Serious complications from IVF are rare. In general, complications can be divided into 4 categories: complications from retrieval, hyperstimulation, multiple pregnancies, and emotional stress.

As we have previously described, follicle retrieval is a relatively simple, straight forward procedure. Nevertheless, in some patients, the anatomy is such that it can be difficult to easily reach the ovaries. In these cases, there is always a slightly higher chance of damage to internal organs such as the bowel, bladder or blood vessels. Even in the simplest of cases, internal damage is possible – albeit very rare. Bleeding from the inadvertent puncture of a small blood vessel is probably the most common minor complication of retrievals. This usually results in annoying pelvic pain and cramps over the next few days, but rarely requires anything other than mild pain medications.

Ovarian hyperstimulation is a condition, which may result following the administration or injectable fertility medications, particularly at the higher doses used in IVF. This condition is characterized by fluid retention, with excess accumulations of fluid in the abdomen, pelvis and occasionally in the chest cavity. Mild or moderate hyperstimulation is quite common, occurring in perhaps 20% of patients. It last only a few days, and requires no treatment other than rest and analgesics. Severe hyperstimulation is a very rare complication, occurring in less than 1% of all IVF patients. It is characterized by more severe fluid retention and often necessitates hospitalization for control of the symptoms.

Carefully managed cycles will result in a lower incidence of hyperstimulation – one of the reasons for frequent monitoring visits. Hyperstimulation is more common in young patients, those with very high estradiol levels and in patients with polycystic ovarian syndrome.