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    in vitro fertilisation (ivf)

    Side Effects and Risk Associated With In Vitro Fertilization (IVF)

    • 161765 views
    • 4.7   (5 Votes)

    There are a number of risks and side effects of IVF, the most serious being ovarian hyperstimulation syndrome and multiple pregnancies. Others include depression, ovarian torsion, ectopic pregnancy, preterm delivery and miscarriage. The association between IVF and cancer is still debatable.

    Some side effects after In Vitro Fertilization include secretion of small amounts of fluid after the procedure. Bloating and mild cramping can also be a side effect of IVF. However, some signs like blood in the urine, heavy vaginal bleeding, pelvic pain, or fevering over 100.5°F must be checked by some of the best gynecologists immediately. The side effects of fertility medications include mood swings, headaches, abdominal pain and abdominal bloating. Ovarian hyperstimulation syndrome (OHSS) is a side effect of IVF in very rare cases. (1) Experiencing any of these symptoms need to be checked with a doctor as soon as possible. Furthermore, with IVF, there are increased chances of multiple pregnancies with two or more fetuses. Multiple pregnancies can increase the chances of low birth weight. (1)Rate of miscarriage is the same as the rate of miscarriage through a normal pregnancy and premature delivery. The risks and side effects increase with an increase in maternal age. IVF procedures involve a lot of financial, physical and emotional commitment from the couple. Experiencing stress and problems emotionally are common in case IVF is unsuccessful. (2)

    In this article, we will look at:

    1. What are the risks associated with IVF?
    2. What are the side effects associated with IVF?

    1. Risks Associated With IVF Treatment 

    1. Nausea and Vomiting 

    Some hormonal tablets incorporated inside the vagina during the IVF procedure can result in nausea and vomiting. (3) Postoperative IVF vomiting patterns were documented in patients having general anesthesia for oocyte retrieval for In Vitro Fertilization. Patterns were also documented to related procedures, compared with patient preoperative history and expectations, response to ovarian hyperstimulation and details of the anesthesia. The results showed that the likelihood of vomiting was related to peak plasma oestradiol level and the patient's expectation based on previous experience of anesthesia. (4)

    2. Decreased Urine Frequency

    Decreased Urine Frequency is one of the risks during IVF that a woman can experience. According to one report, a woman was shown developing acute renal failure due to compression of both ureters from enlarged stimulated ovaries post IVF treatment. The condition was diagnosed using ultrasound and magnetic resonance imaging (MRI). The condition was treated with insertion of double-J stents (thin tube inserted into the ureter to prevent obstruction of the urine flow) in both ureters and resolved without the need of dialysis. The woman showed a decreased urine output. At the same time, she presented gastrointestinal symptoms of nausea and vomiting and refrained from eating and drinking. Even though the complication risk related to IVF is low, one should be aware of a possible compression or damage to the ureters with subsequent development of acute renal failure. (5)

    3. Dyspnea or Shortness of breath after IVF

    Dyspnea or Shortness of breath after IVF occurs when the uterus is expanding and pushing up into the abdomen. This squeezes the lungs, reducing the space they have for oxygen exchange. An even bigger cause for shortness of breath may be due to progesterone, a hormone that increases during pregnancy. High levels of progesterone cause pregnant women to breathe faster. Rise in progesterone level begins early in pregnancy and the shortness of breath it causes can come up as a surprise. (6)

    4. Multiple Births

    The most common side effect of IVF is multiple pregnancies. According to various estimates, the rate of multiple births after IVF is 33 percent. However, the relative contribution of IVF to the number of multiple births resulting from infertility treatment might be higher than that of IUI due to higher success rates of IVF. The risk of multiple births associated with IVF is directly related to the number of embryos transferred in each cycle. (7) The practice of transferring more than one embryo goes back to the early days of IVF when embryo quality and implantation rates were quite low and placing multiple embryos was performed to compensate for low implantation potential. Recent estimate of the average implantation rate is around 50 percent (8), but this varies considerably according to a woman’s age.

    5. Mild to Moderate Pelvic and Abdominal Pain

    Patients may experience mild to moderate pelvic pain before or after IVF treatment. In most cases, the pain disappears within one or two days and can be managed with over-the-counter pain medications. Pelvic infections following embryo transfer or egg retrieval are now uncommon because antibiotic medicines are usually given at the time of egg collection. Severe infection may require hospitalization and/or treatment with intravenous antibiotics. (9)

    6. Miscarriage

    According to research, women who produce fewer eggs during IVF treatment are more likely to miscarry. Around 20 percent of pregnancies ended in miscarriage when they produced fewer than four eggs after the ovarian stimulation phase of IVF. (10) Miscarriage rates by week vary between women. The odds of having a miscarriage start to drop as the pregnancy progresses. If a woman knows about the risks associated with pregnancy, the risk of pregnancy loss reduces to about 10 to 15 percent. A pregnancy loss is the loss of a fetus that occurs before twenty weeks of gestation. (11)

    7. Ectopic Pregnancy

    The risk of ectopic pregnancy following fertility IVF treatment is small but significantly higher than found in natural conceptions. An ectopic pregnancy occurs when an embryo implants outside the uterus, usually in one of the fallopian tubes. Studies have found that its risk is elevated in IVF conceptions, for reasons, which are not completely understood. Several risk factors have been proposed, including abnormalities in the fallopian tubes (an indication for IVF), transfer of multiple embryos, or the treatment technique itself. (12)

    8. Psychological and Emotional Stress

    Patients who are struggling to conceive report feelings of anxiety, depression, isolation, and loss of control. The levels of depression in patients with infertility have been compared with patients who have been diagnosed with cancer. It is estimated that 12 percent of married women have trouble getting pregnant or sustaining a pregnancy. Despite the prevalence of infertility, the majority of infertile women do not share their story with friends or family, thus increasing their psychological vulnerability. The inability to reproduce naturally can cause feelings of guilt, shame and low self-esteem. These negative feelings may lead to varying degrees of depression, anxiety, distress, and poor quality of life. Patients who undergo assisted reproductive treatment are at significant risk of experiencing psychiatric disorders and it is important to recognize, acknowledge, and assist these patients as they cope with their infertility diagnosis and treatment. (13)

    9. Bleeding and Infection

    Bleeding is another complication of IVF resulting from Transvaginal Oocyte Retrieval (TVOR). Although insignificant bleeding from the vaginal vessels can be a common problem encountered with TVOR, the more concerning intraperitoneal bleeding is very rare but does occur. Bleeding may originate from the ovarian vein, iliac or sacral vessels, or from the actual follicle puncture. Other sources of bleeding can be ovarian lacerations, and ruptured endometriomas. Major bleeding is reported in 0.03-0.5 percent of In Vitro Fertilization cases. Pelvic infection during IVF is a complication mainly resulting from the transvaginal oocyte retrieval (TVOR). Infection has been reported with recent studies have shown that preparing the vagina with povidone iodine followed by thorough saline irrigation prior to the punctures helps prevent pelvic infection without compromising pregnancy outcome. (14)

    2. Side Effects Associated With IVF

    Although patients may need to take it easy after the procedure, most women can resume normal activities the following day. Some of the side effects of IVF Treatment are discussed below:

    • Pregnancy-Induced Hypertension (PIH)

    Pregnancy-induced hypertension (PIH) or gestational hypertension is the development of new hypertension in a pregnant woman after 20 weeks gestation (systolic above 145 or diastolic above 95 mmHg) without other signs of pre eclampsia or the presence of protein in the urine. PIH is defined as having blood pressure greater than 140/90 on two separate occasions at least 6 hours apart. (15)

    • Preterm Delivery and Low Birth Weight

    Preterm birth (PTB), defined, as gestational age of 37 completed weeks, is a growing public health problem. Preterm infants have a higher risk of long and short-term health complications compared to babies born near term. Persistent disparities in PTB and LBW (low birth weight) among different race and ethnicity groups are a public concern. Risk factors for PTB and LBW are multiple, including behavioral, biological and psychosocial effects, medical and pregnancy conditions, role of gene-environment interactions and unfavorable sociodemographic and community characteristics. Alcohol misuse is a leading risk factor for many adverse health and social outcomes. Heavy drinking by pregnant women is associated with adverse consequences particularly harmful to the fetus. Prenatal alcohol exposure has been found to result in restricted growth of the fetus, prematurity, and LBW (low birth weight). (16)

    • Birth Defects

    There are many studies on the relationship between birth defects (also known as congenital anomalies or congenital disorders) and IVF. The overall risk of major birth defects in children born after IVF is about 30 percent higher than in children conceived spontaneously. A more recent systematic review and meta-analysis done in Japan, which analyzed 45 cohort studies, similarly showed that IVF infants, including both singletons and multiple births (i.e., twins and triplets), had a 32 percent higher risk of birth defects as compared with naturally conceived infants. Thus, the risk of IVF in total on birth defects compared with natural conception is highly probable. (17)

    • Ovarian Hyperstimulation Syndrome (OHSS) 

    Ovarian hyperstimulation syndrome (OHSS) affects women taking injectable hormone medications to stimulate the development of eggs in the ovaries. It may occur in women undergoing In Vitro Fertilization (IVF), ovulation induction or IUI (intrauterine insemination). Too much hormone medication can lead to ovarian hyperstimulation syndrome (OHSS), in which the ovaries become swollen and painful. A small number of women may develop severe OHSS, which can cause rapid weight gain, vomiting, abdominal and shortness of breath. Less often, OHSS happens during fertility treatments using medications when taken by mouth, such as clomiphene (Clomid, Serophene). (18)

    • Headaches

    Estrogen is closely linked to migraine and its extreme serum level fluctuations have been considered to trigger migrainous headaches. Headache attacks during In Vitro Fertilization and embryo transfer were reported by 28.6 percent of women and were significantly more prevalent among the migraineurs. Headache mostly occurred after gonadotrophin-releasing hormone (GnRH) analog induced hypothalamic-pituitary-ovarian axis down regulation, typically associated with very low 17-beta-estradiol (17-beta-E2) serum level. (19)

    • Ovarian Cancer

    Women who have used IVF are over third times more likely to develop ovarian cancer than other women, a large-scale study finds. Researchers say that the risk is likely to increase for women who have underlying health problems or those who need help conceiving, rather than being a result of the treatment itself. But other findings from the study did suggest treatment could play a role. For instance, the risk of developing ovarian cancer was greatest for younger women and in the first three years following ART. Although the relative risk of ovarian cancer was increased by 37 percent compared to the general population, the risk remains small in absolute terms, 15 out of 10,000 women who had received ART developed ovarian cancer compared with 11 out of 10,000 women in the general population. (20)

    • Changes in Mood

    Women are at their greatest lifetime risk for mood disorders during their childbearing years. Mood swings or affective disorders include unipolar depression and bipolar disorder. The lifetime prevalence of major depression is 16.6 percent and bipolar disorder 3.9 percent. Adult women are at significantly greater risk, up to one and a half times that of men, of having a mood disorder. Infertility, clinically defined as the inability to conceive a child within one year, is also a common problem, affecting an estimated 5–10 percent of women. The question of whether mood disorders influence or contribute to infertility in women is an area in need of further research. (21)

    IVF is a blessing for many parents who have trouble conceiving for different fertility related issues. It gives them a chance to fulfill their dream of having a child and a family. IVF is very safe and is highly recommended by specialists, it also come with a few caveats that are worth considering. Patients should discuss and understand the side effects and risks of In vitro Fertilization with their doctor before undergoing the procedure. It is highly imperative for patients to make a wise decision and know about the risks and side effects of the IVF procedure. This can help them prevent any complications and have a successful procedure without worries.

    Learn more about IVF and other fertility treatment on Elawoman blog. There are many routes to starting a family and it is Elawoman’s privilege to provide you relevant information about the best fertility treatment in your city. Elawoman strives to do their best to respond to your needs, thus helping you to make your dream come true. Call us today at +918929020600.

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    5 Comments

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    Anika Yadav

    My sister is very happy with her IVF treatment. She got pregnant in the first cycle itself.

    Oct. 17, 2018, 12:50 p.m. 4.5

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    Ishita Thakur

    We are thinking to take the procedure of IVF. After having a conversation with a fertility specialist about the IVF risks and procedures I am ready to proceed for the treatment.

    July 22, 2018, 6:18 p.m. 5.0

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    Palak Chugh

    I don't think that IVF has any risks associated with it. I know one of my relatives who conceived through IVF. She and her baby are perfectly normal. So, risks with IVF procedure are optional.

    June 2, 2018, 2:34 p.m. 5.0

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    Raghav Dhawan

    Hi Elawoman, the information that you provided on IVF was very helpful. Thank You

    June 2, 2018, 8:32 a.m. 4.5

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    Raunak Goyal

    May 24, 2018, 1:04 a.m. 4.5

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