Multiple pregnancies: Twins and multiple pregnancies are more common in some forms of infertility treatment including medical treatment – for example, with clomiphene. This is because in some of the treatments using medication, the ovaries may be stimulated for producing more than one egg and therefore more than one is fertilized. Also, in some assisted conception treatments, more than one embryo is put back into the woman’s womb and therefore more than one pregnancy can develop.
Having twins or triplets may be a great thing for any infertile couples. However, it should be explained that it does carry an increased risk of problems during a woman’s pregnancy, such as high blood pressure and diabetes. There are also more likely to be complications for the developing babies like small for date babies, preterm babies etc. For this reason, it is currently recommended in the UK that no more than two embryos should be transferred during any one cycle of IVF for women under the age of 40.
Pregnancy in the Fallopian tube: An ectopic pregnancy (a pregnancy that develops in the Fallopian tube) is more likely in women who are undergoing treatment for infertility, especially if the cause of infertility is due to a problem with the Fallopian tubes.
Stress: Going through investigations and treatment for infertility can be a very stressful thing and can put a strain on many relationships. It is important to discuss your feelings with your partner, doctor, nurse co coordinator or counselor.
Ovarian Hyper stimulation: There is a small risk that some of the medicines used to treat infertility, such as the gonadotrophin medicines, can over-stimulate the ovaries and can lead to a condition known as ovarian hyperstimulation syndrome. In this condition, the ovaries can swell due to a number of cysts that develop on the ovaries. Symptoms can include abdominal pain and distension (swelling), nausea and vomiting. The condition can usually be treated easily and does not lead to any major problems. However, occasionally it can be more serious and can lead to liver, kidney and breathing problems or thrombosis (a blood clot in an artery or vein). Close monitoring using ultrasound is often used when women are given medicines to stimulate the production of eggs by the ovaries. The numbers and size of follicles (the sac containing an egg) can be measured. This helps to reduce the risk of multiple pregnancy and also ovarian hyper stimulation.
Birth defects: The overall risks of an abnormality (a birth defect) occurring following assisted conception are small. However, the risk is about 1% as found in normal conception only. We have observed in these 18 years of our ART practice achieving pregnancies in more than 2800 women after ART, only 0.8% of birth defects – more of urinary tract anomaly and very few severe anomaly which is incompatible with life. Here we should proudly say that this ratio defers from other day 3 / day 2 embryo transfers because Blastocyst culture allow only hardiest embryos without genetic defects to grow until day 5 in vitro. Choosing the best blastocyst on day 5 of culture, for embryo transfer, help us to choose a very good embryo without defect, indirectly.
Other side-effects: Some of the medicines used to treat infertility – for example, the gonadotrophins – may cause hot flushes and menopause-type symptoms. Before embarking on any treatment you should have a discussion with your infertility expert on the pros and cons of the treatment proposed, and the risk of problems and side-effects.