Adverse Reactions and Risks to Gonadotropin Therapy:

Local irritation at injection site.
Symptoms of estrogen excess (dizziness, nausea, headaches, mood swings irritability, hot flashes, breast fullness or tenderness)
Ovarian enlargement
Ovarian\ Torsion (twisting of an ovary, usually because it is enlarged)
Ovarian Hyperstimulation Syndrome
Multiple pregnancy
Miscarriage
Ectopic (tubal) pregnancy
Cycle cancellation

Multiple Pregnancies: Multiple pregnancies are more common with gonadotropins than with clomiphene citrate (Clomid, Serophene). The risk is directly proportional to the number of mature follicles. Overall, multiple pregnancies represent 15-20 % of the gonadotropin induced pregnancies with 2-5 % of all pregnancies being high order multiple pregnancies (e.g. Triplets or more)

Ovarian Hyperstimulation Syndrome (OHSS) is a sudden enlargement of the ovaries and accumulation of fluid in the abdomen. It can be a rapidly progressive medical emergency, which may require hospitalization and even intensive care services in its worst form. The cause is unknown, but it is associated with high estrogen levels. Many of the women who develop it are pregnant. The monitoring is designed to attempt prevent OHSS from occurring. Still, it happens in milder forms in 5-10% of gonadotropin cycles. Severe forms are less common. Early symptoms may include weight gain ( over 5 pounds), bloating, nausea vomiting, diarrhea and shortness of breath. If you think you have these symptoms, please notify us immediately.

Cancellation of the Cycle: Canceling the cycle (not giving the hCG or doing the IUI) can prevent OHSS and multiple pregnancies. At times, this may be the safest way to proceed. Cycles may also be canceled for inadequate response.