- Ovarian Hyperstimulation Syndrome (OHSS)
This is a complication of controlled ovarian stimulation arising in a very small proportion of women undergoing fertility treatment. It is due to the over-sensitivity of the ovaries to the fertility drugs in certain patients, such as those with polycystic ovary syndrome and those of younger age. Symptoms include lower abdominal pain, swelling of the abdomen due to enlarged ovaries, nausea, vomiting and dehydration. Thrombosis may occur in serious cases. OHSS normally occurs in the week after the egg collection or just after the embryo transfer. In most cases the condition can be managed conservatively and it is only very rarely that women developing the condition will require hospitalisation and intensive care treatment. Our team has extensive experience in the prevention and management of this condition. Those at increased risk are identified and specific measures, such as intravenous fluid infusion and freezing of all embryos for transfer in a later cycle, are implemented.
- Multiple Pregnancy
The incidence of multiple pregnancy among patients who conceive as a result of IVF, ICSI or GIFT is about 25% for twins and 5% for triplets. Difficulty in pregnancy, preterm labour and delivery is common in twin and triplet pregnancy, thereby increasing the chance of the babies suffering both short and long term complications. For these reasons, the transfer of three embryos is limited to women over forty years of age.
Approximately 20-25% of all assisted reproduction pregnancies will miscarry. This is slightly higher than for normally conceived pregnancies, largely due to the proportion of older women attempting assisted conception and possible complicating factors associated with some types of infertility. Light bleeding or spotting is not uncommon throughout pregnancy and is only a concern if it becomes heavy or is associated with abdominal pain. Ultrasound scans and blood tests may be required to determine the progress of the pregnancy.
- Ectopic Pregnancy
This is a pregnancy that implants outside the uterine cavity, most often in one of the fallopian tubes. The incidence of ectopic pregnancy following IVF is approximately 3% and is usually slightly higher (5%) in those who conceive after GIFT. It is a potentially serious condition that may be indicated by fluctuating hormone levels, bleeding and abdominal pain, but can be confirmed by ultrasound. The pregnancy cannot continue and therefore must be removed surgically.
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