Nearly four decades ago, when the first baby conceived via in vitro fertilization (IVF) was born, the infertility community hailed the development as a miracle. Skeptics called the child a “test tube baby,” or sounded alarm bells that IVF would eventually remove the need to reproduce in the traditional way. Forty years later, IVF treatment is safer, more effective, and more affordable than it has ever been -- and couples still haven't given up on making babies the old-fashioned way.
With success rates ranging from 20-40%, IVF is the treatment of choice for a range of fertility issues, including unexplained infertility that has not responded to other treatments. Like all medical procedures, IVF carries some risks and minor side effects are common.
Talk to your doctor about potential side effects before beginning treatment, and report all side effects to your provider -- especially if side effects are severe enough to warrant ending treatment.
Changes in Mood
IVF drugs stimulate your ovaries to produce multiple eggs, thereby increasing your chances of getting pregnant each cycle. Though the drug cocktail you take will depend on your specific fertility issues, estrogen is almost always a part of the cocktail. High doses of estrogen may cause mood swings or depression. You might also feel like you're just not yourself.
The reason for this is simple: hormonal changes -- especially those due to drugs -- can affect more than just reproduction, and may alter how your body and brain interact and process information. The good news is that the mood changes are temporary. If you do multiple IVF cycles, you may find that you experience fewer mood changes with the second cycle.
You already know that infertility can be extremely anxiety-inducing. IVF can also trigger anxiety, since regular injections and doctor's appointments constantly redirect your attention to your fertility struggles. You may feel anxious about the effects of treatment, or about your ability to get pregnant. You may struggle to wait to take a pregnancy test, or find yourself constantly looking for signs of pregnancy. Some women find that fertility drugs increase their anxiety.
Some women experience headaches after IVF drug injections, particularly in the hours immediately following an injection. If you experience headaches associated with your menstrual cycle, this may mean you are more sensitive to hormonal shifts, and therefore more vulnerable to IVF-induced headaches as well.
Hormones are the body's chemical messengers, carrying signals from one area of the body to another. Changes in hormone levels can alter how your body perceives temperature, causing sudden hot flashes. You may also find that you are more sensitive to heat, or that you grow winded more easily.
The bloating some women experience immediately before or during their periods is also common during IVF treatments. Bloating can last anywhere from a few hours to several days, and may add several inches to your waistline. Though bloating can be uncomfortable, it should not be painful. If you experience intense abdominal pain, contact your provider immediately.
Estrogen can alter your metabolism and cause you to pack on the pounds. Many women find that they gain 5-10 pounds during an IVF cycle. Much of this weight is water weight due to increased water retention, but don't be surprised if you gain some fat, too.
Ovarian Hyperstimulation Syndrome
IVF drugs cause your ovaries to produce more eggs than they normally do. More eggs means a greater chance of a successful pregnancy with a healthy egg. But because your ovaries are doing something they don't normally do, they can become overstimulated. Rarely, women experience a condition called ovarian hyperstimulation syndrome (OHS).
Symptoms range from mild to severe, and can include ovarian pain, vomiting, and rapid weight gain. Very rarely, OHS may cause blood clots in the legs, ovarian cysts, ovarian torsion, urinary retention, or shortness of breath. If you experience any symptoms of OHS, contact your provider immediately.
Because IVF drugs stimulate your ovaries to produce multiple eggs, you have a much greater chance of becoming pregnant with multiple babies. About 1 in 6 IVF-induced pregnancies (15%) result in two or more implanted embryos.
IVF pregnancies are slightly more likely to result in miscarriage. There are a number of reasons for this, most of which are not directly related to IVF:
- Advanced maternal age, since older women are more likely to use IVF.
- Implantation of an embryo with a genetic defect. Because embryos are implanted directly into the uterus with IVF, it is slightly more likely that a damaged or defective embryo implants.
- Health or structural issues; people with health problems may pursue IVF. Thus the same issues that led to infertility may also trigger a miscarriage.
One in four pregnancies ends in miscarriage. With IVF, the rate is slightly higher.
An ectopic pregnancy occurs when the embryo implants outside of the uterus. The result is an embryo that cannot develop into a baby. Left unchecked, an ectopic pregnancy can rupture your fallopian tubes, triggering life-threatening bleeding. About 5% of IVF pregnancies produce an ectopic pregnancy. To protect your health, these non-viable pregnancies must be surgically removed.
Researchers are not sure why IVF is linked to more ectopic pregnancies. It could be that women who pursue IVF are simply more likely to have ectopic pregnancies due to structural or hormonal abnormalities.
But something about IVF might also be the culprit. If you experience pain in either side, bleeding, or vomiting and suspect you may be pregnant, contact your provider immediately. Although these symptoms are common even in healthy pregnancies, they can also be early warning signs of an ectopic pregnancy.
Pregnancy Postpartum Difficulties
Women who undergo IVF treatment are more likely to experience a number of pregnancy and postpartum complications, including:
- Postpartum depression and anxiety
- Postpartum hemorrhage
- Birth interventions such as forceps deliveries and C-sections
- Giving birth to a baby who needs to spend time in the neonatal intensive care unit (NICU)
As with other complications, these issues might not be directly related to IVF, but instead to the factors that led to IVF. For instance, a woman with a hormonal imbalance may struggle to manufacture appropriate levels of hormones associated with breastfeeding.
Likewise, a woman with structural abnormalities may be more vulnerable to birth complications. Excellent prenatal care, postpartum support from family and friends, lactation support, and discussing your birth expectations with your doctor can help reduce your risk for an array of complications.