IVF is a method of assisted reproduction in which a man’s sperm and a woman’s eggs are combined outside of the body in a laboratory setting.
One or more fertilized eggs may be transferred into the woman’s uterus, where they may implant in the uterine lining and develop.
Serious complications from IVF medicines and procedures are rare.
Injectable fertility medications (gonadotropins) are used for an IVF cycle, and these medicines help stimulate a number of follicles with eggs to grow in the ovaries.
Possible side effects of injectable fertility medicines include:
Mild bruising and soreness at the injection site.
Nausea and, occasionally, vomiting
Temporary allergic reactions, such as skin reddening and/or itching at the injection site.
Breast tenderness and increased vaginal discharge
Mood swings and fatigue
Ovarian hyperstimulation syndrome (OHSS)
Most symptoms of OHSS include nausea, bloating, ovarian discomfort are mild.
OHSS usually goes away without treatment within a few days after the egg collection.
In severe cases, OHSS can cause large amounts of fluid to build up in the abdomen and lungs.
It can cause very enlarged ovaries, dehydration, trouble breathing, and severe abdominal pain.
Very rarely OHSS can lead to blood clots and kidney failure.
There is no clear associations between ovarian cancer and the use of fertility medications.
Risks of the egg retrieval: a vaginal ultrasound to guide the insertion of a long, thin needle through your vagina into the ovary and then into each follicle to retrieve eggs.
Mild to moderate pelvic and abdominal pain, which In most cases, the pain disappears within a day or two and can be managed with over-the-counter pain medications.
Injury to organs near the ovaries, such as the bladder, bowel, or blood vessels.
Very rarely, bowel or blood vessel injury can require emergency surgery and, occasionally, blood transfusions.
Pelvic infections following egg retrieval or embryo transfer are now uncommon because antibiotic medicines are usually given at the time of egg collection.
Women who have had pelvic infections or endometriosis involving the ovaries are more likely to get IVF-related infections.
Risks associated with the embryo transfer as a catheter containing the embryos is used to gently place them into the uterus, omen may feel mild cramping when the catheter is inserted through the cervix or they may have vaginal spotting afterward.
Very rarely, an infection may develop, which can usually be treated with antibiotics.
Having a multiple pregnancy is more likely with IVF, particularly when more than one embyro is transferred.
Multiple pregnancies carry significant risks, including:
Preterm labor and/or delivery: premature babies. Maternal hemorrhage Delivery by cesarean section (C-section) Pregnancy-related high blood pressure Gestational diabetes
The more embryos that are transferred into the uterus, the greater the risk.
One way to avoid multiple pregnancy is to choose to transfer only one embryo at a time.
The risk of birth defects in the general population is 2%-3%, and is slightly higher among infertile patients.
Most of this risk is due to delayed conception and the underlying cause of infertility.
When intracytoplasmic sperm injection (ICSI) is done along with IVF, there may be an increased risk of birth defects.
There may be a slight increased risk of sex chromosome (X or Y chromosome) abnormalities with ICSI.
Men with sperm defects are more likely to have chromosomal abnormalities, which can be transmitted to their children.
Rare genetic syndromes called imprinting disorders may be slightly increased wtih IVF.
The rate of miscarriage after IVF is similar to the rate following natural conception, with the risk going up with the mother’s age.
The rate of miscarriage may be as low as 15% for women in their 20s to more than 50% for women in their 40s.
There is a small risk (1%) of an ectopic (tubal) pregnancy with IVF;
This rate is similar to women with a history of infertility.
If an ectopic pregnancy occurs, a woman may be given medicines to end the pregnancy or surgery to remove it.
There is a 1% risk for a heterotopic pregnancy after IVF, when an embryo implants and grows in the uterus while another embryo implants in the tube, leading to a simultaneous ectopic pregnancy.
Heterotopic pregnancies usually require surgery to remove the ectopic pregnancy.
The pregnancy in the womb can continue to develop and grow safely after the tubal pregnancy is removed.
The risks of in vitro fertilization (IVF) include both maternal and fetal complications.
The most significant maternal risks are ovarian hyperstimulation syndrome (OHSS), which can be life-threatening and is characterized by fluid shifts, thromboembolic events, and rarely, organ dysfunction.
OHSS risk can be minimized by adjusting gonadotropin dosing, using GnRH agonist triggers, and favoring frozen embryo transfer.
IVF increases the risk of multiple gestations, which historically led to higher rates of preterm birth and low birth weight.
This risk has decreased with the routine use of single embryo transfer.
Singleton pregnancies after IVF still have higher rates of preterm birth, low birth weight, small-for-gestational-age status, and perinatal mortality.
There is also an increased risk of placental complications-placenta previa, abruption, hypertensive disorders, and cesarean delivery.
For offspring, IVF is associated with a modestly increased risk of congenital anomalies with a relative risk 1.25–1.5, particularly cardiac, genitourinary, and musculoskeletal defects, though the absolute risk remains low.
There is emerging evidence of possible epigenetic and long-term metabolic or cardiovascular risks in children conceived via IVF.
Risks for the mother with IVF:
Ovarian hyperstimulation syndrome (OHSS) from fertility medications, which can cause abdominal pain, bloating, and in severe cases, blood clots or kidney problems.
Multiple pregnancies (twins, triplets) occur in about 20-30% of IVF pregnancies, increasing risks of premature birth, low birth weight, and pregnancy complications.
Increased risk of ectopic pregnancy (about 2-5% vs 1-2% in natural conception)
Bleeding, infection, or damage to surrounding organs during egg retrieval procedures
Higher rates of pregnancy-related complications like gestational diabetes, preeclampsia, and placental problems
Risks for the Baby with IVF:
Slightly increased risk of birth defects (about 2-3% vs 2% in natural conception) Higher likelihood of premature birth and low birth weight, especially with multiple pregnancies Rare genetic disorders associated with certain IVF techniques
Psychological and Emotional Risks with IVF:
Stress and anxiety from the demanding treatment process Depression from failed cycles or pregnancy loss Relationship strain due to the physical, emotional, and financial demands Hormonal medications can affect mood and emotional well-being Financial burden, as IVF is expensive and often requires multiple cycles Time commitment for frequent monitoring appointments and procedures