# Risks and Side Effects

Risks and Side Effects (Low-tech/IUI)

Throughout a low-tech treatment cycle, your care team monitors closely to ensure you are responding safely to medication. Fertility drugs also raise a common question about long-term health risks. Both are worth a brief explanation.

Clomiphene citrate is usually well tolerated, with mild and infrequent side effects. A small number of patients experience dizziness or visual changes — if these occur, let your care team know. Letrozole is also well tolerated and tends to produce fewer side effects than clomiphene citrate. Both medications can cause ovulation-related symptoms such as mid-cycle pelvic pain, breast tenderness, and menstrual cramps.

Injectable FSH and HMG are also well tolerated. Infrequent side effects include skin reactions at the injection site, fatigue, headaches, nausea, and mood changes. Temporary fluid retention of two to five pounds is also possible.

In rare cases, ovarian stimulation for IUI or timed intercourse can lead to ovarian hyperstimulation syndrome, or OHSS. Some people are predisposed to a stronger response than others — which is why stimulation protocols are individualized and the care team monitors closely throughout. When OHSS occurs, it's usually mild — some bloating and discomfort that resolves on its own within one to two weeks. More significant cases are managed effectively with hydration and, when needed, drainage of accumulated fluid. OHSS is exceedingly rare in low-tech cycles, because stimulation is generally mild, with a goal of recruiting a modest number of follicles.

The second topic worth addressing is a question that emerged in the 1990s. Back then, a small number of studies suggested fertility medications might be linked to increased cancer risk. More recent research — conducted across much larger populations — did not confirm those findings. It also identified a key flaw in the original studies: infertility itself carries a modestly elevated cancer risk, independent of any treatment. Since then, millions of people have gone through fertility treatment. The current body of evidence does not show an increased cancer risk from fertility medications. Patients with a personal or family history of hormone-sensitive cancer should discuss this with their care team to determine whether it warrants any modification to their treatment plan.

Questions about individual risk can be discussed with your care team at any point.
