One of the most common questions patients ask us when they are about to start fertility drugs, is are they are safe? This question comes up whether they are going to start pills (Clomid, Femara) or injectable fertility drugs (Follistim, Gonal-F, Bravelle, Menopur). Unfortunately, the answers are not always so clear cut as we would like. One of the major concerns women have is about cancer, and the cancer which more women seem to fear than any other is breast cancer. In the past there have been questions about whether fertility drugs increase the risk of breast cancer. A recent study may help to reassure anxious couples. The researchers followed fertility patients from multiple institutions and showed that women treated with fertility drugs, both oral and injectables had the same rates of breast cancer as those who were not. The only exception was women with who took clomid for over year, who did have a slightly higher rate of breast cancer, another good reason to be proactive and see a fertility specialist early on.
Most Reproductive Medicine specialists know that our overweight patients often need higher doses of fertility medications, whether that is pills (clomiphene or Femara), or injections (Follistim, Gonal-F, Bravelle or Menopur). When we do IVF cycles, we also add a medication to prevent ovulation such as Lupron, Ganirelix or Cetrotide, and for the most part, the doses are not adjusted based on a patients weight. It turns out that doctors in Colorado looked at one of these drugs, Cetrotide (Cetrorelix) and found that overweight women actually metabolize the drug faster, meaning that the currently used dosing may not be sufficient in these patients. So, what does that mean? If the cetrotide does not last in the system long enough, premature ovulation may occur, and your IVF cycle could be cancelled. It may mean that we need to use higher or more frequent dosing in heavier women.