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Journalism of Courage
When actor Preity Zinta said that she gave up her IVF (in-vitro fertilisation) — an assisted reproductive process that involves removing eggs, fertilising them outside the body and implanting them back in the uterus — cycle midway, she voiced challenges that many women go through, compelling them to give up.
IVF is a complex process that may come with some potential complications. “While many women undergo IVF successfully, it’s important to be both aware of and prepare for the risks. It is important to know of ways to get around them and work with your specialist at every step,” says Dr Pooja Jain, gynaecologist and fertility specialist at Apollo Fertility.
Why do women give up IVF midway?
The IVF process comes with the emotional burden of high expectations, uncertainty and the possibility of failure taking a significant toll on mental health. In most cases, couples are well informed about the success rates depending upon the individual case. This stress, coupled with the financial strain of IVF, low ovarian reserve (capacity of the ovary to produce egg cells) and recurrent implantation failures because of low egg, sperm or embryo quality and problems of receptivity in the uterus wall may lead to multiple cycles of IVF, which affect women mentally.
Generally, IVF is not painful, but some patients may experience mild to moderate discomfort (varies from person to person) with the hormone injections to be taken on a daily basis. This can be challenging to endure for some working women. Egg retrieval is a minor surgical procedure where pain is minimal during the procedure due to anaesthesia and mild to moderate cramping afterward. Embryo transfer is usually quick and painless.
Relationship issues, lack of support from partner or family members, feeling of guilt, self-blame and shame, especially after failed attempts, can further complicate the decision to continue.
What kind of complications to expect and how to work around them?
Though rare, there are cases of Ovarian Hyperstimulation Syndrome (OHSS) when the ovaries overreact to the hormone injections used to stimulate egg production. It causes swollen, painful ovaries, leading to symptoms like abdominal swelling, pain, and, in severe cases, fluid accumulation in the abdomen and chest, forcing the women to terminate. Mild OHSS is seen in 10-20 per cent of cases and severe OHSS in <1 per cent. With proper simulation protocols and frozen embryo transfer, this can be reduced to zero.
IVF may increase the likelihood of carrying twins or higher-order multiples, which are linked to a higher risk of preterm birth and other morbidities. But this complication can be reduced with the use of single embryo transfer (SET).
Egg retrieval process is generally safe but may pose <1% risk of vaginal bleeding, infection, or damage to surrounding organs.
Most IVF clinics offer counselling or psychological support services to help couples cope, one must take them.
How to deal with complications?
Counselling and support groups help process the emotional highs and lows. Mind body practices like yoga and meditation, diet and exercise help. Set realistic expectations and take breaks between cycles. Evaluate and adjust treatment plan after a failed cycle, review the results with your fertility specialist. Consider alternative options if repeated IVF cycles are unsuccessful, like donor eggs or donor sperm. Choose the right clinic.
