The medical risks of ART depend on each specific step of the procedure in IVF treatment in Delhi NCR
The following are some of the primary risks of ART procedures:
Ovarian stimulation carries a risk of hyperstimulation in IVF treatment in Delhi NCR, where the ovaries become swollen and painful. Fluid may accumulate in the abdominal cavity and chest, and the woman may feel bloated, nauseous, and experience vomiting or lack of appetite. Up to 30% of women undergoing ovarian stimulation have a mild case of OHSS that can be managed with over-the-counter painkillers and reduction inactivity. In moderate OHSS, women develop or accumulate fluid within the abdominal cavity, and gastrointestinal symptoms may occur. These women are monitored closely but generally do very well with simple outpatient management.
The condition tends to resolve without intervention unless pregnancy occurs, in which case recovery may be delayed for several weeks. Up to 2% of women develop severe OHSS characterized by excessive weight gain, fluid accumulation in the abdomen and chest, electrolyte abnormalities, over-concentration of the blood, and, in rare cases, the development of blood clots, kidney failure, or death. It may be medically necessary to drain fluid from the abdomen with a needle if breathing becomes difficult. Women with severe OHSS require hospitalization until the symptoms improve. If pregnancy occurs, OHSS can worsen. Occasionally, termination of pregnancy must be considered in the most severe cases.
Although initial reports are shown at nearby IVF centers and suggested that women who use fertility drugs have an increased risk for ovarian cancer, numerous recent studies support the conclusion that fertility drugs are not linked to ovarian cancer. Nevertheless, there is still uncertainty whether a risk exists, and research continues to address this question. An annual gynecologic visit is recommended for all women to examine the ovaries, regardless of prior use of ovulation medications.
There are risks related to the egg retrieval procedure. Laparoscopy carries the risks of any surgery that requires anesthesia. Removing eggs through an aspirating needle entails a slight chance of bleeding, infection, and damage to the bowel, bladder, or blood vessel. This is true whether the physician uses laparoscopy or ultrasound to guide the needle. Less than one patient in 1,000 will require major surgery to repair damage from complications of the egg retrieval procedure. In rare cases, the infection may occur from the retrieval or embryo transfer.
The chance of multiple pregnancies is increased in all assisted reproductive technologies when more than one embryo is transferred. Although some would consider twins a happy result, there are many problems associated with multiple births. Problems become progressively more severe and common with triplets and each additional fetus after that. Women carrying various pregnancies may need to spend weeks or even months in bed or the hospital in an attempt to delay preterm delivery. The risk of preterm delivery in multiple pregnancies is high, and babies may be born too early to survive. Premature babies require prolonged and intensive care and risk lifelong handicaps due to premature birth. Some couples may consider multifetal pregnancy reduction to decrease the risks due to multiple pregnancies, but this is likely to be a difficult decision so meet a gynecologist at a nearby IVF center.
For more information on this topic, refer to the ASRM patient information booklet titled Multiple Pregnancy and Birth: Twins, Triplets, and Higher-Order Multiples and the ASRM patient fact sheet, Complications, and Problems Associated with Multiple Birth. Data also suggest that IVF conceptions, even singletons, have a slightly increased risk of preterm delivery or low birth weight.
First-trimester bleeding may signal a possible miscarriage or ectopic pregnancy. If bleeding or pain (before 13 weeks) occurs, a medical evaluation is needed to determine the cause. Some evidence suggests that early bleeding is more common in women who undergo IVF and GIFT and is not associated with the same poor prognosis as it is in women who conceive spontaneously.
Miscarriage may occur after ART, even after ultrasound identifies a pregnancy in the uterus. Miscarriage occurs after ultrasound in nearly 15% of women younger than age 35, in 25% at age 40, and 35% at age 42 following ART procedures. In addition, there is approximately a 5% chance of ectopic pregnancy with ART. It is not clear whether the risk of congenital disabilities is increased with IVF. Most studies do not show an increased risk, but several studies do. Research is ongoing to determine the magnitude, if any, of this risk. Furthermore, when ICSI is used in cases of severe male factor infertility, a genetic cause of male infertility may be passed onto the offspring.
Assisted reproductive technologies involve significant physical, financial, and emotional commitments on the part of the couple. Psychological stress is every day, and some couples describe the experience as an emotional roller coaster. The treatments are involved and costly. Patients have high expectations, yet failure is common in any given cycle. Couples may feel frustrated, angry, isolated, and resentful. At times, frustration can lead to depression and feelings of low self-esteem, especially in the immediate period following a failed ART attempt. The support of friends and family members is significant at this time. Couples are encouraged to consider psychological counseling as an additional means of support and stress management. Many ART programs have a mental health professional on staff to help teams deal with the grief, tension, or anxieties associated with infertility and its treatment.