births, would they have other health problems with which to contend when they parented those children?

Since the late 1980s, studies have been published regarding the long-term effects of fertility drugs and risks for certain cancers. A recent study does not report an association between the use of fertility drugs and an increased risk of breast and ovarian cancer. The study, published in the May 1999 issues of the journal, Fertility and Sterility, was based on records of 1197 infertile women with an average follow-up of 17.9 +- 5 years.  These results confirm the findings of two other studies published in the Journal of the American Medical Association (JAMA) in 1998. This is good news.

A 1994 study published in the New England Journal of Medicine did report an increased risk of ovarian cancer associated with prolonged use of clomiphene. Specifically, women who used clomiphene for longer than 12 cycles had a 2.5 times increase in ovarian cancer. Those who took the drug for less than a year showed no increased risk for ovarian cancer.

It’s important to follow the data concerning long-term effects of fertility drugs on a woman’s health over time. Ask for copies of recent studies if you are presented with the option of taking fertility drugs. Some clinics will provide that information without asking. You need to think through the potential risks and weigh them against the desired goal. There may be a point at which the risks outweigh the potential benefits. Don’t get so caught up with available options that you don’t carefully consider long-term possible consequences.

Dr. Mintle – author, professor, Approved Supervisor and Clinical member of the American Association for Marriage and Family Therapy – is a speaker and media personality, as well as a licensed clinical social worker with over twenty years in psychotherapy practice.

For more articles and information, visit Dr. Linda Mintle's Web site.