Risks of IVF

IVF risks at a glance

• In vitro fertilization (IVF) has the obvious benefit of greatly increasing chances of a successful pregnancy, often when pregnancy was impossible otherwise.
• Although serious complications from IVF medications or procedures are rare according to the American Society for Reproductive Medicine, IVF is a medical procedure, and so carries some potential risks involving medication, egg retrieval, embryo transfer, risk of multiples, miscarriage, and psychological stress.

Medication

Ovulation induction medications are used during IVF procedures to stimulate the ovaries to develop more eggs. Possible side effects from these medications include:

• Injection site bruising and soreness
• Allergic reaction
• Gastrointestinal pain
• Headaches
• Mood changes

In the vast majority of cases, these side effects are limited and no treatment is required.

IVF medications can also cause ovarian hyperstimulation syndrome (OHSS). Hyperstimulation occurs from medication-induced ovarian stimulation that causes the ovaries to become swollen and painful. Most commonly, this condition is mild, with mild to moderate pain, loss of appetite and feeling bloated. In 1 percent of cases, worse symptoms will surface, including severe abdominal pain, severe nausea or vomiting, decreased urinary frequency, dark-colored urine, shortness of breath, and significant weight gain due to fluid retention. Treatment usually consists of supportive care, occasional hospitalization for intravenous fluid hydration or, in rare circumstances, inserting a needle in the abdomen to remove excess fluid.

Since this condition is very short, if pregnancy does not occur, the doctor may advise that all of the embryos be frozen so they can be transferred after hyperstimulation recovery. If severe OHSS occurs after conceiving, it can last up to the tenth week of pregnancy and then resolve.

Ovarian cancer

Although older reports suggest fertility drugs are linked to ovarian cancer, new studies do not reveal evidence of this risk.

Egg retrieval

Egg retrieval carries the typical risks associated with anesthesia. The procedure also includes a slight risk of internal bleeding, infection, and damage to the bowel, bladder or blood vessels. Only one in 1,000 patients will sustain damage during an egg retrieval procedure that requires repair surgery.

Embryo transfer

The embryo transfer procedure, which uses a special catheter to insert embryos into the uterus, may cause spotting, bleeding, or cramping following the procedure. If in the rare circumstance an infection develops, antibiotics can be prescribed.

Increased risk of multiples

If multiple embryos are transferred, there is an increased chance that a multiples pregnancy will occur. This carries risks for the mother – such as pregnancy and labor complications – and for the baby – including premature delivery and lifelong medical and developmental problems.

Birth defects

Major malformation risk is the same for IVF pregnancies as the general population of patients who conceive using natural means. IVF may increase the risk of certain rare birth defects by a very small amount over the general population.

Miscarriage

IVF does not increase the rate of pregnancy loss or miscarriage compared to women who conceive naturally, according to the American Society for Reproductive Medicine.

Psychological stress

Assisted reproductive treatments in general affect patients, their partners, and sometimes even family and friends on a physical, financial and emotional level. Psychological stress and emotional problems are common, more so if the treatment is unsuccessful.