What are treatments for IVF complications

Rare risks

The risks are low and complications are rare

As with any medical treatment or medical intervention, fertility treatment can also cause side effects - but today it is considered a very low-risk method overall. However, since we consider comprehensive clarification to be self-evident and important, we would also like to explain the possible risks to you. In addition to the experience of the team treating you, this also depends on the medical prerequisites that you as a couple bring with you (e.g. influences such as obesity, smoking, concomitant diseases, etc.). We will go into more detail about individual aspects of individual factors in a personal conversation with you. Rare, but theoretically conceivable risks of treatment are:

  • Mental stress, emotional fluctuations
  • Coagulation disorders (thrombosis, embolism)
  • Premature discontinuation of treatment
  • Side effects of follicular puncture
  • Ovarian hyperstimulation syndrome
  • Multiple pregnancy
  • Miscarriage and ectopic pregnancy
  • Malformations

Emotional stress and mood swings

Fertility treatment takes time and requires patience. In addition, there may be fluctuations in feelings due to an alternation of hope and fear, joy and disappointment. This situation can lead to emotional stress. The team at the University Fertility Center in Kiel supports and accompanies you professionally and personally in detailed discussions. We take time for you and treat you in a pleasant, calm atmosphere. All steps of the therapy can also be accompanied with relaxing acupuncture. In addition, we organize and support the establishment of a self-help group at the University Fertility Center in Kiel "by patients for patients". So that you can be sure: you are not alone with your questions, worries and fears. It is often helpful to be in a group where you can talk openly about these problems.

Blood clotting disorders

A rare risk is the development of a vascular blockage caused by a blood clot, a thrombosis. This risk is increased - similar to the situation in pregnancy - due to increased hormone levels and possibly higher blood concentrations. In very rare cases, a blood clot can loosen from a vessel and be carried around: an embolism. For prevention, we recommend light physical activity and adequate fluid intake while taking hormonal therapy. We will also ask you about any previous coagulation disorders or tendency to thrombosis in your family, in order to then prescribe a targeted blood thinning therapy (the so-called “thrombosis injection”) during the fertility treatment.

Premature discontinuation of treatment

In less than 5% of all treatment cycles, no embryos can be transferred because the treatment has to be stopped prematurely. Embryos cannot be returned if

  • sufficient follicle growth cannot be achieved despite ovarian stimulation,
  • oocytes that cannot be obtained from the follicle puncture, or only of insufficient quality,
  • The egg cells have not been fertilized (fertilization failure) or the subsequent cell division to the embryo has not occurred. This may be due to poor egg or sperm quality.

Side effects of follicular puncture

Egg retrieval (follicular puncture) is one of the smallest gynecological surgical interventions and therefore only very rarely involves risks. Theoretically, bleeding, organ injuries, infections or, rarely, side effects caused by anesthesia could occur. If such side effects occur, we will treat them immediately and monitor them closely.

Ovarian hyperstimulation syndrome

The aim of hormone therapy as part of IVF or ICSI is the simultaneous maturation of several egg cells. Despite careful ultrasound and hormone checks, the ovaries can overreact with the growth of too many follicles. This "overstimulation syndrome" is associated with a significant enlargement of the ovaries, pelvic pain and high levels of estrogen in the blood, which lead to increased vascular permeability. Water retention in the abdomen, a feeling of pressure and breathing problems can result. The blood concentration increases the risk of thrombosis. However, the symptoms are usually easy to treat and often resolve completely within a few days.

Multiple pregnancy

In order to increase the chances of success of the IVF procedure, two, but a maximum of three, embryos are usually transferred into the uterus. On the one hand, this increases the chance of a pregnancy, on the other hand, it also increases the possibility of a multiple pregnancy. These are generally high-risk pregnancies with a health risk for mother and children, many of which end prematurely as miscarriages or premature births. The primary goal of our treatment is a healthy single pregnancy. To achieve this, we recommend returning a maximum of two embryos for patients up to 37 years of age. We will only discuss the possibility of transferring three embryos with you if you are over 37 years old. Nevertheless, we cannot always completely rule out the occurrence of multiple pregnancies. Even if only one embryo is returned, an identical twin pregnancy can occur.

Miscarriage and ectopic pregnancy

Depending on age, around 10 to 15% of all pregnancies end prematurely in a miscarriage. The average age of fertility patients is relatively high - and with increasing age the miscarriage rate naturally increases. We have to take this into account with our fertility treatments. In most cases the cause is genetic "copying errors" that occur in the growing embryo during the daily thousands of cell divisions. This is then recognized by nature and the early pregnancy is automatically terminated - a very painful, but also "protective" intervention by nature. Recently, the risk of miscarriage can be reduced through genetic egg cell testing (polar body diagnosis), a method that we also offer you at the University Fertility Center in Kiel.

In 1 to 2% of all pregnancies, an “ectopic pregnancy”, an extrauterine pregnancy that grows outside the uterus, can occur. In any case, this must be terminated medically, either surgically or with medication. The risk of complications can be minimized through regular check-ups and immediate therapy.

Malformations

The child's health is our top priority. Nevertheless, the risk of a genetically inherited or spontaneous defect cannot be completely ruled out, even in the context of fertility therapy. The occurrence of malformations in children is examined again and again, especially in connection with the ICSI procedure: The intracytoplasmic sperm injection (ICSI) is currently the most frequently used method of artificial insemination in Germany. The procedure was introduced in 1992 and 10 years later included in statutory health insurance as a routine method. This means that it is now also available to all legally insured couples with a severe disruption of the man's semen quality. After many years of experience, we now know that the method is safe in itself. Nevertheless, there are indications that children according to ICSI show an increased risk of malformations compared to naturally conceived children. In order to be able to assess this, the natural "basic risk" for malformations must be known: For example, one out of 15 children is conspicuous in terms of malformation during natural conception. After conception through the ICSI procedure, it is one of 12 children. According to the knowledge available to us today, this difference is not based on the method; H. the injection of the semen into the egg cell, but rather on the background risk that the mostly older or previously ill couple will bring with them to the treatment. In order to be able to assess this given risk, we examine you as a couple for genetic abnormalities before an ICSI treatment, carry out targeted genetic diagnostics if necessary, and offer genetic counseling prior to therapy. In addition, pregnancies can be checked using a special ultrasound method (“genetic ultrasound”) around the 12th week of pregnancy and again using a special organ ultrasound in the 20th week of pregnancy.