IVF complications

 

 

Medical risk connected to IVF depends on the treatment phase. Stimulation of superovulation entails the risk of Ovary Hyperstimulation Syndrome (OHS). The reason of OHS is the development of a big number of follicles (more than 15) and as a result high ovary activity causing high level of oestrogens (female sexual hormones) in the blood. The high level of oestrogens causes abnormalities in vascular permeability and as a result the fluid from vessels goes first to the cavity of the pelvic minor and then to the abdominal cavity. As a result of accumulation of the fluid in the abdominal and pleural cavity the patient may feel spreading, nausea, emesis and lack of appetite.  About 30% of patients undergoing the stimulation of ovulation have OHS mild case, which can be overcome through limitations of physical activity and intake of analgesics. During OHS medium case the fluid is accumulated in the abdominal cavity which causes pain in and around gastrointestinal tracts. These women need constant observation but usually the ambulatory treatment is enough. Gradually the health conditions of such patients are getting better without additional interventions but in case of pregnancy the improvement may last several weeks. 1-2% of patients experience OHS severe case characterized with the accumulation of the fluid in the abdominal and pleural cavity, abnormalities in electrolytic balance, high blood coagulation and sometimes formation of clots of blood. When they have difficulties when breathing pump-out of the fluid may be required. Patients with the severe form of ovary hyperstimulation need hospitalization.

 

As a rule, after the stimulation of ovulation the ovaries have an increased size. This is conditioned with the fact that “yellow bodies” are formed in the place of aspirated follicles. Increased follicles become extremely mobile and in rare cases can kink on ligaments. Ovary torsion causes abnormalities in its blood circulation and necrosis – death of the ovary.

 

The other rare complication which needs laparoscopic operation is the bleeding of the increased ovary. Bleeding becomes evident with the development of general weakness, sleepiness, cardiopalmus and sometimes pains in the belly.

 

After the embryo transfer patients should carefully follow their health conditions. With a view to prevent these complications patients are recommended to limit their physical activity, exclude sexual life during the first two months of the pregnancy after IVF.

 

Although some early publications point out the assumption that the use of simulating remedies can increase the risk of ovary cancer, many recent researches haven’t detected any connection between medicaments for stimulation of superovulation and cancer of ovaries or other organs.

 

Certain risk is connected to the procedure of ovary puncture. The puncture is fraught with the same complications as in case of any surgical operation requiring anesthesia. Besides that the puncture has a small risk of bleeding, infection, damaging urinary bladder, bowels or blood vessel. However the operational intervention for liquidation of complications after the puncture is necessary in case of less than one patient out of thousand.

 

In rare cases an inflammatory processes may develop after the embryo transfer.

 

During the pregnancy and delivery different pathologies of the fetus development, extrauterine pregnancy, spontaneous miscarriage, stillbirth, multiple pregnancy and newborn child with innate pathologies may be evident. If you’re undergoing treatment with in vitro fertilization method you need to know that infertility, age, availability of multiple pregnancy increase the risk of premature delivery or stillbirth. Multiple pregnancy increases the risk of premature delivery and development of neurological diseases. In case of a multiple pregnancy (twins or triplets) you need to be observed by experienced gynecologist.

 

The risk of multiple pregnancy exists during all options of assisted reproductive technologies connected to the embryo transfer. Although many patients think that twins are the best solution to the treatment the multiple pregnancy is connected to a number of problems during the pregnancy and delivery. Women with multiple pregnancy may be forced to lie in bed or hospital for weeks or even months. Prematurely born children need long-term and intensive care and frequently have problems with health during their whole life.

 

Some of spouses may consider the reduction of multiple pregnancy to decrease the risks but this will, probably, be a quite difficult question. In case of a reduction one or several fetuses stop development (usually through injection of a toxic chemical agents, such as potassium chloride into the heart of the fetus under the ultrasound control). In most cases those fetuses will be resolved, but the other ones will continue developing. Of course there is a risk of losing all fetuses as a result of miscarriage (as a result of trauma when conducting reduction) and that makes up 10% independent of the experience of the doctor.

 

Blood-tinged discharge during the first trimester of the pregnancy may be a sign of miscarriage or extrauterine pregnancy. If blood-tinged discharges have started you should immediately be examined to reveal its reason.  According to some information early discharges are observed in case of women after IVF, but they shouldn’t become a ground for interruption of the pregnancy as it’s done in case of normally fertilized women. Therefore you shouldn’t stop taking medicines the doctor has prescribed, as bloody discharges don’t necessarily mean the start of menstruation.

 

The risk of extrauterine pregnancy after IVF makes up 2-3%. Extrauterine pregnancy is not caused by the IVF procedure itself, but because many women, undergoing treatment with ART methods, have damaged fallopian tubes which increases the tendency for extraurine pregnancy.

 

The risk of innate pathologies in case of IVF doesn’t exceed the risk of innate pathologies in case of a natural conception. Certain risk of genetic pathologies exists no matter whether the child was conceived with IVF or normally.

 

Assisted reproductive technologies require considerable physical, financial and emotional efforts. Psychological stress is also possible. The necessary treatment is quite expensive. As a rule patients hope for favorable results but the treatment cycle may fail. The patient may feel disappointment, anger, indignation and loneliness. Sometimes the disappointment may cause depression and low self-appraisal particularly after the failed IVF cycle. At this moment support by relatives and friend is very important. As an additional support mean patients can be recommended to visit a psychologist.