Continuing my series on infertility treatment, allow me to explain the IUI and IVF risks and side effects without all the medical mumbo jumbo.
Though infertility treatments such as IUI and IVF increase one’s chances of getting pregnant, there are also a number of risks.
Don’t miss my other informational posts on Infertility and IVF:
IUI and IVF Risks and Side Effects
I am not a doctor, I am simply telling my story and the information that has been shared with me regarding IUI and IVF risks and my own personal risks. Please consult your doctor, advocate for your own health, and decide for yourself!
Let’s face it: the women that are coming into infertility clinics to see help getting pregnant are doing so because they want it. They want to get pregnant badly enough to put themselves at a certain amount of risk to do so.
If they are younger women, such as myself, they are likely very upset about the fact that they are unable to get pregnant when a) many of their friends are getting pregnant and b) they are supposedly at the ripest time of their fertility. When you are in your 20s, your uterus, ovaries, your “equipment” is in mint condition and ready to go, right??? Well, it might not be. And that can carry a helluva lot of guilt. Also, they might not have finances in place yet for the procedures, or at the very least be worried about paying for the procedures.
If the woman is older, they are thinking about their biological clock and the tick-tick-tick and the fact that they have older equipment and that this might be their last chance and what if this time doesn’t work, will they have a next time? And even though the older woman might have finances in order (or she might not!), there is still considerable cost to accommodate. A final factor? The older woman might be turning to IVF because she does not have a partner, but she wants to get pregnant and have a family. Going through this process without the support of a partner (which can obviously happen in younger cases) can be incredibly stressful.
And then there is the process itself. I have been giving myself shots for years, and even I was intimidated at first by the number of shots that I would have to give myself! Luckily, I discovered fairly quickly that it all wasn’t so horrible after all, but if you don’t like needles… well, it is going to be a very long, very stressful process. Plus, remember my meltdown?
Ovarian Hyperstimulation Syndrome (OHSS)
One of the biggest of the IUI and IVF risks is Ovarian Hyperstimulation Syndrome, of OHSS. OHSS is due to the use of injectible infertility drugs (such as Follistim, Gonal F, etc) to induce ovulation. In so doing, these drugs basically send your system into overdrive, and symptoms that mimic severe PMS can occur: nausea, vomiting, and fluid retention and bloating. In the more severe cases, the fluid might need to be drained from your abdomen, and in the most severe cases, proceeding with the embryo transfer after such bloating, etc, can put both mother and baby at rest.
Per my doctors, the severe fluid retention occurs due to the ovulation and not the transfer and pregnancy aspect, so what they would do is hospitalize you to drain the fluid, carry out the egg retrieval, create embryos, and then wait until your system has normalized before proceeding with the embryo transfer and pregnancy. But having OHSS does not mean that you will have a problematic pregnancy, as progesterone, a totally different hormone than those used to induce ovulation, is the support drug for pregnancy.
You may have heard of testicular torsion, and well, congratulations, something strikingly similar can happen to women. Particularly when your ovaries are like microwave popcorn bags a few minutes into cooking. Ovarian Torsion is, simply put, when your ovaries flip over (that is the vast oversimplification of it). It is extremely painful and must be reversed surgically.
What causes ovarian torsion? Too much jingle jangling and/or contorting of the body. The risk for ovarian torsion is the main reason that the doctors order you to abstain from sex and exercise after about 5 days of stimulation injections (as discussed in part 1 of the IVF Protocol). Sex Sent Me to the ER, anyone? But without the random foreign objects (at least, I hope!).
Dehydration is another side effect of the stimulation treatments that patients need to be aware of and vigilant about, and it is yet another reason that the doctors et al don’t want you working out. I was basically told not to sweat (which, luckily enough for me, isn’t really a problem!) and to drink 8 12 oz glasses of fluids daily (um… not going to be a problem. I don’t remember the last time that I didn’t drink at least that much liquid.
PMS -like Symptoms
Basically, you are having the largest PMS of your life (think about it…), so whatever your PMS symptoms might be (bloating, cramps, sore boobs, breakouts, irritability, mood swings, absentmindedness), you can pretty much expect to experience them in FULL glory during these treatments. If you don’t generally have PMS, you might just discover what it is like for the rest of womankind, lol.
One of the biggest IUI and IVF risks in my case is the chance of multiple births, or “multiples.” We are worried that my body simply won’t be able to handle taking care of multiple babies. IUI carries with it a rather high chance of multiples because you are inducing ovulation and then injecting the sperm in to fertilize the eggs at will–sort of a “free for all” situation. With IVF, the doctors control how many eggs are fertilized and how many fertilized eggs are implanted in the uterus. The number of fertilized embryos that are placed in the uterus is determined by you and your doctor based on your age, your personal risk, and the number of days of incubation of the embryos before transfer.
In my case, we will be implanting one, and thus my risk for multiples is basically up to whether or not the cells divide and I have identical twins.
Egg Retrieval Complications
Any procedure carries with it some risk of complications, even swallowing a pill (you can choke on it). There is a risk of infection when retrieving the eggs because you are going through the vagina and uterus, which are not sterile channels. There are a few other risks, such as damage to the surrounding internal organs, but if you have a doctor worth his salt, these should be minimal. Lastly, there are risks with anesthesia, but my doctors use Twilight Sleep anesthesia, which is the same as for a colonoscopy. (but without the prep, YAY)
A final major IUI and IVF risk is the chance for ectopic pregnancy, where the fertilized egg implants outside the uterus and thus cannot develop and survive. This type of pregnancy will not be continued. Of course, ectopic pregnancies can also happen when making babies the old fashioned way!
There are some studies out there that suggest that IVF can lead to an increase in birth defects, low birth weight, and high risk pregnancies, but I (and the majority of what I have read) surmise that those results might actually be more a result of the age of the mothers and the predisposition of the mothers to have high risk pregnancies. Of course, this is my uneducated opinion, and the research is still very tenuous.
Sources: Mayo Clinic and Northwestern Reproductive Endocrinology and Infertility Consent and Information Packet.This post really helped me understand the risks + side effects of #IVF! #infertility Click To Tweet
Obviously, each case is unique to some extent, and we all have to remember that this is life: even if you do everything “perfectly,” you might end up with every issue possible. Likewise, you might have all the major risk factors and none of the problems.
My IVF Risks
For me, IVF is a risk mostly due to the unknowns and the chance for a problematic pregnancy: how will my body react to the hormones? Will my body accept the embryo when it is transferred? Can and will my body continue to support the pregnancy? What effect will all of these hormones, stress, and changes in lifestyles and medications have on my Crohn’s Disease?
Ultimately, we knew that a) I wasn’t going to be able to get pregnant without major help due to my hormonal history, and b) that IVF was the safest way for me to go about getting pregnant after Clomid didn’t work (which we assumed would be the case). We took IUI off the table and are only going to implant one embryo at a time due to the risk of multiples.
Before trying to get pregnant, we made sure that my body could maintain itself Crohn’s Disease-wise on just the Remicade alone for several months before we took me off of birth control and started trying. I did have a flare this summer, but that was due to stress rather than the Crohn’s itself, and thus I have entered psychotherapy and we have been looking at adjusting my medication to help prevent future problems. I have been working hard at gaining weight and being as healthy as possible, and I think that we are in the best position possible right now to try to get pregnant!
If you went through IVF or pregnancy, what was the most obnoxious side effect you dealt with?