Wessex Fertility - Consultation Booklet

Risks of Fertility Treatment

Risks of Fertility Treatment

WHAT RISKS ARE ASSOCIATED WITH THE EGG RECOVERY? a) Post-operative Pain

Fertility treatments, as with all medical treatments involving drugs and surgery, can carry some risks to you. These risks will be discussed with you by your consultant and you should consider them before you start your treatment. WHAT RISKS ARE ASSOCIATED WITH THE DRUG TREATMENT? A. Down Regulation/Suppression Medication e.g. Buserelin, Prostap, Synarel These medicines can cause mild side effects including hot flushes, mood changes, headaches and restlessness. The side effects are usually worse around the suppression blood test and improve once the ovaries respond to the stimulation medication. Very rarely a rash can be seen with this medication and you must contact the clinic if this occurs so the medication can be changed. These tablets can cause mild side effects with mood changes and hot flushes being the most common. NOTE: If any visual disturbance is experienced the medication should be stopped immediately and the clinic informed. b) Gonadotrophin injections It is rare to experience side effects from the ovarian stimulation medication but occasionally a mild skin reaction around the injection site is seen. More commonly abdominal discomfort will be felt as the ovaries are stretched by the developing follicles. c) Antagonist injections These rarely cause side effects. The most common problem is a skin reaction around the injection site that can last for a couple of hours. d) Luteal support medication e.g. utrogestan, cyclogest pessaries, progesterone injections All of these medications contain progesterone which can make you feel emotional and can cause sore swollen breasts as the main side effects. i. Pessaries can sometimes cause a local soreness around the vulva and vagina. It may help to use a small amount of a barrier cream such as conotrane on the vulva if you do experience soreness. Alternatively the pessaries can be used rectally but as the absorption is reduced you will need to use one extra pessary a day at night time. ii. The injections are intramuscular and can cause pain at the injection site. e) Sedation medication given in theatre e.g. midazolam and pethidine These medications can cause nausea and vomiting. Anti-sickness drugs will be given in theatre but sometimes nausea can still occur. Being well hydrated at the time of the egg recovery can reduce this so you will be advised to have a large drink of water two hours before the procedure. You may feel tired and sleepy for a couple of days after egg recovery as a result of the medication. It is important you do not drive or operate machinery at this time. B. Stimulation Medication a) Anti-oestrogen tablets e.g. Clomid and letrozole

After egg recovery the ovaries can swell and stretch the ovarian capsule. This causes pain which can be severe on the night after egg collection. It is not harmful but can be distressing. You will be given some stronger pain killers to use for the first 24 hours to help with this pain. Sitting in a reclined position with pillows under your knees can take pressure off the ovaries and ease the discomfort. b) Vaginal Bleeding As a fine needle is passed through the back of the vaginal wall into the ovary to collect an egg occasionally there will be bleeding from the puncture site into the vagina. This usually settles within a few hours but if it is heavy and does not settle, you need to contact Wessex Fertility for advice. Extremely rarely there may be internal bleeding needing assessment in hospital. c) Bowel Disturbance It is common to experience some bowel disturbance after egg collection. Some women will have diarrhoea while others may be constipated. Bowel movements are often delayed for two to three days after the egg collection and this can make you feel bloated and uncomfortable. Usually the bowels will resume their normal activity without the need for medication but occasionally a mild medicine such as lactulose will be needed. Bowel spasm can be experienced which may be extremely uncomfortable and we would advise using painkillers such as paracetamol until the spasm passes. Extremely rarely a bowel perforation may occur especially if there has been previous extensive surgery in the pelvic region. If this was suspected hospital admission would be arranged. WHAT IS OVARIAN HYPERSTIMULATION SYNDROME (OHSS)? Ovarian hyperstimulation syndrome is a dangerous over-reaction to fertility drugs used to stimulate egg production. It is rarely seen with ovulation induction medication or in intrauterine insemination (IUI) cycles using very low gonadotrophin doses. In IVF treatment 5% of all cycles have this as a complication. It is more likely to occur in women with a high ovarian reserve who are young or have polycystic ovaries. OHSS can cause symptoms of abdominal swelling and pain with shortness of breath, feeling faint and reduced urine output. It usually occurs several days after egg collection when the ovarian cysts fill with fluid and the fluid collects in the abdomen. In severe cases the fluid also collects around the lungs. Hospital admission may then be needed to ensure adequate hydration and treat the symptoms of pain and nausea. If you have concerns that you may have ovarian hyper-stimulation, please contact Wessex Fertility. IS THERE A RISK OF AN ECTOPIC PREGNANCY? An ectopic pregnancy happens when an embryo implants outside the uterus most commonly in the fallopian tube. The chances of having an ectopic pregnancy are higher

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