Hormone treatment

If you aren’t ovulating (producing and releasing an egg each month) at all, or only sometimes, you may be offered fertility drugs.

Hormones are a type of fertility drug that can come from human sources or be artificially produced. They trigger egg production in a similar way as your body’s own hormones.

The use of these fertility drugs is known as ovulation induction. You may come across them under their trademarked names, such as Gonal-f, Puregon, Menogon, Menopur and Merional.

How does hormone treatment affect the risk of multiple birth?

These drugs (called gonadotrophins, FSH – follicle stimulating hormone, and LH – luteinising hormone) help your ovaries to produce more than one egg at a time (unlike your natural cycle), making multiple birth more likely.

According to the manufacturer of Pergonal, a gonadotrophin, its use carries a 40% risk of a twin pregnancy.

Other side-effects include:

• over-stimulation of the ovaries, known as ovarian hyperstimulation syndrome (OHSS, which is a potentially dangerous over-reaction that can cause nausea and vomiting, severe stomach pains and swelling, shortness of breath, faintness and reduced urine) and 
• allergic reactions and skin reactions.

Hormone treatment is generally included in IVF and often with IUI.

What are my options?

If you are receiving hormone treatment, you should discuss the following with your clinician:

• Monitoring: This is to check on the number and quality of any eggs that develop.
• Dosage: The aim is to maximise your chance of becoming pregnant while keeping your risk of multiple pregnancy to a minimum.
• Different types of treatment: You may also want to discuss the different types of hormone treatment with your clinician. Some recent evidence suggests that using a different type called gonadotrophin-releasing antagonists instead of the more commonly used gonadotrophin-releasing agonists may reduce your risk of a multiple birth.