Complications of fertility treatment
Despite our approach to provide treatment at the highest possible standard, IVF treatment is not without some risks. For many clients treatment runs smoothly with no complications occurring. We inform you of these complications from the outset as part of your consent to treatment.
Complications (Risks) include:
- Ovarian Hyperstimulation
- Multiple Birth (twin or triplet pregnancy)
- Potential for cancellation of your treatment cycle
- Ectopic Pregnancy
Ovarian Hyperstimulation Syndrome (OHSS) is a complication occasionally seen in women who take certain fertility medicines that stimulate egg production. With this condition the ovaries over-respond to the stimulation injections and can suddenly become very swollen or enlarged. The abdomen can also become swollen due to fluid accumulation and in rare cases fluid can build up in the chest area. OHSS occurs only after the eggs are released from the ovary (ovulation) or following an injection of a hormone called human chorionic gonadotropin (hCG) to help trigger ovulation. If pregnancy occurs, there maybe an even greater risk of this syndrome occurring in the following few weeks.
In most cases the condition is mild, but some women get a severe and dangerous form of OHSS which can be fatal. Additional risk factors for OHSS include:
- Age younger than 35
- Very high oestrogen level while undergoing fertility treatment
- Polycystic Ovarian Syndrome
All clients undergoing O.I. or IVF in Galway Fertility Clinic require close monitoring with ultrasound and blood tests, where necessary, to try to prevent the chance of this condition occurring. Less than 5% of women attending Galway Fertility Clinic for treatment develop OHSS, and these are managed by the medical team. Treatment may be cancelled if OHSS is anticipated. Further information is available from clinic staff.
Multiple Birth (twin or triplet pregnancy)
Fertility treatment involves the stimulation of the ovaries with medications to produce more mature follicles. Although 70% of all IVF pregnancies result in singleton deliveries, nearly a quarter result in the birth of twins and approximately 3% result in triplets.
Galway Fertility Clinic aims to avoid a multiple pregnancy as this can be complicated for both the mother and babies. The introduction of the EmbryoScope® has been instrumental is not only improving our success rates but in our ability to select a single blastocyst to transfer, thus reducing your risk of multiple pregnancy occurring. (create link to Embryoscope)
Multiple births carries risks for the babies in that they may be delivered prematurely (too early) or they may have developmental problems for life due to Cerebral Palsy.
Risks to the mother during a multiple pregnancy include high blood pressure, diabetes and the development of medical complications due to the extra demands on her body. There is also an increased risk of delivery by caesarean section. In addition, caring for multiple babies brings financial and emotional pressures and exhaustion to the parents.
Potential for cancellation of your treatment cycle
Treatment cycles may be cancelled where there is an under or over response during stimulation which is not optimum for pregnancy to occur. In cases of over response or of a risk of Ovarian Hyperstimulation occuring, cancellation is advised by Galway Fertility Clinic. In such cases client’s are asked to abstain from intercourse or to use protection during intercourse until the next menstrual cycle occurs, to avoid a multiple pregnancy.
This pregnancy occurs outside the uterus usually in the fallopian tubes. The incidence of ectopic pregnancy with fertility treatment is 2.5% approximately but may be marginally higher in those with a history of tubal disease or blockage. An early pregnancy scan is recommended after a pregnancy is confirmed to diagnose and manage this potentially serious condition.
The incidence of miscarriage increases with increasing female age. The chance of a miscarriage occurring in a spontaneous pregnancy is approximately 20%. In couples having fertility treatment, the incidence for miscarriage is similar, but is increased for those over 40 (approximately 50% incidence for age 43 +).