From the Research
Neither Leuprolide (Lupron) nor Follitropin alfa (Ovidrel) is known to cause macrocytosis as a side effect. Macrocytosis, characterized by abnormally large red blood cells with a mean corpuscular volume (MCV) greater than 100 fL, is not listed among the documented adverse effects of these fertility medications, as supported by the most recent study 1. Lupron is a gonadotropin-releasing hormone (GnRH) agonist that works by suppressing sex hormone production, while Ovidrel is a recombinant human chorionic gonadotropin (hCG) that triggers ovulation. These medications primarily affect the reproductive hormonal system rather than erythropoiesis or vitamin B12/folate metabolism, which are the common pathways involved in macrocytosis development, as discussed in 2, 3, and 4.
Some key points to consider:
- If a patient on these medications develops macrocytosis, other causes should be investigated, such as:
- Vitamin B12 or folate deficiency
- Alcohol use
- Liver disease
- Certain medications (e.g., methotrexate, anticonvulsants)
- Myelodysplastic syndromes
- Regular complete blood count monitoring during fertility treatment is advisable, but any blood abnormalities that emerge are likely unrelated to these specific medications, as suggested by 5.
- The most common causes of macrocytosis are vitamin B12 deficiency, folate deficiency, and other preventable causes, as found in the most recent study 1.
In clinical practice, it is essential to prioritize the patient's overall health and investigate other potential causes of macrocytosis, rather than attributing it to the fertility medications.