Prescription Medication Impact of maternal intake – natural conception Impact of maternal/paternal intake on ART Suggestion
SSRIs
Low risk. Risk-benefit analysis. Reported increased incidence of cardio-septal defects.
No statistical difference on outcomes yet data is limited. Further research required.
Amber
PPIs Current data suggests omeprazole is safe however limited data on other PPI’s. Negative impact on sperm if taken >6m prior to ART. Further research required to assess maternal effects. Amber
Metformin Considered safe; insufficient data on 1st trimester and miscarriage risk. Beneficial in PCOS patients undergoing ART. Further research required for others. Amber
Levothyroxine Considered safe. Positive effect on live birth rates in subclinical hypothyroidism. Further research required on paternal effects. Green
Anti-hypertensives
ACEi/ARBs: proven fetal renal risk in 2nd and 3rd trimesters. CCBs: animal studies demonstrate risk but lack of data in humans. Beta-blockers: labetalol considered safe.
Further research required for maternal effects. Beta-blockers: no adverse effects on sperm quality. ACEi/ARBs, CCBs: isolated impacts on sperm Diuretics: no impact
Amber ¥
Asthma medications
Increased risk of cleft palate, renal dysplasia and gastroschisis with inhaled beta2 agonists. Inhaled corticosteroids have not been associated with adverse impacts. However, uncontrolled asthma can cause significant impacts
Further research required.
Amber (inhaled beta2 agonists) Green (inhaled corticosteroids)
Steroids Further research required. Limited association with low birth weight and cleft lip/palate Further research required. Amber