IVF emergencies and complications

IVF treatment is usually fairly straightforward . Patients are usually young and healthy, and the treatment usually goes smoothly as planned. This is why most IVF cycles are uneventful without any problems at all . However, sometimes there can be emergencies which patients need to be aware of.

The commonest medical emergency is ovarian hyperstimulation syndrome or OHSS. This occurs when the patient grows too many follicles, and if the doctor doesn’t know how to manage this problem , patients can end up with severe hyperstimulation which can be life-threatening . The good news is that hyperstimulation is a preventable problem , and can also be treated effectively by a knowledgeable doctor. We have lots of tools and techniques to prevent the problem , and to ensure that it doesn't become severe.

The other medical emergency IVF clinics have to deal with is that of ectopic pregnancy . Even though we transfer the embryos into the uterus in an IVF cycle, sometimes the embryos move out of the uterus in a a retrograde fashion into the fallopian tube, resulting in an ectopic pregnancy . In a good clinic, hCG levels are actively monitored routinely in order to make sure that the pregnancy is in the right location , If an ectopic is diagnosed in a timely fashion , it's very easy to treat this medically by giving a methotrexate injection which can kill the ectopic pregnancy. However , if the diagnosis is delayed or missed, then an ectopic pregnancy can rupture and be life-threatening.

In the past, a high order multiple pregnancy was a common complication of IVF because doctors transferred too many embryos in order to inflate their success rates. However, by restricting the number of embryos we transfer, this can be prevented.

There can also be complications during the egg collection, such as vaginal bleeding or infection. However, in a good clinic, these are very rare.

One of the vexing emergencies is that of a difficult embryo transfer , where 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. This can be extremely distressing for both doctor and patient, because a difficult embryo transfer does reduce the success rates. This is why many clinics will routinely do a dummy embryo transfer to prevent this situation from arising.

Finally, the commonest emergencies are the emotional ones , where patients break down when they find their beta hCG is negative and the IVF cycle has failed. This is best managed by an empathetic doctor,. who can provide patients with a shoulder to cry on , and explain to them that it's more important that they focus on the long-term perspective , rather than get disheartened just because one cycle has failed.

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