Multiple pregnancy

Ovarian enlargement, hemoperitoneum, febrile reactions, multiple pregnancies, hypersensitivity Failure to respond to therapy due to development of antibodies, hypothyroidism, insulin resistance, swelling of the joints, joint and/or muscle pain Same as somatropin... 

Some patients will have repeatedly nonspecific reactivity in an ELISA assay, since the HIV-1 antigen used for the antibody assays is produced in cultured human T cells. It is not unexpected that occasional false positive assays occur in human sera from individuals with autoimmune diseases a history of multiple pregnancies or multiple transfusions or antibodies to certain class II histocompatibility antigens (especially HLA-DR4). Block reagents have been added to specimen diluents to minimize cross-reactions in these sera. This necessitates the use of confirmatory tests, especially the Western blot. With the use of both ELISA and Western blots, false positives decrease to less than 1 per 100,000. 

In women treated with gonadotropins and hCG, the two most serious complications are the ovarian hyperstimulation syndrome and multiple pregnancies. Overstimulation of the ovary during ovulation induction often leads to... 

Follitropin alfa Activates FSH receptors Mimics effects of endogenous FSH Controlled ovulation hyperstimulation in women infertility due to hypogonadism in men SC injection 3-7 x/wk Toxicity Ovarian hyperstimulation syndrome and multiple pregnancies in women gynecomastia in men headache, depression, edema in both sexes... 

In an unusual case reported in detail from Saudi Arabia, a 28-year-old woman receiving gonadotropins developed acute respiratory distress, abdominal pain, and severe hyponatremia associated with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) (19). A multiple pregnancy nevertheless resulted and three fetuses went to term successfully. 

Follitropin treatment for infertility has been reviewed in detail (1,2). Multiple pregnancy occurs in 20% of patients, 80% being twin pregnancies. There is no documented increase in congenital abnormalities in children conceived after ovulation induction with follitropin. 

Nikkola E, Ekblad U, Ekhom E, Mikola H, Polo O. Sleep in multiple pregnancy breathing patterns, oxygenation, and periodic leg movements. Am J Obstet Gynecol 1996 174 1622-1625. 

Because of its use in the treatment of female infertility, which inevitably involves early exposure of some embryos, the safety of bromocriptine in early pregnancy has been systematically evaluated in a large multicenter study with prolonged follow-up (SEDA-13, 112). There was no evidence that this use of bromocriptine was associated with an increased risk of spontaneous abortion, multiple pregnancy, or the occurrence of congenital malformations nor did exposure in utero seem to have any adverse effects on postnatal development. Cervical incompetence may be a problem at the time of delivery, but this may well be due to a long history of infertility rather than to the drug itself. 

Some clinicians use induction therapy with IL2RAs or RATG for all transplant recipients. Others reserve induction therapy for patients who are at a higher risk for rejections, such as those who have a high PRA, had previous transplants or multiple pregnancies, or are of non-Caucasian race. 

Clomiphene (e.g., Clomid) Clomiphene stimulates LH and FSH release by reducing negative-feedback by estrogen on the pituitary. Increased LH and FSH levels induces ovulation and maintains functional corpus lutea. The rate of multiple pregnancies is 8%. Abnormal ovarian enlargement occurs in 14% of patients and may cause pain. 

---