|
Possible Complications of Assisted Reproduction |
Possible Complications of Assisted Reproduction
On occasion the following following complications have been reported from assisted reproduction techniques: Multiple pregnancies, ovarian hyperstimulation syndrome, and hemorrhage or infection.
Multiple pregnancies:
This is the most frequent complication and can occur in any assisted reproduction procedure. The way to diminish this risk is to attempt to obtain no more than four follicles from the treatments that can be used for directed intercourse or artificial insemination, and to transfer the minimum number of embryos when we work with IVF or ICSI. However, this depends on certain variables such as the age of the patient, the quality of the embryos and the number of failed pregnancy attempts.
Ovarian hyperstimulation syndrome:
This is defined as the set of signs and symptoms that appear as a result of administered hormone medications in the ovarian stimulation stage, previous to egg harvesting. Ovarian hyperstimulation is classified as slight, moderate and severe. A slight hyperstimulation of the ovaries only occurs in 10-20% of the cases, that presents only a small increase in the size of the ovaries and light pelvic pain, and can sometimes merit ambulatory medical treatment.
Severe ovarian hyperstimulation occurs in only 1-2% of patients, in which the ovaries could enlarge even more, and are associated with pelvic pain, retention of liquid, dehydration, electrolytic disruptions, and torsion or rupture of one or both ovaries. Such symptoms would require hospitalization for medical treatment.
Generally, ovarian hyperstimulation syndrome is avoided by a set of preventive measures:
We apply gentler ovarian stimulations to achieve ovulation induction, as well as ultrasound and hormonal monitoring of the ovulation process. In rare occasions, even after taking the greatest precautionary measures, ovarian hyperstimulation syndrome can still occur. The key for the control of ovarian hyperstimulation syndrome is the identification factors to which the woman may be predisposed, detection of the syndrome in its early phases, and rapid medical intervention to correct the problem. In 11 years of operation, Reprotec Fertility Center has done a magnificent job of managing these precautions, and we have never had a case of ovarian hyperstimulation.
Even though the origin of ovarian hyperstimulation syndrome is not well known, it is recognized as a 'self-limited disease'. As such, in cases where the patient does not become pregnant, the problem is generally resolved within 10 days, but if pregnancy occurs it can last up-to four to six weeks.
Hemorrhage or infection:
The aspiration of ova under ultrasound control is a minor surgical procedure, that it is performed in our fertility center. Great attention is given to the location of the ovaries as well as neighboring structures like intestines and blood vessels. Additionally, the procedure is carried out without the use of general anesthesia, to minimize the risk to the patient with minimal discomfort and for ease-of-experience for our patients.
Other long-term effects that have been widely studied are the potential that drugs used in the stimulation of the ovaries may cause a predisposition to the formation of malignant tumors of the ovaries or the early onset of menopause. These potential consequences have been refuted by European and American fertility associations. Today we can say that these drugs are actually safe, and that each should be used appropriately.
|
