Complications of IVF Treatment Cycle

Like any other treatments, a number of people may respond poorly to treatment and experience some side-effects.

Ovarian Hyperstimulation Syndrome (OHSS)

OHSS is a condition when there is overstimulation of the ovaries, the ovaries may swell due to >20 follicles developing simultaneously. It is a serious complication but only occurs in 1-2% of women who received ovarian stimulating medications. It is more common in women with polycystic ovaries.

Women with OHSS may experience mild to severe symptoms such as bloating, swelling of the abdomen, nausea and vomiting. Fluid will collect in the lungs and/or body cavity, hospital stay may be required for around 1% of patients with OHSS.

If you are at risk of OHSS (if OHSS occurred in the past cycles) or experiencing any of the above symptoms, you are advised to receive a smaller dose of HCG (i.e. 5000IU) before egg collection, or use an alternative form of drug to stimulate follicle development. For women with polycystic ovaries, the lowest dose of stimulation will be prescribed and your ovaries are monitored closely by doctors It is also advised that these women should contact their doctors immediately if they experience any symptoms of OHSS.

Risk of egg collection procedure

Simple measures like cleaning the speculum with antiseptic solution before using it for egg collection helps lowering the risk of complications occur during this procedure. Although rarely happens, there is still a risk of the needle, which penetrated the vaginal wall into your ovaries, inadvertently enter the blood vessels or a loop of bowel, leading to internal bleeding and infection.

When these complications occur, operations to repair the damaged vessels or antibiotics are usually given to treat these problems.

Risk of a multiple pregnancy

The use of ovarian stimulation drugs for the IVF treatment can result in multiple pregnancies. For couples who received IVF, there is 1 in 6 chances of having a twin pregnancy; 3 in 100 chances of having a triplet if 3 embryos are transferred. The problems of multiple pregnancies include increased risk of miscarriage and pre-maturity, restricted fetal growth, pregnancy complications in mothers and the need for operative delivery.

Triplet pregnancy tends to lose each baby more easily than twin pregnancy (1 in 12 chance vs 1 in 21 chance, NEJM report HFEA Annual report 1997). It is also more likely for the triplet pregnancy to produce handicapped child, with approximately 1 in 4-5 sets of triplets.

Risk of Ectopic Pregnancy

Despite doctors place the embryos back into women’s uterus artificially as part of the IVF treatment, there is still a small chance that some women will develop ectopic pregnancy, where the embryo implanted in the fallopian tube instead of the uterus. In some cases, a woman can have embryos implanted in the uterus and fallopian tube at the same time, a condition known as heterotopic pregnancy.

Risk of miscarriage

Many believe that IVF bears higher risk of miscarriage; however no difference has been reported in terms of risk for miscarriage between single IVF pregnancy and natural conception. The risk tend to increase slightly for those with multiple pregnancies, but this risk will reduce substantially (by a third) once the pregnancy sac is established and a fetal heart is identified.