Risks of IVF Treatment

What Is IVF Treatment?

IVF treatment is the final and most advanced stage of assisted reproductive technologies. Today, the term IVF most commonly refers to intracytoplasmic sperm injection (ICSI). In this treatment, ovarian stimulation is used to promote follicle growth. Under anesthesia, eggs are retrieved via a transvaginal needle. Mature eggs are then fertilized with the partner’s sperm in a laboratory setting. The resulting embryos are transferred into the uterus on day 3 or day 5.

Is IVF Treatment Risky?

IVF treatment is not inherently risky, but it requires careful management by experienced physicians. During ovarian stimulation, especially in patients with polycystic ovary syndrome (PCOS),accurate dose adjustment is crucial, as these patients are at higher risk of developing ovarian hyperstimulation syndrome (OHSS).

OHSS is a potentially life-threatening complication characterized by increased vascular permeability, fluid accumulation in body cavities, and possible multi-organ dysfunction. During egg retrieval, due to the proximity of the ovaries to intra-abdominal organs, injuries to the bowel, bladder, or major blood vessels may rarely occur. Post-procedural infections can also be seen. When performed by experienced clinicians, the incidence of these complications is extremely low.

IVF treatment does not cause breast or uterine cancer; however, it may stimulate the growth of pre-existing hormone-sensitive lesions that were previously undetected or too small to identify. Therefore, cervical cancer screening (Pap smear and HPV testing),breast ultrasound, and mammography for women over 40 should be performed prior to treatment.

What Are the Possible Risks of IVF Treatment?

During IVF treatment, particularly in patients with PCOS, ovarian hyperstimulation syndrome (OHSS) may occur. Today, this risk can largely be prevented through alternative stimulation protocols, the use of alternative trigger injections, and by freezing embryos with subsequent frozen–thawed embryo transfer (FET) in high-risk cases.

During egg retrieval, there is a small risk of injury to adjacent organs and post-procedural infection; however, the incidence of these complications is very low.

Because the hormones used in IVF can stimulate hormone-sensitive tumors, patients should be evaluated for potential lesions prior to treatment. Routine imaging studies and cancer screening tests should be completed.

Are There Long-Term Health Risks Associated with IVF Treatment?

IVF treatment does not pose significant long-term health risks. Regardless of whether IVF is performed, all patients should continue routine medical follow-ups, cancer screenings, and recommended imaging studies without interruption.

Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian hyperstimulation syndrome (OHSS) is a condition in which the ovaries become excessively enlarged, blood estradiol levels rise significantly, and in severe cases, increased vascular permeability due to elevated vascular endothelial growth factor (VEGF) leads to fluid accumulation in body cavities and potentially life-threatening organ failure.

OHSS is most commonly seen in patients with polycystic ovary syndrome (PCOS) receiving high doses of stimulation medications, but it may also occur in lean patients even at lower doses. To prevent OHSS, appropriate dose adjustment based on body weight and ovarian reserve is essential. Once OHSS develops, management may include intravenous fluid therapy, fluid restriction, and hospital monitoring in severe cases.

Risks and Complications of Multiple Pregnancies

In IVF treatment, the number of embryos transferred is limited to reduce the risk of multiple pregnancies. In women under 35 years of age with fewer than two unsuccessful IVF attempts, up to two embryos may be transferred; in women over 35, the transfer of two embryos is also permitted.

The transfer of more than two embryos is strictly prohibited by regulations, as it significantly increases the risk of multiple pregnancies. Multiple pregnancies are generally undesirable because they are associated with a higher risk of preterm birth and neonatal complications. In patients who meet the criteria and undergo double embryo transfer, the goal is not to achieve twin pregnancy, but to increase the overall chance of pregnancy.

What Are the Possible Risks After Embryo Transfer?

During embryo transfer, a thin catheter containing the embryo is passed through the cervix, and the embryo is placed into the uterus. This procedure does not require anesthesia and is considered safe, with no significant associated risks.

What Measures Can Be Taken to Reduce Risks in IVF Treatment?

Individualization of IVF treatment is crucial for minimizing risks. In personalized treatment protocols, medication doses are adjusted according to the patient’s age, weight, height, and response to previous treatments. This approach helps prevent inadequate ovarian response, excessive stimulation, cycle cancellation, or cancellation of fresh embryo transfer.

During egg retrieval, avoiding multiple needle entries into the ovaries, collecting all eggs through a single entry when possible, and carefully preventing injury to adjacent organs can further reduce risks.