In vitro fertilization (IVF): What are the risks?

Introduction

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IVF is assisted reproduction that involves the use of sperm from a man and eggs from a woman. This is done in a laboratory. One or more fertilized eggs, also known as embryos, may be transferred into a woman’s uterus. They may then implant in the uterine membrane and develop. IVF procedures and medicines can cause serious complications. There are risks associated with any medical treatment. These are the most frequent risks.

IVF medications can cause side effects.

Injectable fertility medication (gonadotropins) is often used to perform an IVF cycle. These medications stimulate the growth of eggs in the ovaries by stimulating several follicles. The ASRM booklet, Medications to induce ovulation, provides a more thorough discussion on fertility medications.

Injectable fertility medications can have side effects such as

  • Mild bruising or soreness around the injection site can be caused by using different injection sites.
  • Sometimes, nausea, and vomiting
  • Temporary allergic reactions such as skin reddening or itching at the injection site.
  • Tender breasts and more vaginal discharge
  • Fatigue and mood swings
  • Ovarian hyperstimulation syndrome (OHSS)

Most symptoms of OHSS, such as nausea, bloating, and ovarian discomfort, are mild. They typically disappear within a few days of egg collection. In extreme cases, OHSS may cause fluid buildup in the abdomen (belly), and lungs. This can lead to enlarged ovaries and dehydration. It can also cause severe abdominal pain. Rarely (in less than 1% of women who have egg retrieval for IVF), OHSS can cause blood clots or kidney failure. See the ASRM factsheet Ovarian hyperstimulation Syndrome (OHSS) for more information.

Reports from decades ago suggested that there was a link between ovarian carcinoma and the use of fertility medications. Recent and more thorough studies have not shown any clear association between ovarian cancers and the use of fertility medication.

What are the potential risks associated with egg retrieval?

Your doctor will use vaginal ultrasound to guide you through the procedure of egg retrieval. A long, thin needle is inserted through your vagina and into each follicle to extract eggs. This procedure can pose risks:

  • Mild to moderate abdominal and pelvic pain (during or afterward). Most cases disappear within a few days and can be treated with over-the-counter pain medication.
  • Organs around the ovaries can be injured, including the bladder, bowel, and blood vessels. Rarely, emergency surgery is required for bowel or blood vessel injuries.
  • From mild to severe pelvic infection Because antibiotics are often given immediately after egg collection or embryo transfer, pelvic infections are rare. In severe cases, hospitalization may be necessary and intravenous antibiotics may be required.
  • Rarely, severe infections may require surgery to remove one or both ovaries, tubes, and/or the uterus. IVF-related infections are more common in women who have experienced pelvic infections, endometriosis, or ovaries problems.

What are the risks of embryo transfer?

To gently place the embryos in the uterus (womb), a catheter with the embryos is used. The catheter may cause mild cramping in women who are inserted through their cervix. They may also experience slight bleeding (vaginal spotting) afterward. An infection can occur very rarely and is usually treated with antibiotics.

Will my pregnancy be more difficult if I have IVF?

Multiple pregnancies are more common with IVF, especially when more than one embryo is transferred. These pregnancies can pose significant risks.

  • Preterm labor and/or birth: Premature babies, regardless of whether they were conceived naturally, with IVF, or artificially, are more at risk for developing health complications like learning disabilities, lung development problems, and intestinal infections.
  • Maternal hemorrhage
  • Delivery via Cesarean section (C Section)
  • High blood pressure during pregnancy
  • Gestational diabetes

The greater the chance of having multiple embryos in the uterus, Your doctor should only transfer as many embryos as necessary to ensure a high probability of pregnancy and a low risk of multiple pregnancies. The ASRM booklet Multiple pregnancy and childbirth: twins, triplets, and high-order multiples. Contains more information. You can avoid multiple pregnancies by choosing to only transfer one embryo at a given time. This is how you can avoid multiple pregnancies.

Is there a greater chance of my child developing a birth defect if IVF is used?

Birth defects are a risk in the general population, which is between 2% and 3%. It is slightly higher in infertile patients. This is due to infertility and delayed conception. It is still unclear whether IVF alone can cause birth defects. This issue is being studied. There may be an increase in birth defects if intracytoplasmic fertilization (ICSI), is performed alongside IVF.

There may also be an increased risk of sex chromosome abnormalities (X or Y chromosomes) with ICSI. It is not clear if the ICSI procedure or the sperm itself is to blame for these risks. Men who have sperm problems are more likely than others to have chromosomal abnormalities that can be passed on to their children. These disorders are rare. The possibility of rare genetic disorders called imprinting diseases may be slightly increased by IVF.

Ectopic pregnancy and miscarriage

IVF has a similar rate to natural conception. The risk of miscarriage increases with age. Women in their 20s and 40s may experience miscarriage rates as low as 15%, while women in their 40s could see more than 50%.

A small chance of having an ectopic (tubal), pregnancy after IVF is performed is possible, but this is less than the rate for women who have had infertility. A woman might be offered medication to terminate the pregnancy or even surgery to end it if an ectopic pregnancy is discovered. Call your doctor immediately if you experience sharp, stabbing pain, vaginal bleeding, dizziness, fainting, or lower back pain while pregnant. 

These symptoms are signs of an ectopic pregnancy. After IVF, there is a 1% chance of heterotopic pregnancy. It occurs when one embryo implants and grows inside the uterus, while another embryo implants inside the tube. This can lead to an ectopic pregnancy. To remove an ectopic pregnancy, heterotopic pregnancies typically require surgery. Most cases of ectopic pregnancies can be continued to grow and develop in the womb after the tubal pregnancy has been removed.

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