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In vitro fertilization (IVF)

• Overview
• Recovery
• Risks

Alternative Names:

IVF; Assisted reproductive technology; ART; Test-tube baby procedure

Risks:

IVF requires a significant physical, emotional, financial, and time commitment. Stress and depression are common among couples dealing with infertility. A woman taking fertility medicines may have bloating, abdominal pain , mood swings, headaches, and other side effects. Many IVF medicines must be given by injection, often several times a day. (The health care team will teach the couple how to properly mix the medicines and give a shot.) Repeated injections can cause bruising.

In rare cases, fertility drugs may cause ovarian hyperstimulation syndrome (OHSS). This condition causes a build up of fluid in the abdomen and chest. Symptoms include abdominal pain, bloating, rapid weight gain (10 pounds within 3-5 days), decreased urination despite drinking plenty of fluids, nausea, vomiting, and shortness of breath . Mild cases can be treated with bed rest. More severe cases require draining of the fluid with a needle.

Medical studies to date have concluded that fertility drugs in general are not linked to ovarian cancer.

Risks of egg retrieval include reactions to anesthesia, bleeding, infection, and damage to structures surrounding the ovaries, including the bowel and bladder.

There is a risk of multiple pregnancies when more than one embryo is placed into the womb. Carrying more than one baby at a time increases the risk of premature birth and low birth weight. (However, even a single baby born after IVF is at higher risk for prematurity and low birth weight.) It is unclear whether IVF increases the risk of birth defects.

IVF is very costly. Some, but not all, states have laws that say insurance companies must offer some type of coverage. But, many insurance plans do not cover infertility treatment. Fees for a single IVF cycle -- including costs for medicines, surgery, anesthesia, ultrasounds, blood tests, processing the eggs and sperm, embryo storage, and embryo transfer -- can quickly add up. The exact total of a single IVF cycle varies with each individual, but may cost more than $12,000 - $17,000.

References:

Stenchever A. Comprehensive Gynecology. 4th ed. St. Louis, Mo: Mosby; 2001:1204-1206.

Wilson EE. Assisted reproductive technologies and multiple gestations. Clin Perinatol. Jun 2005; 32(2): 315-28, v.

Min JK. Guidelines for the number of embryos to transfer following in vitro fertilization. J Obstet Gynaecol Can . Sept 2006; 28(9): 799-813.

The Practice Committee of the Society for Assisted Reproductive Technology and the Practice Committee of the American Society for Reproductive Medicine. Guidelines on number of embryos transferred. Fertil Steril . 2006 Nov;86 Suppl 5:S51-2.

Jackson RA, Gibson KA, Wu YW, et al. Perinatal Outcomes in Singletons following in vitro fertilization: a meta-analysis. Obstet Gynecol . 2004; 103: 551- 563

Society for Assisted Reproductive Technologists. Clinic Summary Report: All SART Member Clinics. 2005.

• Review Date: 1/31/2007
• Reviewed By: Bryan R. Hecht, MD, Department of Obstetrics and Gynecology, Cleveland Clinic, Canfield, OH. Review provided by VeriMed Healthcare Network.

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