There are three concerns associated with drugs used to induce ovulation:

  • They are associated with a greater chance of multiple pregnancy. The general rate of twins in the population is one in every eighty deliveries but with clomiphene, it is one in twenty or a four-fold increase. Higher order multiple pregnancies (e.g. triplets and quads) can occur with clomiphene but this is rare. Injections of gonadotrophins are more likely than clomiphene to result in multiple pregnancy.
  • Occasionally ovulation induction can lead to ovarian hypersensitivity syndrome (OHSS).
  • Finally, there has been concern that ovulation induction treatments may increase the chance of ovarian cancer. A comparison was made of the risk of cancer among women who received clomiphene with the risk among infertile women who did not receive it. There were 11 invasive or borderline malignant ovarian tumors, as compared with an expected number of 4.41994-01. A confounding factor is that infertility is itself associated with an increased risk. Furthermore, the risk is reduced with secondary infertility and is dependent on the causation of the infertility.2004-01Several infertility units have reported their data. Some seemed to confirm the link between clomiphene and ovarian cancer but the majority have produced reassuring results.1999-02,2004-02 2006-01

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This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

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David Viniker retired from active clinical practice in 2012.
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