Side Effects & Complications

As with any medical treatment, fertility treatment is not exempt from possible side effects and complications. We’ve highlighted below some of the more common side effects and complications so you are aware of the risks before undergoing your treatment.  

Minor General Side Effects And Drug Reactions

  • Headache, tiredness, mood swings, hot flushes, pelvic discomfort and very occasionally nausea.
  • Discomfort and local reaction at the injection site.
  • Nasal irritation if using nasal spray.
  • Breast fullness and constipation because of progesterone therapy.
  • Occasional vaginal bleeding at the down regulation phase.
  • Poor response.
  • Over response (OHSS).

The dose of fertility drugs we give you is based on our evaluation of multiple factors which allows us to determine your correct dosage – and here at The Fertility & Gynaecology Academy we have many years of successful experience. However, as everybody is unique, there is a chance you might under or over respond to the dosage. If you under respond we increase the dose. Occasionally it can be too late for this and we may need to cancel the cycle and start again from the beginning to get a better response. On the other hand, if you over respond you can be at risk of developing Ovarian Hyper-Stimulation Syndrome (OHSS).

Ovarian Hyperstimulation Syndrome (OHSS)

If your ovaries are particularly sensitive, you can over respond to the stimulation from the drugs and develop OHSS. OHSS occurs in 0.5% of patients and can be dangerous.

We have extensive experience of IVF and pay great attention to matching and adjusting dosages precisely and carefully. We monitor you closely with blood tests and scans and can reasonably predict if you are likely to develop OHSS. In this instance we can adopt one of the following options:

  • Reduce the dose of the stimulating drugs.
  • Coasting: you stop the stimulating drugs. We measure the level of E2 (estradiol hormone) in your blood every day and give you the trigger injection only when the level is right. As you will not develop OHSS unless we give you the trigger injection, we will not give that injection unless we feel you are safe.
  • Freeze all the embryos (as OHSS becomes worse if you get pregnant).
  • Cancel the cycle if all other options are not suitable.

OHSS is characterised by low abdominal discomfort, bloating and pain, and occasionally nausea and vomiting. In severe cases OHSS might be associated with feeling unwell and restless, difficulty in breathing and palpitation. If you have these symptoms you need to contact us for a review. Alternatively, you can contact your GP or go to the Accident & Emergency of your local NHS Hospital.

Although OHSS is unpleasant and potentially dangerous at the time, this condition is short lived and, fortunately, recovery occurs within a few days to two weeks.

If you develop symptoms of OHSS you should drink lots of fluid, start a high protein diet and avoid excessive physical activities. OHSS does not reduce your chance of conceiving or cause miscarriage.

Egg Collection

There are small risks of internal haemorrhage and infection associated with ultrasound guided transvaginal egg collection. We routinely administer an antibiotic to prevent any infection.

Multiple Pregnancy

Multiple pregnancies, mainly twins, can follow assisted conception treatment. There is an increased risk of miscarriage, prematurity, intrauterine growth restriction and cerebral palsy as well as maternal complications, such as anaemia, hypertension and caesarean section.

We will assess the following factors and discuss the number of embryos for transfer, to maximise your chance of a singleton and minimise the risk of a multiple pregnancy:

  • Young mothers
  • High number of retrieved eggs
  • High percent of fertilization and number of resulting embryos
  • Quality of the embryos
  • The number of embryos transferred
  • Quality of the surplus embryos and hence freezing
  • The length and cause of infertility
  • The outcome of previous treatment cycles
  • Previous pregnancy or live birth

Ectopic Pregnancy

Assisted conception treatments carry a small risk of ectopic (outside the uterus) pregnancy; about 3% in IVF. This is due to the patient’s pre-existing pelvic condition.

Because we know exactly when we put the embryos back and when you got pregnant, we check early for an intrauterine vs. an ectopic pregnancy. We can avoid the dangers of the pregnancy rupturing and we can also deal with it with medication or down the laparoscope rather than through an open abdominal incision.

If you develop any complications, please contact us immediately on 020 7224 1880.