While rare, there are some risks associated with ART treatment. If you have any additional queries or concerns related to your ART treatment, feel free to reach out to a member of our team. We are committed to providing you with the utmost care and support.
Egg collections are undertaken by trans-vaginal ultrasound guided aspiration. For patients where this is not suitable, the procedure may be performed laparoscopically.
Bleeding can occur from the ovaries or from adjacent pelvic structures post-surgery. It usually settles by itself but sometimes requires minor suturing (stitches). Some light vaginal bleeding may also be experienced.
Bruising around the ovaries after egg collection can cause pelvic discomfort for a few days. Use of regular pain medication is recommended, e.g. Panadol. Please avoid ibuprofen based medications, such as Nurofen, as these are not recommended during fertility treatment.
Pelvic infection may lead to a pelvic abscess, damage to the fallopian tubes and may require further surgery and hospitalisation. All patients are prescribed a dose of antibiotics before (or during) egg collection to help prevent this from occurring.
Egg collections are performed using a twilight sedation. This type of anaesthesia has fewer associated risks than a general anaesthetic, though some post-operative nausea and dizziness are relatively common, and will dissipate naturally.
The anaesthetist will discuss any concerns with you prior to your procedure.
OHSS is where fluid from the blood vessels leaks into the pelvic cavity, causing abdominal swelling and thickening of the blood. This condition is rare with approximately 1% to 2% of patients who undergo controlled ovarian hyperstimulation becoming symptomatic.
In most cases, OHSS can be prevented by careful hormone and ultrasound monitoring. OHSS is more likely to occur in patients who have produced a large number of follicles and have a high oestrogen (E2) level.
The symptoms of mild to moderate OHSS include nausea, vomiting, diarrhoea and abdominal swelling. The symptoms of severe OHSS can be breathing difficulties, reduced urine output and thrombosis (blood clot formation), which may require hospitalisation. Treatment generally involves intravenous fluids and may require draining of the fluid from the abdomen. It is very important that patients experiencing symptoms of OHSS inform a nurse coordinator immediately.
OHSS will gradually settle over a week or so unless pregnancy occurs. In early pregnancy the condition may last weeks and require prolonged hospitalisation.
All patients using stimulation injections require close monitoring with blood tests and ultrasound scans to ensure early detection and intervention for OHSS.
Patients who have an elevated E2 (estrogen) level and are considered to be at risk will have the following options considered by their doctor:
These options will be discussed with you should the situation arise.
Human Serum Albumin (HSA) is added to the embryo culture media. It is made from human plasma which has been screened and tested for known transmissible agents (viruses and prions) such as HIV, Hepatitis B, Hepatitis C and Creutzfeldt-Jakob disease (CJD). Chemical processing and virus inactivation stages included in the manufacture of these products are believed to render them safe from the risk of infection. Nevertheless the possibility of transmitting these agents must always be considered.
All products are subjected to strict quality control testing by the manufacturers. The Therapeutic Goods Administration (TGA) has approved these culture media products for use in Australia. If you have any concerns over the use of any of these agents, please discuss these with the Scientific Director or your doctor.
Studies have shown that fertility treatments do not appear to significantly increase the risk of invasive ovarian, endometrial, breast or other cancers.
Many research studies have examined the abnormality rate in children born after ART. A systematic review of ART treatments and birth defects published in 2013 has established that there is likely to be a small increase in abnormalities. The background risk for naturally conceived births is about 5% but when reproductive treatments are used this increases to 6.5-7%.
The complexity of reproductive treatment makes identifying risk factors extremely challenging. At this time, we believe this is due to a combination of factors, such as:
It has also been suggested that children born after ART procedures may have an increased risk of the very rare genetic disorder known as Beckwith-Wiedemann Syndrome and the childhood cancer Retinoblastoma. This, however, has not been scientifically established.
Epigenetics refers to factors that alter expression (imprinting) of genes in DNA. These factors rarely result in serious disease. Based on current evidence, the absolute risk of imprinting disorders after ART is extremely low.
The research on birth outcomes after ART suggest that over 93% of children born are free from congenital abnormalities. Follow-up studies on the birth outcomes of ART children are ongoing.
Unfortunately there are instances when the treatment is unsuccessful and can result in the following outcomes:
Sometimes no eggs are found at egg collection. This can be due to a low number of follicles or because no follicles contain a mature egg.
On occasion, when using IVF or ICSI procedures, fertilisation may still not occur. Reasons for this are often unexplained.
An embryo can fail to develop at the required rate and others might arrest in the early stages of development. Such embryos are usually found to have a high incidence of genetic abnormality or of poor quality.
Many factors involving the embryo and the uterus lining can affect a patients chance of becoming pregnant. Even with good quality embryos, some patients may need many ART attempts before coming pregnant.
Unfortunately, a rising pregnancy hormone does not always mean there is an ongoing viable pregnancy. An ultrasound scan is performed at approximately seven weeks gestation to determine the viability of the pregnancy.
Although there is an increased pregnancy rate with an increase in the number of embryos transferred, there is also an increased risk of a multiple pregnancy. With a single embryo transfer, a multiple pregnancy may still occur due to the potential of a single embryo to split in two. This will lead to identical twins (monozygotic twins) meaning both have developed from one fertilised egg (embryo).
When an embryo implants outside of the uterine cavity it is called an ectopic pregnancy. Until implantation, the embryo may move around the cavity of the uterus, the fallopian tubes, or beyond. This can lead to a surgical emergency.
Symptoms of an ectopic pregnancy can be but not limited to: shoulder tip pain; heavy bleeding; and sudden onset of lower abdominal pain, especially on one side. Early detection is vital, therefore it is important to attend for the requested blood tests and ultrasound scans as advised by your Doctor.
Approximately 1 in 5 of all pregnancies, no matter how they were conceived, end before they are viable. A miscarriage is defined as the loss of a pregnancy before 20 weeks gestation. Most miscarriages occur within the first trimester, the first 12 weeks of the pregnancy and women over the age of 35 years are at greater risk.
There are varying types of miscarriage:
Heavy bleeding and/or bleeding associated with increased abdominal pain can indicate a miscarriage. It is important that you seek advice or contact your fertility specialist. Our nurse coordination team can assist you in contacting the specialist. Reasons miscarriages occur are varied.
A blighted ovum refers to a condition where the gestational sac develops without an embryo. It occurs when the embryos never develops or stops developing. This adverse outcome is often picked up on ultrasound during an early pregnancy scan.
Symptoms often include minor stomach cramps, light spotting, or bleeding. Often there can be no cause found. In the event a miscarriage does not occur naturally, medication or a minor procedure to remove the sac may be required.
Adverse outcomes can create feelings of shock, grief, guilt, anger, sadness and depression. Grieving is a very personal experience and each patient may experience it differently. At Concept Fertility, we have experienced and compassionate counsellors that are here to guide you through these difficult and emotional times.