Typically, IVF treatment is fairly straightforward; patients are usually young and healthy, and the treatment usually runs smoothly as planned. This is why most IVF cycles are seamless and uneventful. However, there are times when certain emergencies may arise and patients need to be aware of what these are.
Different Types of Emergencies
• Ovarian hyperstimulation syndrome (OHSS)- This is the commonest medical emergency in an IVF clinic. This occurs when the patient grows excessive follicles. If the doctor doesn’t know how to manage this problem , the patient can end up with severe hyperstimulation that can be life-threatening. The good news is that hyperstimulation is a preventable problem; a knowledgeable doctor will also be able to treat it effectively. Today, there are a number of techniques and tools that can be used to prevent this problem and to ensure that it does not become severe
• Ectopic Pregnancy- This is another emergency that IVF clinics have to deal with. Though we transfer the embryos into the uterus in an IVF cycle, there are times when the embryos move out of the uterus in a retrograde fashion into the fallopian tube- this results in an ectopic pregnancy.
In a good clinic, the specialists will routinely monitor hCG levels in order to make sure that the pregnancy is in the right location. If an ectopic is diagnosed in a timely manner, it’s very easy to treat this medically. A methotrexate injection is administered and this kills the ectopic pregnancy. However, if the diagnosis is either delayed or missed, an ectopic pregnancy can rupture and be life-threatening to the woman
• High Order Multiple Pregnancy- In the past, a high order multiple pregnancy was a very common complication of IVF. This was because doctors transferred too many embryos in order to inflate their success rates. However, this can be prevented by restricting the number of embryos we transfer
• Vaginal Bleeding or Infection- There can also be complications during egg collection, such as vaginal bleeding or infection. However, in a good clinic, these are very rare
• Difficult Embryo Transfer- This is one of the most vexing emergencies, when the doctor has technical difficulty in depositing the embryos through the cervix into the uterus. This may be because of cervical stenosis; or a sharply angulated cervical canal. It can be extremely distressing for both doctor and patient, as difficult embryo transfer does reduce the success rates. This is also why many clinics routinely do a dummy embryo transfer to prevent this situation from occurring
When Emotions Surface
Last but not the least, the commonest emergencies are the emotional ones; many patients break down when they find their beta hCG is negative and the IVF cycle has failed. An empathetic doctor will be able to manage this kind of a situation in a skillful manner. He will provide patients a shoulder to cry on, and explain to them that it's more important that they take a long-term view, rather than get disheartened just because one cycle has failed.
The best way to avoid emergencies and complications is to find a high quality experienced IVF clinic which has the required expertise in preventing problems.
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