IVF is a complex and amazing process, performed over two million times annually across the globe. Serious complications from IVF medications and procedures are rare. But as with all medical treatment, there are risks involved and it is necessary to review them. Each physician will review specific risks of IVF with their patient, following is an overview.
FERTILITY MEDICATION Injectable fertility medications (gonadotropins) are used in IVF to help stimulate multiple eggs to grow within the ovaries. Side effects vary but may include: ● Soreness or mild bruising at the injection site ● Temporary minor irritation at the injection site, such as skin reddening and/or itching ● Abdominal bloating and discomfort ● Breast tenderness and increased vaginal discharge ● Fatigue and mood swings
OHSS Ovarian hyperstimulation syndrome (OHSS) is an exaggerated response to IVF stimulation medications and hormones. The ovaries become painful and swollen, but in most cases symptoms are mild and resolve on their own within a few days after retrieval. In more severe cases, fluid can build up in the abdomen and lungs requiring medical intervention. Symptoms can include:
● Abdominal pain and bloating ● Nausea and/or vomiting ● Diarrhea ● Dehydration ● Shortness of breath
EGG RETRIEVAL The egg retrieval procedure is performed using a needle attached to a vaginal ultrasound probe for guidance. Your doctor will insert the tip through your vagina into the ovary, and then into each follicle to retrieve eggs. Possible risks for this procedure include: ● Mild to moderate abdominal pain - most discomfort can be managed with over-the-counter pain medications and resolves quickly ● Injury to nearby organs, such as blood vessels, bowel, or the bladder - very rarely, these injuries may require emergency surgery ● Pelvic infection - uncommon as antibiotic medication is usually given at the time of egg retrieval ● General risks associated with anesthesia and other sedative medications CANCELED CYCLE Having your IVF cycle canceled prior to egg retrieval can understandably be shocking and frustrating, among many other emotions. No one goes into their IVF cycle expecting not to make it to embryo transfer, but your fertility doctor will use the cycle information to make further recommendations. A few reasons an IVF cycle may be canceled are: ● Ovarian cysts present prior to starting fertility medications ● Low number of follicles developing ● Too many follicles developing/increased risk for OHSS ● Ovulating prior to egg retrieval occurring ● No mature eggs retrieved ● No eggs fertilize to become embryos ● No embryos available for transfer PREGNANCY OUTCOMES A positive pregnancy test does not always equal a full-term delivery. It is important to be aware of all possible pregnancy outcomes so there will be no surprises. The best method for figuring out your options for moving forward is to be educated. Following are some potential pregnancy outcomes:
Ectopic Pregnancy An ectopic pregnancy occurs when an embryo implants somewhere other than the uterus, such as the fallopian tube or cervix. Once confirmed through ultrasound and lab work, a woman may be given medicines to end the pregnancy or surgery to remove it. Signs of an ectopic pregnancy may include:
● Severe, one-sided pain ● Vaginal spotting or bleeding ● Dizziness or fainting ● Shoulder pain
Chemical Pregnancy
A chemical pregnancy occurs when an embryo tries to implant in the uterus, but is ultimately not successful in remaining implanted. There is a rise in the pregnancy hormone, but it then reaches a peak and returns to a negative level.
Miscarriage
Experiencing a loss after the pregnancy is confirmed on ultrasound, but before the 20th week of pregnancy is called a miscarriage. Miscarriage rates with IVF are similar to that of women who conceive without fertility treatment.
Multiple pregnancy
The goal of IVF is a healthy singleton pregnancy, safer for both baby and mom. A pregnancy with more than one baby is more likely when two or more embryos are transferred. One way to avoid multiple pregnancy is to choose to transfer only one embryo at a time. Multiple pregnancies carry significant risks, including:
● Preterm labor and/or delivery
● Maternal hemorrhage
● Delivery by cesarean section (C-section)
● Pregnancy-related high blood pressure
● Gestational diabetes
Your physician should spend time reviewing in detail the risks associated with IVF in your particular case and provide ample opportunity for you to discuss any concerns you may have.
Embrace Fertility offers IVF Cycle Coaching and 1:1 Fertility Support for your complete fertility and IVF journey. Click here to learn more.