October 20, 2007	Saturday	Shawwal 7, 1428

WASHINGTON: Fertility-boosting injections given to thousands of women each year may be a waste of time and money and put mothers and babies at risk, experts say. The warning follows the most comprehensive investigation yet into the costs and effectiveness of different fertility treatments offered by clinics.

Hormone injections are typically given to women who have failed to become pregnant after being prescribed milder clomiphene fertility pills but before they are admitted for full IVF treatment. The injections stimulate the ovaries to overproduce eggs, and so increase a woman’s chances of pregnancy. But they also have significant side-effects, including headaches, abdominal pain and ovarian hyper-stimulation syndrome, which is rarely serious but in exceptional cases can be fatal.

The injections also increase the chances of a woman having twins or triplets. Around 20 per cent to 30 per cent of women given the injections have multiple births, which increase the risk of birth defects and are linked to pregnancy-induced hypertension.

Doctors at the Dartmouth-Hitchcock medical centre in New Hampshire conducted an extensive study to investigate whether hormone injections were effective for women who had failed to become pregnant after taking fertility pills.

The study found that women became pregnant more quickly – and spent less on treatment – if they were sent straight for IVF, suggesting hormone injections were not worth the cost or risk. “The use of these injections does not provide added benefit,” said Richard Rheinhold, who led the study.

The doctors enrolled 503 infertile couples for the study and randomly assigned them to two different groups. Women in the first group joined a standard three-tier fertility programme. As a first step, they were given clomiphene pills before artificial insemination (IUI), which injects sperm directly into the womb. If they failed to conceive, they were given daily hormone injections and further artificial insemination. Women who did not become pregnant at this stage were sent for full IVF treatment, which entails ovary-stimulating drugs, egg retrieval, fertilisation and embryo implantation. The second group were fast-tracked straight to IVF if they failed to get pregnant after a course of fertility pills and artificial insemination.

Overall, both groups had similar chances of becoming pregnant, with 75 per cent in the three-tier and 78 per cent in the fast-track scheme eventually conceiving. But those in the fast-track programme became pregnant three months earlier than the others, on average after eight months. Fast-tracked women also had substantial cost savings.

“When compared to conventional infertility treatment, the accelerated approach to IVF that eliminates fertility injections results in roughly equal percentages of pregnancies with fewer treatment cycles and lower costs,” Dr Rheinhold told the annual meeting of the American Society for Reproductive Medicine in Washington. —Dawn/ The Guardian News Service