In-Vitro Fertilization (IVF) - Risks and Limitations
Published: 12/11/2015
In Vitro Fertilization (IVF), patients are informed of the following
procedures, risks, and limitations, and will have the opportunity to discuss
them with their physician:
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Fertility medications and ovulation-inducing drugs may result in
overstimulation of the ovary(s), which may cause pain, abdominal swelling,
or other discomforts.
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A vaginal ultrasound will monitor follicle development. This is considered
non-invasive and not associated with any known risk.
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Transvaginal egg retrieval is an outpatient procedure using IV anesthesia.
There is a very small risk of injury to surrounding organs or tissues. If
this occurs, the repair will be made at the time of injury and is usually a
small bleeder in the vaginal wall from the aspirating needle.
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Transferring the embryos into the uterus may cause slight discomfort,
cramping, spotting, or infection. There is a slight possibility of ectopic
pregnancy (less than 5%) with any attempt at pregnancy. This would require
treatment by MTX (methotrexate) or surgery to remove the
ectopic pregnancy.
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The transfer of multiple embryos may result in
multiple gestations.
The risks of prematurity and other complications have been explained.
Patients are advised that any of the following may occur to prevent pregnancy:
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The time of ovulation may be misjudged (is rare to non-existent with the use
of hCG trigger), may be unpredictable (again rare with the use of hCG
trigger), may occur prior to retrieval (only if retrieving on a natural
cycle), or may not occur in the monitored cycle (only if there is no
follicular response) precluding any attempt to obtain an egg(s).
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Pelvic adhesions may prevent access to the ovary(s) but fortunately is very
uncommon.
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Medical emergencies may make an operating room and/or anesthesia unavailable
(would have to be a natural disaster, but Arizona Center for Fertility
Studies has a backup power supply to adequately run the entire Assisted
Reproductive Technology (ART) and cryo labs).
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Withdrawing an egg may be unsuccessful (generally because there was no egg
in the follicle).
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The egg(s) may be of poor quality. This may or may not be visible or known
to the embryologist or physician at the time of recovery.
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The partner may be unable to obtain a semen specimen (if this is
anticipated, then Arizona Center for Fertility Studies will get a sperm
sample in advance and freeze it, or in extreme cases, schedule back-up
MESA/TESA.
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The sperm sample may be of poor quality (this is generally eliminated by
doing ICSI).
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Fertilization may not occur; performing ICSI (intracytoplasmic sperm
injection) does not guarantee fertilization (generally an egg quality
issue).
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Cleavage or cell division of the fertilized egg(s) may not occur (again,
generally an egg quality issue).
- The embryo(s) may not develop normally and would not be transferred.
- Implantation may not occur.
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A laboratory accident may result in loss or damage to the egg, sperm, or
embryo (very rare).
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Transfer of the embryo(s) may not be successful (by doing a mock transfer
first, this should never happen).
VIDEO OF TRANSVAGINAL ASPIRATION (TVA) OF FOLLICLES FOR OOCYTE (EGG)
RECOVERY.
A picture of our embryologist receiving follicular fluid through a window
attached to the adjacent operating room. The follicular fluid is at all
times kept in a heat block on a warming tray at 37 degrees Celsius until it
is checked for the egg. As the eggs are identified, they are
"cleaned" of surrounding tissue and blood and placed in a holding
dish on the warming stage of the microscope until all the eggs are
collected, then placed in the incubator to await later
ICSI.
A picture of the holding dish on the microscope warming plate after all the
oocytes (eggs) have been recovered and identified from the follicular fluid.
Each egg is surrounded by specialized cells called cumulus cells, making the
usually microscopic egg visible to the naked egg.
Jennifer and Scott
October 2009
"I recall the first phone conversation I had with Gina. She spent over
an hour explaining every detail of the transfer process to me. Every time I
called the office, no matter who answered, they have always been polite and
helpful. Scott and I were stunned at how much time Dr. Nemiro spent
consulting with us. He is so friendly and approachable. After everyone
adjusted schedules and plans for surgery, I witnessed Dr. Nemiro's
passion and love for what he does. Your entire staff is compassionate and
has a unique understanding of patients. Scott and I are thankful for each
and every one of you. You've made this such a positive, memorable
experience. We will plan a return visit in the future with the newest member
of the family. Until then, thanks so much, and we'll keep you
updated."