IVF - Risk factors and important things to consider

The multiple step process of IVF treatment does carry some degree of risk. The following factors will need to be carefully considered in the decision-making stages prior to undergoing treatment:

• OHSS: Artificially stimulating a woman’s ovaries can place her at risk of ovarian hyperstimulation syndrome, making them quite painful and swollen. Symptoms of this include mild to moderate abdominal pain, diarrhoea and nausea or vomiting. Discomfort can last for a week prior to pregnancy. If OHSS occurs during pregnancy, symptoms can last for several weeks at a time. Bed rest is usually recommended for mild cases. Severe cases of OHSS can occur, but are fairly rare. If severely experienced, symptoms include shortness of breath and rapid weight gain which can be life-threatening if not managed appropriately.
• More common side-effects of medication: It is not uncommon for women on hormonal medications to experience bloating, mood-swings, headaches and abdominal discomfort. If medications are administered by injection, bruising can also occur at the site of injection.
• The possibility of multiple pregnancies / births: Implantation of more than one embryo can result in the development of more than one baby. Multiples can carry increased risk of low birth weight in babies as well as premature labour.
• Increase risk of premature delivery and low birth weight: Even in instances where success is achieved with a single baby, the risk of premature labour / delivery and a low birth weight is increased if pregnancy occurs as a result of IVF treatment.
• Miscarriage: The rate of miscarriage is higher with maternal age, as well as when frozen embryos are used. Naturally conceived embryos and IVF fresh embryos have a 15 – 25% rate of possible miscarriage.
• Ectopic pregnancy: An estimated 2 to 5% of women undergoing IVF may experience an ectopic pregnancy (this is when the egg implants in the fallopian tube or somewhere other than the uterus). It is not possible for a fertilised egg to survive outside of the uterus and a pregnancy will thus not be able to be continued.
• Complications during egg harvesting (retrieval): The aspirating needle used to suction eggs from the ovaries can sometimes result in damage to the bladder, bowel or a blood vessel. A woman can thus experience possible infection, tissue damage or bleeding. Some woman may also have adverse reactions to sedative medications (anaesthetic) used in the retrieval and / or embryo transfer process.
• Stress: Most experiencing IVF treatments are likely to go through a little stress. The process is demanding on a person’s pocket (financially) and quite taxing both physically and emotionally. From a financial standpoint, most health insurance providers do not provide cover for fertility treatment. This cost factor can be incredibly stressful, especially when multiple attempts are required. Having to take so many medications can also be a stress-factor for some women. If anxious or apprehensive, it is very important to discuss all concerns with a specialist. Often, many women cope better on the medications than they initially expected to. Although counselling is recommended by fertility specialists (and provided), it is also a good idea to build a caring support group throughout the process. No matter how prepared a woman or couple are beforehand, treatment can have several ups and downs throughout the process. Battling infertility issues can result in depression for many, especially if treatment attempts have been tried and failed multiple times. Having effective support throughout treatment can often alleviate stress which can also impact chances of success.