Fertility Medication Does Not Put Baby's Health at Risk

DEAR MAYO CLINIC: I am trying to get pregnant and my doctor suggests Clomid. Are fertility drugs harmful (physically or intellectually) to the baby?

ANSWER: No. You will not be putting your baby's health at risk if you choose to take clomiphene (Clomid).

Clomiphene has been used for more than 35 years to treat infertility. Research has shown that the rate of birth defects in patients with infertility may be slightly higher than the general public, but treatment with clomiphene or other similar fertility medications does not seem to increase the risk of birth defects. In addition, there is no increased risk of miscarriage in pregnancies conceived using clomiphene.

Clomiphene is an oral medication that works by changing the hormone balance in your body, causing ovulation. It's often the first step in fertility treatment for women who aren't ovulating regularly. Patients take clomiphene for five days during an ovulation cycle. The medication causes the pituitary gland to release more follicle-stimulating hormone and luteinizing hormone, which stimulate the growth of an ovarian follicle that contains an egg. Then, in most cases, the body ovulates naturally.

Although clomiphene doesn't pose any risks to the baby, there are some potential side effects for the mother. While taking clomiphene, some women have mood swings, hot flashes, headaches and vision disturbances, such as briefly seeing flashes of light. Rarely, a woman's body may be sensitive to clomiphene, and the medication causes her ovaries to swell and become overstimulated. These and other side effects are uncommon, and all go away when you finish taking the medication.

According to research, clomiphene stimulates ovulation in 80 percent of women who take the medication, and approximately 40 to 50 percent of them will become pregnant within six ovulation cycles.

At Mayo Clinic, we typically recommend that women take clomiphene alone for no more than six to eight ovulation cycles. The limited time is not due to any potential health risks. Rather, studies have shown that women who don't get pregnant within that amount of time while taking clomiphene are more likely to benefit from additional fertility therapies, such as intrauterine insemination or medications that are injected, rather than taken orally.

Clomiphene does slightly increase your chance of conceiving multiple fetuses, also known as multiples. But, it's rare. With oral fertility medication, the possibility of multiples is five to eight percent. If you do conceive more than one baby, it's likely they will be twins, and not the larger numbers of multiples that can be associated with other fertility treatments.

For most women, taking clomiphene is a reasonable first step in fertility treatment. Over several decades, it has proven to be a safe and, in many cases, effective therapy. And, if you conceive using clomiphene, the health considerations for your baby during pregnancy and after birth will be the same as if you had not used fertility medication. -- Charles Coddington III, M.D., Reproductive Endocrinology, Mayo Clinic, Rochester, Minn.

READERS: For most healthy adults, deep vein thrombosis (DVT), the medical term for blood clots in the legs, is extremely rare. Every year, about 350,000 Americans are affected by DVT or a pulmonary embolism, where a clot breaks away and blocks an artery to the lung -- often a fatal condition.

DVT develops in the larger, "deep" veins that funnel blood back to the heart. The condition usually affects the largest veins of the legs and pelvis. Many factors increase risk of clotting, including certain cancers, advanced age, living in a nursing home, use of hormone replacement therapy, pregnancy, recent childbirth, a family history of DVT and obesity.

Any of several situations can trigger DVT. Airplane rides lasting six hours or more and long periods of sitting for any reason pose risks. That's why travelers are urged to stretch or walk every hour and stay well hydrated. Hospitalization for a sudden medical problem also creates risks. Trauma or a fracture in the leg area or pelvis puts patients at high risk, as does major surgery -- especially surgery that involves hip and knee replacement or is in the pelvic area.

Many DVTs develop and grow quite large before symptoms appear. Eventually, in most cases, symptoms are present and can include:

-- Swelling in the ankle of the affected leg. Typically only one leg is affected.

-- Leg pain that often starts in the calf and can feel like a cramp.

-- Redness or warmth over the affected area and fever.

These symptoms should prompt a visit with a physician. Ultrasound and other imaging techniques are used to diagnose DVT. Treatment seeks to prevent the clot from becoming bigger and to reduce the risk of pulmonary embolism. Most people with DVT are prescribed anticoagulant medications to take for three months or longer. -- Adapted from Mayo Clinic Health Letter

Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. E-mail a question to medicaledge@mayo.edu , or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For more information, visit www.mayoclinic.org.(c) 2009 Mayo Foundation for Medical Education and Research. Distributed by Tribune Media Services Inc. All Rights Reserved.