The risks of IVF

Today I would like to raise a very important theme – possible health risks, caused by IVF. I will give answers to the most frequently asked questions.

How dangerous are the drugs used in IVF (for ovarian stimulation, for example)? That is, if a not quite healthy person can have a baby without heavy consequences?

In my opinion, in its current form the question is somewhat vague. What does it mean - not quite healthy? An amputee too, can hardly be called an absolutely healthy person, but there are no contraindications for the conception, pregnancy and childbirth.

Also, let's clearly separate two concepts - the ability to successfully conceive a child does not mean the ability to safely carry and give birth. For example, if a patient has a serious heart disease, then she will likely support IVF normally, being carefully supervised by her doctor; but whether she is able to survive pregnancy and childbirth successfully - is a big question. As far as the safety of pregnancy and childbirth is concerned, this issue doesn’t depend on the way of conception at all and should be addressed not to fertility specialists, but rather, to the obstetricians-gynecologists. Therefore, I propose to focus on the issue of proper medical contraindications to ensure IVF.

Undoubtedly, the most serious blow to the woman's organism is made by gonadotropes – hormones, stimulating the simultaneous maturation of multiple eggs. All other medications, in fact, are complementary and supportive. So, 3 main products are used: Gonal-F, Menopur, Puregon. Not to be unfounded, I wrote all the contraindications to their use. Here is a general list: hypersensitivity (read - individual intolerance of the drug), ovarian, breast, uterus , pituitary gland or hypothalamus tumors, primary ovarian failure, ovarian cysts or ovarian increase not associated with polycystic ovary syndrome, impaired genital anatomy or fibroids of the uterus incompatible with pregnancy, vaginal (uterine) bleeding of unknown etiology.

That's all. Simply put, the vast majority of the contraindications are associated with diseases or anatomical deformation of the female reproductive system. And this despite the fact, that manufacturers usually like to play safe, and often include in the list of contraindications the risks that can be called so purely theoretically.

So, if the reproductive function is OK, you can safely undergo IVF?

It’s not that easy. Let's not forget one very important point. The most common complication during hormone therapy for in vitro fertilization is OHSS (ovarian hyperstimulation syndrome), and torsion of an ovarian cyst (as a complication of OHSS). Mild form of OHSS is accompanied by pain in the abdomen, nausea, vomiting, weight gain, increased ovarian, including due to the formation of cysts. With medium and severe OHSS dyspnea, oliguria (reduced urine flow), the accumulation of free fluid in the peritoneal cavity, the accumulation of transudate in the pleural cavity, i.e., effusion of non-inflammatory origin, accumulation of fluid in the pericardial cavity, lung failure and thromboembolism are possible. Naturally, the severe form of OHSS can aggravate existing diseases, not related to the reproductive system. However, it would be incorrect to speak of the relationship of these exacerbations and IVF – in the same way they can be caused, for example, by food poisoning, or the flu.

What shall a woman do in this situation? Give up the dream about a child? Not at all. Ovarian hyperstimulation syndrome in a mild form – is a quite unpleasant thing, but still harmless enough, the main thing is to prevent its development in time. So even if a woman has a certain disease, it’s early to give up IVF. There are some simple rules to minimize the risk in this case: to tell your doctor about your illness (or better yet - give him a chance to get to know your medical card), to strictly follow its recommendations and not to self-medicate in any case, and to call to your clinic at first signs of discomfort.