Complications of IVF Treatment

While In Vitro Fertilization, or IVF, is a relatively safe procedure, women moving forward with this treatment must be aware of some of the potential complications that can arise. Most of these complications are extremely rare, but keep an eye out for symptoms and report any concerns to your physician.

What is IVF?

• IVF is a procedure in which a woman is given doses of follicle-stimulating hormone (FSH) and lutenizing hormone (LH), to cause the ovaries to produce a large number of egg follicles. Once you have a sufficient number of mature egg follicles, you will take a final injection of HCG, or human chorionic gonadotropin, to stimulate the maturation of the eggs.

  The eggs are then removed surgically and fertilized with sperm in the laboratory. The resulting embryos are allowed to grow and develop for a specified number of days, then a select number are transferred back into the uterus for implantation and pregnancy to occur. Remaining embryos can be frozen for future cycles, or discarded, according to the patient's preference.

  During the cycle, the patient must be monitored frequently--often every day--to ensure that she is responding appropriately to the medication.

OHSS

• Ovarian Hyperstimulation Syndrome, or OHSS, is the most common complication resulting from IVF. After the eggs are removed from the ovary, large amounts of hormones and chemicals called cytokines are released. These cytokines can make the capillaries--tiny blood vessels--leaky, which causes fluid to shift from the bloodstream into the abdomen or lungs. The patient is at greatest risk for OHSS around the time of her final HCG injection, even up to the pregnancy test.

Symptoms of OHSS

• The most common symptoms of OHSS include sudden, rapid weight gain and bloating. Monitor your weight every day and promptly report a weight gain of more than two to three pounds in a 24-hour period to your doctor. Persistent nausea, vomiting, difficulty breathing or difficulty urinating are also symptoms and should be reported as well.

Treating OHSS

• Ovarian hyperstimulation is graded on a spectrum, ranging from mild to moderate to severe, depending on the severity of symptoms as well as the amount of extraneous fluid found. Most cases are mild to moderate and require monitoring and bed rest. Your doctor may want you to monitor how much fluid you're drinking as well as how much and how often you are urinating. They may also want to draw blood to determine if your blood is more concentrated than normal.

  Severe cases may require hospitalization and administration of an intravenous medication called albumin to correct the fluid shifts. Early detection and strict bed rest may reduce the severity.

Internal Bleeding

• Bleeding after the egg retrieval is another, though significantly much less common, complication of IVF. This occurs when the needle used to aspirate the egg follicles may nick a blood vessel and cause internal bleeding. Symptoms include worsening abdominal pain and bloating and feeling faint or dizzy. While this is very rare, report any concerns promptly to your doctor.