Risks of Fertility Treatment

As with any medical treatments or surgical procedure, fertility treatment carries some risks and your fertility centre should discuss these with you before you proceed. Risks can include reactions to fertility drugs that may be prescribed, and also the risks associated with any pregnancy as well as the procedure itself. Other risks, of which some are not yet fully understood, relate to the children born as a result of the treatment.

You might develop a mild reaction to fertility drug during IVF cycle which include:

  • Hot flushes
  • Feeling down, irritable or mood swing
  • Headaches
  • Restlessness

Talk to your fertility specialist if the intensity of the reaction gets worse, she may be able to adjust your dosage or switch to another drug.

Occasionally, the side effects of fertility drugs could be serious. We advise you to contact your fertility clinic directly if you notice:

  • Allergic reaction – these include difficulty in breathing and tightness in your chest
  • The symptom of severe ovarian hyperstimulation (OHSS)
One of the biggest risk of fertility treatment is multiple pregnancy. Multiple gestation pregnancies are associated with:

  • Preterm Labour
  • Low birth weight
  • Intrauterine Growth Restriction (IUGR)
  • Preeclampsia
  • Gestational Diabetes
  • Placental Abruption
  • Foetal Demise/Loss
  • Caesarean
  • Risk of death before birth, or within the first week of life
  • Cerebral palsy

The only way to reduce the risks of multiple pregnancy is through elective single embryo transfer (eSET) strategy, transferring only one superior quality embryo into a woman’s womb in an attempt to establish pregnancy (blastocyst transfer).

 

OHSS occurs due to over reaction to fertility drug use in egg triggering, known as hCG trigger in IVF cycle. OHSS is characterized by enlargement of ovaries with presence of multiple corpus luteum cysts and shift of fluid into the extravascular space of abdominal cavity.

The chances of OHSS increase in women with:

  • Polycystic ovarian syndrome
  • Young age
  • Low body weight
  • Previous episodes of OHSS
  • High number of follicles

OHSS can be classified as mild, moderate, or severe according to the degree of symptoms which include abdominal distention, ovarian enlargement, respiratory, hemodynamic, and metabolic complications.

The symptoms of OHSS usually develop during the week after egg retrieval. Most cases of OHSS are mild and without any serious or prolong complication (usually lasts within a week or two). In some cases, your fertility specialist might consider delaying the embryo transfer by freezing the embryo and transfer at a later date. Occasionally, in rare severe cases, OHSS can be life threatening.

It has been proven that the risk of OHSS can be reduced by using GnRH Agonist triggering during IVF cycle. Consult the fertility specialist on the treatment regime associating with OHSS. Newlife@PHKL takes into consideration of the risks and safety of OHSS seriously, and as a result, GnRH Agonist triggering is applied as a strategy to reduce your risk of developing OHSS.

The term refers to when the stimulated ovary twists on itself, due to high number of follicles in the ovary, cutting off its own blood supplies. The overall risk is 0.2%. In a normal condition, the ovary is meant to carry only one mature follicle, however, due to stimulation in IVF cycle, the number of mature follicles increase, causing the ovary to become heavier and lead to twisting. Treatment is surgery to untwist the ovary and even removing it sometimes.
Egg retrieval or ovum pick-up (OPU), is a medical procedure to surgically remove eggs from a woman’s ovaries transvaginally for IVF purpose. At Newlife@PHKL, general anaesthetic is used during OPU procedure to ensure you are unconscious and feel no pain during the procedure.

Common complication post OPU includes:

  • Vaginal bleeding/spotting
  • Mild bloating
  • Mild cramping
  • Breast tenderness due to high oestrogen levels
  • Constipation
  • In rare occasion, pelvic infection might occur

OPU is a simple procedure; you will be allowed to go home several hours after completion of procedure with some antibiotics to prevent infection.

Ectopic pregnancy happens when the fertilised egg implants outside the uterus, usually in a fallopian tube. The incidence of ectopic pregnancy seems higher with IVF treatment, especially if you already have problems affecting your fallopian tube. However, it has been proven that blastocyst transfer is associated with lower risk of ectopic pregnancy compare to cleavage stage transfer (Day 2 or Day 3 transfer) in IVF treatment.

The symptoms of ectopic pregnancy may include:

  • One-sided low abdominal pain
  • Vaginal bleeding
  • Dark brown vaginal discharge

The pain intensifies as the pregnancy progresses. The major risk of ectopic pregnancy is rupture of the fallopian tube causing internal bleeding. You should talk to your doctor if you experience sharp abdominal cramp or vaginal bleeding in early pregnancy.

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