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How safe is IVF for women?

Women considering in vitro fertilisation treatment for fertility problems need better information about the risks. This is especially true if they are older or have other health problems, concluded a report in the BMJ (British Medical Journal) that looked at the safety of pregnancy and childbirth after IVF.

What do we know already?

IVF is a safe procedure for most women. But it is not without risk. Some types of IVF involve taking high doses of hormones to stimulate the ovaries, which can lead to a rare, dangerous condition called ovarian hyperstimulation syndrome.

Also, IVF may indirectly increase the risks of pregnancy and childbirth by increasing the chances of a multiple pregnancy (if more than one embryo is implanted) or by increasing the numbers of older women getting pregnant. Older women and women with multiple pregnancies face greater risks of complications during pregnancy and childbirth.

Studies have shown that the numbers of women who die during pregnancy or childbirth after IVF, although still low, are higher than among women who get pregnant without IVF treatment. Deaths during pregnancy or childbirth, which had become very rare, are slowly increasing in the UK, which probably reflects the increased numbers of older women getting pregnant and the increased use of IVF.

What does the new study say?

The authors of the report looked at recent research into the safety and risks of IVF for women. They say that, although deaths are rare, they still occur in the UK. There were four deaths from ovarian hyperstimulation syndrome from 2003 to 2005, the latest years for which figures are available.

The researchers add that doctors should make sure they report ovarian hyperstimulation syndrome to get a better understanding of how common it is.They also say that women, particularly those with underlying health conditions, should receive more information about the risks of pregnancy before they start IVF treatment.

Looking at total numbers of women’s deaths during pregnancy and childbirth, the report’s authors highlight a recent study from the Netherlands.The study calculated that, compared with a national maternal death rate of 13 for every 100,000 pregnant women, the rate for maternal death after IVF was 43 for every 100,000 pregnant women.

How reliable are the findings?

The report's authors say that we need better information about the risks of pregnancy and childbirth after IVF. They suggest that information about complications or deaths during IVF pregnancy and childbirth should be collected centrally so doctors and women have a better idea of the risks.

Where does the study come from?

The report was written by three obstetricians working for London hospitals, and published in the BMJ (British Medical Journal) which is owned by the British Medical Association.

What does this mean for me?

If you are considering IVF treatment, there are many things to take into account, such as the chances of success, whether you have to pay for treatment, and what the effect may be on the rest of your life. This report is a reminder that IVF is not a risk-free procedure.

What should I do now?

If you are planning IVF treatment, speak to your doctors about the risks of pregnancy and childbirth to you as an individual. Ask about how these risks can be minimised; for example, by having one embryo implanted rather than two or more.Your doctors will also want you to be as healthy as possible before you start treatment.You can ask about how to do this.

From:

Bewley S, Foo L, Braude P. Adverse outcomes from IVF. BMJ. 2011; 342:d436. Available online at www.bmj.com/content/342/bmj.d436.full (last accessed 28 January 2011).

Jan 28, 2011