Side effects & complications

• Headache, tiredness, mood swings, hot flushes, pelvic discomfort and very occasionally nausea.
• Discomfort and local reaction at the injection site.
• Nasal irritation if using nasal spray.
• Breast fullness and constipation because of progesterone therapy.
• Occasional vaginal bleeding at the down regulation phase.
• Poor response.
• Over response (OHSS).

If your ovaries are particularly sensitive, you can over respond to the stimulation from the drugs and develop OHSS. OHSS occurs in 0.5% of patients and can be dangerous.

We have extensive experience of IVF and pay great attention to matching and adjusting dosages precisely and carefully. We monitor you closely with blood tests and scans and can reasonably predict if you are likely to develop OHSS. In this instance we can adopt one of the following options:

• Reduce the dose of the stimulating drugs.
• Coasting: you stop the stimulating drugs. We measure the level of E2 (estradiol hormone) in your blood every day and give you the trigger injection only when the level is right. As you will not develop OHSS unless we give you the trigger injection, we will not give that injection unless we feel you are safe.
• Freeze all the embryos (as OHSS becomes worse if you get pregnant).
• Cancel the cycle if all other options are not suitable.

OHSS is characterised by low abdominal discomfort, bloating and pain, and occasionally nausea and vomiting. In severe cases OHSS might be associated with feeling unwell and restless, difficulty in breathing and palpitation. If you have these symptoms you need to contact us for a review. Alternatively, you can contact your GP or go to the Accident & Emergency of your local NHS Hospital.

Although OHSS is unpleasant and potentially dangerous at the time, this condition is short lived and, fortunately, recovery occurs within a few days to two weeks.

If you develop symptoms of OHSS you should drink lots of fluid, start a high protein diet and avoid excessive physical activities. OHSS does not reduce your chance of conceiving or cause miscarriage

There are small risks of internal haemorrhage and infection associated with ultrasound guided transvaginal egg collection. We routinely administer an antibiotic to prevent any infection.

• Young mothers
• High number of retrieved eggs
• High percent of fertilization and number of resulting embryos
• Quality of the embryos
• The number of embryos transferred
• Quality of the surplus embryos and hence freezing
• The length and cause of infertility
• The outcome of previous treatment cycles
• Previous pregnancy or live birth

Assisted conception treatments carry a small risk of ectopic (outside the uterus) pregnancy; about 3% in IVF. This is due to the patient’s pre-existing pelvic condition.

Because we know exactly when we put the embryos back and when you got pregnant, we check early for an intrauterine vs. an ectopic pregnancy. We can avoid the dangers of the pregnancy rupturing and we can also deal with it with medication or down the laparoscope rather than through an open abdominal incision.