Call us today 844-315-2229
Contact Us
Pay Bill Patient Portal Resources Schedule Appointment

What Are the Risks of IVF?

By CNY Fertility Published on
What Are the Risks of IVF?

In vitro fertilization (IVF) is a revolutionary approach to assisted reproduction, offering hope to millions of couples struggling with infertility. In the United States alone, there were 413,776 IVF cycles during 2021, up from 99,629 in 2000.  In 2021, approximately 2.3% of all infants born in the United States were conceived using IVF. And number this number is expected grow. Though IVF is considered to be a very safe procedure, like any medical intervention, IVF comes with some risks that are worthy of exploration. In this article, we will detail the most common IVF risks, empowering you with the knowledge you need to navigate the complexities of IVF with confidence and clarity.

IVF Risks: Overview

In vitro fertilization (IVF) treatment entails retrieving eggs from a woman’s ovaries and fertilizing them with sperm in a laboratory to create embryos. These embryos are then transferred to the woman’s uterus, where they can implant into the uterine lining and develop into live births. 

As a complex medical procedure with multiple steps, there are factors and situations in IVF that have the potential for some risk, including:

  • Risks of taking fertility medications like ovarian hyperstimulation 
  • Complications during egg retrieval
  • Complications during embryo transfer
  • Increased risk of twins
  • Potential birth defects
  • Potential for ectopic pregnancy
  • Potential for pregnancy loss

Of course, several of these, like birth defects, ectopic pregnancy, and pregnancy loss, are risks of every pregnancy.

Advertisement – Making Genes come True

Risks Associated with IVF medications

The most common IVF medications are administered via injection. These include

  • Gonadotropins that stimulate the ovaries to produce multiple eggs.
  • Progesterone to prepare the uterine lining for implantation of the embryo.
  • Estroidial to thicken the uterine lining, supporting embryo implantation. 

Studies show that these medications are considered safe when used for in vitro fertilization (IVF), with most women experiencing no greater risk or side effects to their overall health and pregnancy than women who conceive naturally.

That said, there are some potentially serious risks and negative side effects that occur on occasion. 

Ovarian Hyperstimulation 

Ovarian Hyperstimulation Syndrome is the most serious risk of IVF. OHSS occurs when follicles are overstimulated and become swollen.

Most cases of OHSS have mild and moderate symptoms, such as mild pain in the ovaries, bloating, and nausea. 

Though very rare, OHSS can also have severe symptoms associated with fluid buildup in the abdomen and chest, blood clots, and kidney failure. Moderate to severe OHSS affects around 1% of women undergoing IVF.

What Causes Ovarian Hyperstimulation?

Ovarian hyperstimulation occurs most often after use of the gonadotropin FSH followed by human chorionic gonadotropin (hCG). The hCG is used to trigger the final maturation of eggs in a woman’s ovaries. Fortunately, OHSS can be effectively managed and prevented by adjusting your medication protocol.

How to Reduce The Risk of Ovarian Hyperstimulation?

To minimize the risk of OHSS, specialists will closely monitor ovarian response to medications through regular ultrasound scans and assessments of hormone levels. 

The most common and effective strategy for reducing the risk of OHSS is to adjust medication protocols. Using an antagonist protocol of gonadotropin-releasing hormone (GnRH) and a Lupron trigger (as opposed to an hCG trigger) with  has been found to virtually eliminate the risk of OHSS.

If you are at risk of OHSS your provider will also use the lowest possible dose of gonadotropins to stimulate your ovaries and trigger ovulation.

Who is Most At Risk for OHSS? 

Risk factors for OHSS, include: 

  • Being younger than 35
  • High estrogen levels during IVF treatment
  • Your body responds to medications by producing unusually high numbers of follicles during treatment
  • Polycystic Ovarian Syndrome (PCOS)
  • Low body weight

Ovarian Torsion

Ovarian torsion is rare but serious and very painful. It occurs when the ovaries become overstimulated and enlarged to the point where they twist or fold, cutting off their blood supply. 

Ovarian torsion can result in severe abdominal pain and requires emergency medical attention to prevent tissue damage and preserve fertility.

This rare but painful complication affects between 0.024%–0.2% of IVF patients.

Reactions at the site of injection

Mild and temporary reactions at the site of injection include pain, irritation, swelling, and bruising. In rare instances, infection. 

Risk of Mood Swings and Emotional Distress

Dramatic fluctuations in hormones from IVF medications can cause mood swings, irritability, anxiety, and symptoms of depression. However these issues are generally temporary and subside when treatment concludes.

Ovarian Cancer

Some older studies have suggested a potential association between using fertility medications for long periods of time and a small increase in the risk of ovarian cancer for women who do not ultimately conceive after treatment. However, this link is not “causal,” and it may be that the underlying reasons that these women do not conceive are responsible.

However, numerous recent studies have not found an increased risk of ovarian cancer.

One large-scale study from 2015 looking at 53,859 IVF patients found no association between invasive ovarian cancer and IVF compared to the general population. 

Reassuringly, this same study found that IVF patients had a decreased risk of all cancers over the 5-year follow-up period.

It’s also important to note that potential risks can be minimized with close monitoring during treatment and by adhering to the recommended protocols.

Risks of IVF egg retrieval? 

During the egg retrieval procedure, a thin needle is guided by ultrasound imaging as it is inserted through the vaginal wall and into the ovaries. The needle then draws follicular fluid containing the eggs from each follicle. 

Some potential risks of egg retrieval include : 

  • After the retrieval, it is common to experience mild to moderate abdominal and/or pelvic pain and bloating. For most women the pain goes away on its own within a few days. If needed, you can manage pain with over-the-counter medications. 
  • Injury to organs near the ovaries, such as the bladder, bowel, or blood vessels. These uncommon puncture injuries are usually superficial. On very rare occasions, such as when a blood vessel is struck, there may be the need for emergency surgery. 
  • As with any surgical procedure, there is always a risk of infection. Puncture wounds from the aspirating needle can become infected. However, most clinics administer antibiotic medicines at the time of egg retrieval, making infections very uncommon. The risk of infection is less than 1 in 100 people.
  • The risk of infection increases for women who have previously had pelvic infections or ovarian endometriosis. 
Advertisement – Making Genes come True

Risks associated with IVF embryo transfer?

For the transfer procedure, ​ultrasound is used to guide a thin, flexible catheter containing the embryos through the cervix and into the uterus, where the embryos are deposited.

This is a safe procedure with a few potentially mild side effects, including

  • Cramping
  • Spotting (light bleeding)
  • Rare risk of infection, treated with antibiotics

The most significant risk associated with embryo transfer is the chance of multiple pregnancies (twins) when multiple embryos are transferred at the same time. Twins are considered a high-risk pregnancy. 

Risk of Twins and Multiple Pregnancy with IVF? 

The more embryos that are transferred into the uterus, the greater the risk is of having a multiple pregnancy. 

In the early days of IVF, it was believed that transferring more embryos equated to a better chance of implantation and pregnancy. 

However, the modern standard at most fertility clinics, including CNY, is elective single embryo transfer (eSET). Transferring a single embryo provides essentially the same success rates as a multiple embryo transfer. 

Single embryo transfers allow leftover embryos to be frozen and used for future Frozen Embryo Transfers if the first attempt fails or if you want to have more children in the future. 

If, for some reason, it is in your best interest to transfer multiple embryos, your doctor should transfer the minimum number necessary to provide the highest likelihood of pregnancy. 

The risks of multiple pregnancies include: 

  • Miscarriage
  • Premature birth
  • Bleeding
  • Prolonged bed rest
  • Preeclampsia
  • Gestational diabetes
  • Pregnancy-induced hypertension
  • Increased need for cesarean section
  • Postpartum depression
  • Developmental disabilities
  • Cerebral palsy
  • Increased infant mortality rates

Risks of birth defects with IVF? 

In the general fertile population, the risk of birth defects is 3-5%. This risk increases by around 1% for women who undergo IVF.

However, whether or not IVF treatment is responsible for an increased risk of birth defects is currently being debated. It is widely believed that most of the increased risk is associated with the various causes underlying infertility and/or conceiving at a later age. 

Another factor that may slightly increase the risk of birth defects is ​​the use of intracytoplasmic sperm injection (ICSI) where an individual sperm is injected directly into the egg. Again, it is not clear if this increase in defects is due to the procedure or to the fact that the sperm from men with issues of morphology and motility are more likely to have chromosomal problems that eventuate into birth defects.

Risk of Miscarriage and Ectopic Pregnancy with IVF

All pregnancies carry the risk of miscarriage. The national average rate of miscarriage for the general fertile population is between 10-20%. The rate of miscarriage with IVF treatment is essentially the same. 

A 2018 review found that the overall miscarriage rate for IVF pregnancies was 12.5%. However, as age increases, the rate of miscarriage rises significantly. The risk of miscarriage for women between 35 and 45 is 35%. For women over 45, the risk is 50%.

IVF is associated with a 1% chance of an ectopic pregnancy–a pregnancy that occurs outside of the uterine cavity. The most common area where this takes place is in the fallopian tubes. When this occurs, the pregnancy is ended with medication or surgery if needed. 

IVF Risks: The Bottom Line

In vitro fertilization involves a series of complex medical procedures, each with its own specific risks. However, the overall process is remarkably safe and well worth the minimal risks involved for most people. 

Article Sources