With IVF Comes Benefits And Risks

In vitro fertilization (IVF) is an innovative approach to couples struggling with infertility. More couples are opting for the procedure, with as many as 4 million births attributed to IVF yearly. IVF occurs in several stages. The fertility clinic will extract viable eggs from the woman’s ovaries. These eggs are fertilized with a sperm sample to create viable embryos. Once ready, a single embryo or, in some cases, multiple embryos are surgically implanted into the uterus, then monitored for pregnancy. Despite the high success rates, there are risks and complications. Ovarian hyperstimulation syndrome (OHSS), for instance, is a possible issue that can impact IVF’s success. Identifying and treating complications like OHSS is vital to the procedure’s success.

A little overstimulated

At different stages, IVF requires the use of fertility medication to mature several eggs at the same time. The woman is expected to inject hormone medicine at specific doses to stimulate the ovaries. The therapy usually consists of a form of follicle-stimulating hormone (FSH) or other gonadotropins. OHSS is an excessive, overactive response to medication. The ovaries become enlarged and develop multiple fluid-filled cysts. Fluid sometimes leaks into the abdominal cavity, causing weight gain, bloating, abdominal pressure, abdominal pain, decreased urination, and nausea. Some cases can become more severe. Statistics estimate that up to 7% of women are at risk of experiencing OHSS during IVF.

Risk factors for developing OHSS

Figures indicate that OHSS rates are low, but there are possible risk factors to consider. While all women are potentially at risk, some are more likely to develop the condition than others. For instance, younger women attempting IVF are more likely to develop OHSS. Women who struggled with irregular ovulation patterns would have tried IVF to get pregnant. These women are also at risk of developing OHSS, especially if the condition developed before. Conditions like polycystic ovarian syndrome (PCOS) also increase the risk due to changes in hormones.

How do we treat with OHSS?

Fertility medication is necessary during the IVF process. More eggs mean the chances of creating multiple healthy embryos increase significantly. At the same time, OHSS can develop. Should a woman face OHSS, the fertility team can establish individual treatment plans. Mild cases can be managed through rest, pain medication, and simple lifestyle changes. Monitoring fluid intake, taking anti-nausea medications and anti-inflammatory drugs may be necessary. For severe cases, the patient may require hospitalization. The medical team may administer intravenous fluids, provide diuretics, or drain fluid from the abdomen. OHSS requires close monitoring using ultrasounds and blood tests. With time and an individual treatment plan, OHSS can be managed, and the IVF process can proceed.

Possible prevention options

The fertility team can put steps in place to reduce the possibility of OHSS, especially if the woman is high-risk. Doing the necessary blood tests before fertility treatment can indicate if someone will be more sensitive to fertility drugs. Women with high anti-müllerian hormone (AMH), for instance, may be more sensitive to higher doses of medication. These women should be given lower doses. Continuous monitoring of hormone levels during the medicine regimen could help doctors pre-emptively treat the condition, changing medication accordingly. This change of medicine is beneficial before the trigger shot process.

With OHSS under control, there is hope

OHSS symptoms must be taken seriously. Should a woman develop OHSS, the fertility team may delay the embryo transfer process. Performing an embryo transfer may lead to a failed cycle and can be harmful to the patient. The primary goal is to get OHSS under control before the condition becomes severe. Fertility clinics are skilled in identifying and treating IVF complications. The safety and well-being of the patients undergoing IVF are a top priority. Taking the time to address this issue can lead to better IVF outcomes in the future.