Side Effects and Complications

  
 

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

We estimate the dose of the drugs base on your ovarian reserve, body weight, previous response, …etc. As every body is different you might under or over respond. If you under respond we increase the dose of the drugs to catch up. Mostly we are successful. Occasionally it is too late and we might have to cancel the cycle hoping to get a better response if we start again on the higher from the beginning. On the other hand if you do too well it is not good either as you will be at risk of developing Ovarian Hyper-Stimulation Syndrome (OHSS).

Ovarian Hyperstimulation Syndrome (OHSS)

If you ovaries are very sensitive, you might over respond to the stimulation. Your will develop too many follicles (> 25) and have a high oestradiol (E2) level. This could be a potentially dangerous situation but OHSS occurs in sever forms only in 0.5% of patients. We have enormous experience of this treatment and we pay great attention to matching and adjusting dosage to response precisely and carefully. As we monitor you closely with blood tests and scan we can reasonably predict if you are heading in that direction. 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 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 characterized by low abdominal discomfort, bloating and pain, and occasionally nausea and vomiting. In sever cases this might be associated with feeling unwell and restless, difficulty in breathing and palpitation. If you have these symptoms you need to contact the clinic for a review. Alternatively you can contact your GP or present at 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 in a few days to two weeks.

If you develop symptoms of OHSS you need to drink lots of fluids (at least 3 litres/day), start high protein diet and avoid excessive physical activities. OHSS, if it happens, does not reduce your chance of conceiving or cause miscarriage.

With Egg Collection

There are small risks of internal haemorrhage and/or infection associated with ultrasound guided transvaginal egg collection. We routinely administer an antibiotic to try and 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
Good 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 patients’ pre existing pelvic condition.

Because we know exactly when we put the embryos back and when you got pregnant we check early for an intra-uterine vs. an ectopic pregnancy. W e 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.