Safety issues and Risks of IVF

Dr  Richa Sharma & Dr Samit Sekhar
As you all aware that there is a rising trend of infertility in view of the multiple factors which includes both natural and man made-Lifestyle changes one of major contributing factor.
IVF per se is a stressful treatment but the problem doesn’t end here for the couples. To start with couples often come with query of efficacy and safety issues related to the medicines which we use in the treatment. So far over a period of 35 years, millions of babies have been born with no added risks either to the mother or the baby.
Once the pregnancy happens then the blood levels are monitored and once they cross a titer then the early pregnancy scan is done- to see the location, number and viability of pregnancies.
Limitations and Risks Of IVF
There are some associated risks and limitations of IVF even though it is one of the most advanced and refined treatment option.
These are
* Limitation in the fixation of embryos to the womb of uterus(called Implantation failure)
* Multiple  pregnancies
* Ectopic pregnancy
Implantation Failure- When the pregnancy doesn’t happen in a couple inspite of transfer of good quality embryos multiple times.Even though science has progressed a lot such that we can create life but we cant make in 100% transformed into a live birth that’s why success rate even in the best situations is 45-50% per cycle if its with self gametes and its 50-60% per cycle in donor surrogacy cycles.These are the realistic figures .Success of a clinic depends on the Various parameters starting from clinical scenario of the couple to use of consumables to embryology labarotory parameters and not to forget the most important factor being the skills and expertise of the team.So far there is no exact way to predict the results though some research is on a chemical which is found to be secreted by healthy embryos- may be that will be a breakthrough helping more of the childless couples.
Ectopic Pregnancy-
Early pregnancy complications are more common in women who conceive after infertility treatment. Most of these occur before 12 weeks of gestation and include miscarriage, vaginal bleeding, intrauterine haematoma, vanishing twin and ectopic pregnancy. The incidence of ectopic pregnancies (EP) following infertility treatment is much higher compared with that in spontaneous pregnancies. The occurrence of ectopic pregnancy is very distressing to an infertile couple, who has lots of hopes pinned on the treatment outcome, especially because of the cost incurred and the physical and mental trauma they have gone through during the treatment process. The association between infertility and ectopic pregnancy is complex, as it can be a consequence of infertility as well as a cause. The two principal risk factors for EP are genital tract infections or tubal surgeries.  Though several aetiologies are proposed, but patients with tubal factor infertility are at an increased risk of EP.  Earlier diagnoses of ectopic pregnancy helps to improve prognosis and optimize subsequent fertility. It is pivotal to evaluate the likelihood of subsequent occurrence of ectopic pregnancy and be too vigilant when treating. The correct choice of the treatment modality should be made to prevent the recurrence. The early prediction of pregnancy outcome therefore has great importance for both couple as well as clinician
Ovarian Hyperstimulation (OHSS)- This is one of the complication which can especially happen in case of Pcolycystic ovaries due to which there will be fluid accumulation which can vary in grade and in situation we may have to freeze all embryos and transfer at a later date.
Multiple pregnancies- In IVF there are 5- 25% chances of twins and 1-3% of triplets .Generally couples are permitted to carry maximum upto twins and if the number exceeds two then it can be reduced by a procedure called Fetal Reduction(ultrasound guided)
Riskof Cancer- As such so far studies shows that there is no increased risk of cancer of any organ of body in patients persuing  ART.
Birth Defects- No added risks to the babies born as per the studies so far.
(The authors are senior IVF Consultant Gurgaon Fertility Centre and Chief Embryologist and MS men’s Health Australia, Executive Director Gurgaon Fertility Centre)