In Vitro Fertilization Process: Risks

There are multiple risks involved with the medications and retrieval process. You should fully understand these risks and ask questions regarding these risks prior to signing your consent forms.

• Ovarian Hyperstimulation Syndrome (OHSS): This is a combination of symptoms that result from the elevated levels of hormones and other factors that result from excessive stimulation of the ovaries. There is a fine line that exists in many women between just the right amount of stimulation and OHSS.
• Multiple gestations: The use of medications to stimulate increased numbers of follicles will also increase the rate of multiple pregnancies. Up to 20 percent of pregnancies conceived while taking gonadotropins will be multiple gestations. Most of these will be twins, however, triplets and higher numbers of gestations are seen as well. This is in contrast to the one to two percent risk of multiple gestations in the general population.
• Ectopic pregnancies (tubal): There is a very small increase in the incidence of ectopic pregnancies due to gonadotropins. The risk of ectopic pregnancy is not eliminated by in vitro fertilization, though it is very uncommon.
• Ovarian torsion: With ovarian stimulation from gonadotropins, the size of ovaries is increased. This increase in size can lead to a twisting of the ovaries which interrupts the blood supply. Surgery is often required to alleviate the problem. Torsion occurs in less than 1 percent of patients.
• Ovarian cancer: There is much debate about ovulation induction agents increasing a woman's risk for ovarian cancer. The risk of ovarian cancer does have a correlation with the number of times a woman ovulates. Pregnancy and breast feeding have been shown to decrease the risk of breast cancer as do birth control pills.
• Infection: The retrieval process involves the passage of a needle into the abdominal cavity through the vagina. There is a risk of infection as a result of the oocyte retrieval. Prophylactic antibiotics are used to help prevent infections. The actual incidence of peritonitis is exceedingly rare.
• Perforation: Injury to intra-abdominal organs and vessels is always a concern during the retrieval process. Organs at risk include the bowel, bladder, and vessels. Because the needle is relatively small this complication is not as common as one would expect. Keep in mind needles are used to puncture vessels to draw blood. Punctures of intra-abdominal organs likely seal themselves in a similar fashion.

Following your procedure you may experience a moderate amount of abdominal discomfort due to enlarged ovaries and manipulation from the procedure. If you are experiencing increasing abdominal pain, fevers, or unexpected symptoms, contact the clinic.