Is it safe to use Dysport (botulinum toxin) in a woman of reproductive age undergoing egg harvesting procedures for In Vitro Fertilization (IVF)?

Dysport and Egg Harvesting Safety

There is no evidence-based contraindication to using Dysport during egg harvesting procedures for IVF, as botulinum toxin does not affect oocyte quality, ovarian function, or the egg retrieval process itself. However, the critical consideration is timing relative to potential pregnancy, not the egg harvesting procedure.

Key Safety Considerations

Timing Relative to Egg Retrieval

• Dysport can be safely administered before or during the ovarian stimulation and egg harvesting phase, as this procedure does not involve pregnancy and botulinum toxin does not interfere with oocyte development or retrieval 1
• The egg harvesting procedure is an outpatient surgical procedure that requires 10-14 days of ovarian stimulation from the beginning of the menstrual cycle, and Dysport administration does not impact this timeline 1

Critical Timing for Embryo Transfer

• If embryo transfer is planned (rather than embryo/oocyte cryopreservation), Dysport should be discontinued before attempting pregnancy 1
• Women planning immediate embryo transfer should avoid Dysport in the cycle when transfer will occur, as inadvertent pregnancy exposure requires immediate discontinuation 1

Clinical Algorithm

Scenario 1: Egg Harvesting with Cryopreservation (No Immediate Transfer)

• Dysport can be used without restriction during the stimulation and retrieval cycle
• No washout period is required before egg retrieval
• This applies whether cryopreserving oocytes or embryos for future use 1

Scenario 2: Fresh Embryo Transfer Planned

• Discontinue Dysport at least 3 months before the planned transfer cycle to ensure complete clearance before potential pregnancy
• Switch to alternative management strategies for the indication requiring Dysport
• If pregnancy occurs unintentionally while on Dysport, discontinue immediately 1

Important Caveats

Pregnancy Exposure Risk

• The primary concern with Dysport is pregnancy exposure, not the egg harvesting procedure itself 1
• Botulinum toxin has shown adverse effects in animal reproduction studies and lacks adequate human pregnancy data 1
• Inadvertent exposure during pregnancy would not be considered grounds for termination, but requires immediate discontinuation and close fetal monitoring 1

Duration of Effect

• Dysport's clinical effects last 15-17 weeks on average, with some patients requiring retreatment every 2-6 months 2
• Plan timing accordingly if fresh embryo transfer is anticipated within this timeframe

No Impact on Ovarian Function

• There is no evidence that botulinum toxin affects ovarian response, oocyte quality, or fertilization rates 1
• The decision regarding single versus double embryo transfer should not be influenced by prior Dysport use 1