In the Netflix show Kohraa 2, actor Mona Singh’s character Dhanwant Kaur is seen excusing herself mid-conversation to deal with nausea as a result of a fertility treatment she has had while prepping for in-vitro fertilisation (IVF), an assisted reproductive procedure where a woman’s egg and a man’s sperm are fertilised to form an embryo in a laboratory dish. Many celebrities like Jennifer Aniston and Farah Khan have talked about gearing up for IVF as a painful and difficult experience that’s now being discussed in the public domain.
“It’s important to know that IVF is a safe procedure and modern technology means that the pain threshold has gone down substantially. What you need is a good clinic that has expertise to deal with the procedure with minimal discomfort,” says top fertility specialist, Dr Anjali Malpani, Emeritus Professor of Gynaecology and Obstetrics, KEM Hospital, Mumbai.
When do women experience symptoms like pain and nausea during IVF cycles?
Women have to take hormone-stimulating injections for 8–12 days before egg pick-up. These stimulate the ovaries to produce multiple mature eggs in a single cycle rather than the natural, single egg. Side effects include minor pinching, bruising at the injection site, bloating and mood swings. Previously, injections were intramuscular, especially those which used progesterone. Now progesterone is administered via vaginal suppositories during IVF to support the uterine lining for embryo implantation. These cause no pain. Vaginal absorption of progesterone is much better than through the intramuscular route.
Recombinant follicle stimulating hormone injections stimulate the production of eggs in women undergoing treatment for infertility. These are subcutaneous and come in pre-loaded, ready-to-use pen devices. They come with a fine needle, more like an insulin pen, causing minimal pain.
The removal of eggs through an aspirating needle entails a slight risk of bleeding, infection and damage to the bowel, bladder or a blood vessel. Some cramping happens after egg retrieval, which is a minor surgical procedure performed under sedation or light anaesthesia. The embryo transfer involves a catheter, usually causing little to no pain, though some experience light cramping.
What are complications during an IVF procedure?
Fertility drugs overstimulate the ovaries, causing them to swell, resulting in significant abdominal pain, bloating and nausea. Severe cases can cause vomiting, diarrhoea, and shortness of breath. This is called hyperstimulation, when more than 20 eggs are produced. Rapidly growing follicles (sometimes 10–20+ per ovary) cause the ovaries to expand, causing physical discomfort and pressure.
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After ovulation, a huge amount of estrogen-rich fluid is poured directly out of the enlarged and fragile ovaries into the abdominal cavity. This fluid pushes the lining of the abdominal cavity and makes it leaky. The ovaries balloon in size, your abdomen swells, you get lightheaded with relatively low blood pressure and you may get dizzy because of the decreased blood volume. Many women will have mild degrees of hyperstimulation syndrome with a little bit of lower abdominal swelling, discomfort, nausea and dizziness. This does not require hospitalization, just bed rest at home. It is only the rare, severe cases that require hospitalization to drain the fluid.
Done in a controlled manner and with close monitoring, there is no case of hyperstimulation. I do it personally at my clinic and there is none. After initial egg retrieval, we flush the follicles repeatedly with a double-lumen needle to dislodge any trapped eggs and clear any debris.
What’s the best way to manage discomfort, nausea and pain?
Specialists should follow the proper technique to minimise complications in the first place. Over-the-counter pain relievers can manage post-procedure cramping. There is medication to reduce the size of the ovaries, the number of eggs and unnecessary clotting. The woman has to drink at least three or four litres of water so that nothing accumulates in the cavity. Doctors can also salvage a complicated cycle by collecting all the eggs and freezing embryos. These can then be transferred in a future cycle.
Rinku Ghosh is the Health Section Lead at The Indian Express, where she oversees the publication’s comprehensive health, wellness, and medical science vertical. With years of experience in high-impact journalism, Rinku specializes in translating complex medical research into actionable insights for the public. Her reporting spans a wide spectrum—from deep-dives into childhood obesity and the effects of urban pollution to the frontiers of medical technology, such as the use of AI and nanobots in cancer treatment.
Authoritativeness: As a veteran editor at one of India’s most trusted news organizations, Rinku has interviewed world-renowned experts, including cardiologists from the Mayo Clinic, oncologists from AIIMS, and researchers from the Indian Institute of Science (IISc). Her column often serves as a primary source for "Explained" features, where she breaks down global health trends, vaccine safety, and public health policy. Her work is recognized for bridging the gap between clinical data and the lived experiences of patients.
Trustworthiness: Rinku’s editorial approach is rooted in the "Journalism of Courage" philosophy, prioritizing evidence-based science over healthcare myths. In an era of medical misinformation, she ensures that every piece of advice—whether regarding chronic disease management or nutritional supplements—is backed by peer-reviewed studies and verified by leading medical practitioners. ... Read More
