Usually up to 3 embryos are transferred to the uterus in a given cycle, hoping that one or at most two will implant and develop. However, occasionally we “over-succeed” and find that a patient has a triplet pregnancy. The outcome of these pregnancies is not optimal, as premature delivery is the rule, with potential severe impact on the newborns prognosis. In these cases we offer a procedure in which we selectively reduce the number of fetuses to two. Multiple pregnancy can be completely avoided if only a single embryo is transferred. This is our recommended procedure for “good prognosis” patients (young, first timers, mechanical or male factor infertility).
Ovarian hyperstimulation syndrome
Fertility drugs override the natural process of egg development, for the purpose of obtaining as many eggs as possible. Occasionally, a patient may develop a large number of eggs, a process that can give rise to a clinical syndrome known as “Ovarian Hyperstimulation Syndrome” (OHSS). The syndrome is characterized by lower abdominal pain, ovarian cysts, and in its severe form, accumulation of fluid within the abdomen. Patients with previous history of OHSS are welcome for specific inquiries on details. Read more.
We have developed a sophisticated therapeutic approach that manipulates the hormonal milieu in a way that prevents this syndrome, even in patients who are at very high risk.
Increased risk of cancer?
About 1 -in- 10 women will develop cancer of the breast at some stage of their lives. About l-in-90 women who live to their 70s will develop cancer of the ovary. Since IVF has become a common procedure, it’s understandable that quite a number of cancers will develop among women once treated this way just through coincidence.
However, like pregnancy itself, stimulating the ovaries during IVF causes the ovarian hormones to reach high levels – and this may accelerate the development of a breast cancer (or an ovarian cancer) that is already present but which has not been detected. Before starting IVF – or before embarking on pregnancy generally – it is important to have a breast examination and gynecological check-up, including a PAP smear. We do not know if the long-term risk of breast cancer is increased after repeated IVF treatments. Studies are presently underway.
There is a strong presumption that repeated IVF cycles, especially if there’s been no pregnancy, are likely to increase the risk of cancer of the ovary in later life. There are two reasons for that: (1) some studies have implied the use of fertility drugs is associated with an increase in risk; and (2) we know that anything that stops ovulation and menstruation, such as having been on the pill for a number of years, or having been pregnant and having breast fed, is rather protective against later cancer of the ovary. Ovulating 10 eggs in one month on an IVF program may have the same effect as 10 months of normal ovulation in terms of risk.