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Associated Risks and Side Effects
There are risks associated with all medical or surgical procedures, and some patient’s will experience side-effects and complications during the treatment with in vitro fertilization. The most common complications are due to problems with ovarian stimulation, risks associated with collecting the eggs, the possibility of an ectopic pregnancy, multiple pregnancies or the failure of the treatment.
Studies have hinted at a link between using fertility drugs and the risk of ovarian, breast and endometrial cancer. These divisive studies suggest that ovarian stimulation medications are linked to ovarian cancer. Evidence shows there are significant problems in many of these studies, particularly in subgroup analysis and by their inability to control for other cancer factors. A few patients experience side-effects when using fertility medications, including local reactions such as bruising and tenderness at the site of injections, or a generalized allergic reaction. Medications, such as GnRh analogues can cause short term headaches, mood changes, hot flushes and vaginal dryness.
Problems can arise during collection of the eggs, such as discomfort, minimal bleeding during the procedure from the ovary or vagina, or infection, which is rare, and is treated with antibiotics. Internal organs such as bowel and bladder or blood vessels can be injured, but is extremely rare.
Ectopic pregnancy after IVF treatment usually occurs in the fallopian tube, but an ectopic pregnancy can occur in the ovary and cervix. The ovary and cervix locations are less common. Abdominal pregnancy is rare and usually the fetus dies.
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Common and Serious Complications
The most serious complication of IVF is ovarian hyper-stimulation syndrome (OHSS). Severe OHSS is a life threatening complication following ovarian stimulation. Symptoms begin 4 –5 days after collection of eggs. The symptoms of pain, bloating, abdominal swelling are usually mild in most women, but in some can be quite severe. Sometimes cysts appear in the ovaries (ovarian cysts) and fluid may collect in the abdominal cavity causing discomfort. Rarely, in about 2% of women, the ovaries will severely swell and the woman will experience nausea or vomiting. Fluid collects in the abdominal cavity and chest which causes shortness of breath and reduction in urine output. Urgent hospitalization is needed in order to restore fluids and electrolyte balance, control pain, and in some causes termination of the pregnancy is necessary.
Complications associated with severe OHHS include blood clotting disorders, kidney damage and a twisted ovary (adnexal torsion). Adnexal torsion happens when the stimulated ovary twists on itself, cutting of its own blood supply; surgery is then needed to untwist the ovary. Sometimes the ovary will be have to be removed. Women at risk of developing OHSS include women with polycystic ovaries, younger women, high estrogen levels and a larger number of eggs, and women who were given GnRh or hCG.
The most common complication of IVF treatment is the failure of a viable pregnancy. This is normally due to failure to collect eggs, failure of fertilization or failure of implantation. Recent studies show no significant difference of congenital or chromosomal abnormalities in children conceived via IVF versus children conceived naturally. In addition, babies appear to develop normally with no significant difference when conceived from fresh versus frozen embryo.