Success after IF

XP: Q about IVF & placental abruption risk - induce early?

Hi SAIF! I hope to be joining you here in a few short weeks. :) I have a question that I wanted to XP since some of you may know more about it than my fellow PAIFers.

My doctor said to me at our u/s yesterday to get ready to talk about labor and delivery at my cervix check next week. He also mentioned that IVF pregnancies have a higher chance of placental abruption, which can lead to stillbirth without any warning, and that it may be a good idea to consider inducing ~1wk prior to my EDD to minimize this risk.

Does anyone know anything about this? I felt a little bit blindsided by this info since I hadn't heard about it before. I was hoping to avoid inducement, but I really trust my doctor, too. I'm working on doing some independent research on this but thought I'd come here to find out if any of you have heard of this. Thanks, ladies!
*** Trigger Warnings ***

TTC #1 since March 2011
Dx = Unexplained IF
1 medicated TI cycle & 4 clomid IUIs = all BFNs
June 2013 IVF #1 = 6 frosties + BFP!
DS1 born 2/14

TTC #2 since December 2014
May 2015 unassisted BFP ended in m/c at 7wks
April 2016 FET #1 = BFN
June 2016 FET #2 = c/p
August 2016 FET #3 = BFP!
DS2 born 4/17

Re: XP: Q about IVF & placental abruption risk - induce early?

  • So I didn't deal with this since I was at a birthing center and J came at 38w. However, my IRL IVF buddy fended off her OB practice until 42w. Her son is fine. I think this might be due to many IVF mom having risk factors associated with placental abruption (35+ is a big one).

    Every time they tried to take the baby, she would ask what risk factors she was exhibiting that worried them. When they couldn't give her one she said they would discuss at her next appointment. 

    Research and get informed. I think many OBs would rather ere in the side of caution, especially with IVF patients. 
    TTC Since 3/2010
    Me-36, Unexplained Infertility, DH-35, all clear
    Clomid 50mg 12/2011 = BFN
    Clomid 100mg 1/2012 = BFN, with Cyst
    IVF #1 Lupron/Menopur/Gonal-f/HCG Trigger
    ER 4/19/12 = 11 retrieved, 6 fertilized,
    ET 4/22/12 = 2 transfered (day 3), remaining 3 weren't good enough to freeze
    Beta 5/3 = BFP, 87 Beta #2 5/7 560.9 Beta #3 5/9 1376.5 First u/s One Baby, 125bpm!
    Second u/s, 176bmp! Kicked over to the OB by the RE at 8w. Team Green!! 
    Baby girl J arrived two weeks early! Born into water, med-free. Hooray for Team Pink!

    TTC #2 - back to the RE, treatment started 12/2014. 

    image
  • How old are you?  I've only had one pregnancy from and IVF and my doctor never discussed this being a possible concern, however, he had other concerns and we both knew I'd never make it past 38 weeks so even if it was a concern of his it may not have come up for that reason.

    If I were age 40 or over, IVF or not, I would not let myself go past my due date.  I know many, many women do and it all works out but just for me, I wouldn't.

    Kelly, Mom to Christopher Shannon 9.27.06, Catherine Quinn 2.24.09, Trey Barton lost on 12.28.09, Therese Barton lost on 6.10.10, Joseph Sullivan 7.23.11, and our latest, Victoria Maren 11.15.12

    Secondary infertility success with IVF, then two losses, one at 14 weeks and one at 10 weeks, then success with IUI and then just pure, crazy luck.  Expecting our fifth in May as the result of a FET.

    This Cluttered Life

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  • This was not raised by my OB or MFM. I guess I'd ask a lot of questions. Inductions have risk factors, too, so I'd want to compare the risks of each approach, rates of incidence, if i had other risk factors, and severity of the risks before making a decision.
    Married 8/2008. IVF with PGD March 2013.
    3/22 ER: 25R, 20M, 15F. 9 genetically normal, and 3 survived to Day 5
    3/27 ET: transferred 1 embryo, beta 9dp5dt=163, 12dp5dt=639
    4/25 1st ultrasound at 7 weeks = identical twins with heartbeats?!!!
    PPROM at 31w, delivery at 32 weeks of two beautiful girls
    image
  • I had an IVF and a FET pregnancy and with the first my water broke at 40w1d and I needed pitocin to start labor and with my second I was induced at 40w4d because I couldn't stand being pregnant any longer. She was a really big baby and got stuck on the way out, so I'm glad I was induced.

    But anyway, IVF alone shouldn't make you high risk for anything and I would seriously side eye any OB who wants to induce early. If you are IVF plus other risk factors, then see an MFM for another opinion.
    IVF, acupuncture, meditation and a miracle. 

    image

     Our sweet Valentine's Day FET.

    image

  • Ditto @CarrieB. - I was induced for pre-e and know it was the right decision. I would push for more of an explanation if your OB wants to induce. Inductions are sometimes necessary, but pitocin is no joke! I wouldn't want it if it wasn't necessary. I've never heard of this.
    dx: MFI 0% morph & low count. Occasional Anovulatory cycles.

    TTC #1
    • IVF #1 4/21/12 - c/p
    • IVF#2 8/1/12 - BFP! DD arrived 4/10/2013.

    Baby Birthday Ticker Ticker

    TTC #2
    • FET #1 3/18/14 - BFP! DS arrived 11/19/2014.

    Baby Birthday Ticker Ticker
  • I think the other ladies have it covered. I would ask a lot of follow up questions before agreeing to a 39 wk induction due solely to IVF. It wasn't something my OB (who is also a licensed MFM) ever brought up and induction significantly increases the chances of needing a c-section. Good luck with your decision!
    DX: Severe MFI 
    IVF # 1 ~ Antagonist ~ ER 1/27/11~ ET 1/30/11 ~ + HPT 7dp3dt 
    DD born med-free on 10/24/11 
    Lilypie - (lZjk)
    IVF # 2 ~Antagonist ~ ER 6/5/13 ~ ET 6/10/13 ~ + HPT 4dp5dt 
    Lilypie - (OUlo)

  • I have never heard of that being the reason why it happened. I had a partial placenta abruption my last pregnancy at 31 weeks and went into labor. But it could of been due to high bp not being diagnosed etc. And I just did stims with IUI. But a few weeks later had full blow pre-e that was toxic by the time they realized. But with placenta abruptions when it happens you know. I was pouring blood everywhere. So I feel like maybe they are warning you without cause unless they somehow saw an issue with your placenta already? As far along as your are I wouldn't worry about it. Don't let them push you around for things that are not necessary.

    Married: 5/09 ~ TTC Since: 10/10 ~ PCOS ~ Progesterone from 10/10 - 2/11 ~ HSG on 3/18 - Clear ~ Started Metformin 1000mg & Clomid 50mg 2/11 ~ Metformin upped to 1500mg 4/6 ~ 6/7 Now going to SG and put on Clomid, Ovidrel, Gonal F, Prometrium, Estrace ~ IUI #1 7/2 = BFP!!!!!! March 6th our little man was born. 

    6/17/13 - Ovidrel, Follistim, Prometrium ~ IUI #1 7/2 = BFP! March 17th our St. Pattys day baby arrived

    10/29/17 - Started process for IVF, got pregnant & miscarried a 2nd time since summer. 2/22 started stims - Menopur, Gonal F, Cetrotide - retrieval 3/6 - , PIO, estrace 3xday - FET 4/18 = Beta 1: 616; Beta 2: 1342 = BFP 

  • Thanks, everyone! I will definitely do some further research and ask a lot of follow up questions. It's just something he mentioned to consider at the end of my appointment, and he did mention that it had actually happened to a couple of his patients during his career. He also said he would not induce if he wasn't certain that a vaginal birth was the likely outcome. I'm really hoping to avoid induction, so hopefully I can get some answers at my next appointment to help me make a good decision.

    Thanks again, and I hope to be here with you all soon! :)
    *** Trigger Warnings ***

    TTC #1 since March 2011
    Dx = Unexplained IF
    1 medicated TI cycle & 4 clomid IUIs = all BFNs
    June 2013 IVF #1 = 6 frosties + BFP!
    DS1 born 2/14

    TTC #2 since December 2014
    May 2015 unassisted BFP ended in m/c at 7wks
    April 2016 FET #1 = BFN
    June 2016 FET #2 = c/p
    August 2016 FET #3 = BFP!
    DS2 born 4/17
  • I have one daughter from IVF and I was induced at 39 weeks and 1 day.  But, my induction was because I was on Lovenox for blood clotting issues and not because I was pregnant from IVF.  When you are on blood thinners, they prefer to induce you so that they can time when to stop the blood thinners. 

    imageimage


    ~SAIF/PAIF/Everyone Welcome~ 

    Me= 37 and DH = 41 

    Dx: DOR, Endo, APA+ (really high beta 2 glycoprotein antibody and high everything else tested), heterozygous MTHFR mutation, positive for lupus anticoagulant, high FSH, low AMH and both tubes blocked (per HSG on 3/8/11)

    IVF #1 - long lupron (with HGH, intralipids, lovenox and BA); 4 retrieved, 3 fertilized; ET 2 blasts and 1 frozen = BFN

    IVF #2 - a version of antagonist with EPP (with HGH, intralipids, lovenox and BA); 6 retrieved, 4 mature, 3 fertilized, 2 blasts and 1 frozen blast transferred on day 5 = BFN.

    IVF #3 April was postponed to May, May was canceled. June/July was canceled. Had a cyst aspiration and then began IVF #3 in August. ER on 8/22; ET on 8/24 with AH. +HPT on 9/5. Beta #1 (11dpo) = 3; Beta #2 (15dpo) = 29; Beta #3 (17dpo) = 60; Beta #4 (19 dpo) = 118. Heartbeat at 6 weeks 6 days =132.  Lil is here!

    TTC#2:  Trigger + TI = BFN; Clomid + Trigger + IUI = BFN.

    IVF #4:  BCP + MDLF + Lovenox = 7R, 1F = Transferred 1 6-cell embryo on day 3 = BFN

    IVF #5:  MDLF + Lovenox = 4R, 1F = Transferred 1 10-cell compacting embryo on day 3 = BFN

    IVF #6:  (New RE):  Long Antagonist November 2014 (transferred two 8 cell grade 1 embryos and froze one blast) = BFN

    FET#1:  BFN

  • Here is my personal experience. I went to almost 42 weeks with H and had to be induced becuase he wasn't budging ad my midwifecould no longer care for me (and I was 35 at the time). I went natural with pitocin (BAD idea) and had an acute placental abruption at 7cm. It was the most terrifying thing I have ever experienced, but my child is alive, and that is all that matters. I don't know if it was related to the IVF, if the pitocin caused it, the fact that he was in there so long and the placenta was getting old, that I am 35, or if it was just a fluke. My abruption happened during labor so it isn't the same thing as what your dr is talking about but I read a ton about this after it happened and I would be ery wary of induction. The guy who ended up being my dr (midwife couldn't help at that point) believes that it was the pitocin. The contractions are so intense, the placenta has been known to detach from the sheer force of them. Good thing is that you would be monitored, as well as your baby (with a probe). And ditto what PP said, when you abrupt, you know. I was hemmoraging blood so bad even my mom knew what was happening.

    This is one of those damned if you do, damned if you don't things becuase you will nervous either way now that he put it in your head, but from my own research, I don't think there is enoguh evidence to support IVF being the culprit, but there is a ton of support for pitocin being a culprit. I would not induce at 39 weeks for this reason. Just my opinion!

    Good luck!!

    Me: 37 DH: 40 TTC since 9/09
    #1 BFP 1/10/11; missed m/c discovered 7w5d
    IF Dx: Endo, hetero MTHFR mutation, poor morphology
    #1 IUI: 1/18/12 = BFN
    #1 IVF/ICSI 4/2/12 = 2 x 7-cell and 1 x 5-cell transferred (3dt) = BFP!!
    H was born at 41w2d on 12/29/12 - be still my heart!
    #2 IVF/ICSI 1/19/14 = 2 x 8 cells transferred (3dt) = BFP!! EDD 10/09/14
    M&W born at 37 weeks on 9/18/14 - I am the momma of 3 boys!!!

      Image and video hosting by TinyPicImage and video hosting by TinyPicImage and video hosting by TinyPic
  • Here is my personal experience. I went to almost 42 weeks with H and had to be induced becuase he wasn't budging ad my midwifecould no longer care for me (and I was 35 at the time). I went natural with pitocin (BAD idea) and had an acute placental abruption at 7cm. It was the most terrifying thing I have ever experienced, but my child is alive, and that is all that matters. I don't know if it was related to the IVF, if the pitocin caused it, the fact that he was in there so long and the placenta was getting old, that I am 35, or if it was just a fluke. My abruption happened during labor so it isn't the same thing as what your dr is talking about but I read a ton about this after it happened and I would be ery wary of induction. The guy who ended up being my dr (midwife couldn't help at that point) believes that it was the pitocin. The contractions are so intense, the placenta has been known to detach from the sheer force of them. Good thing is that you would be monitored, as well as your baby (with a probe). And ditto what PP said, when you abrupt, you know. I was hemmoraging blood so bad even my mom knew what was happening.

    This is one of those damned if you do, damned if you don't things becuase you will nervous either way now that he put it in your head, but from my own research, I don't think there is enoguh evidence to support IVF being the culprit, but there is a ton of support for pitocin being a culprit. I would not induce at 39 weeks for this reason. Just my opinion!

    Good luck!!

    This was super helpful info. Thank you for sharing your story, and I'm glad that you and your LO are okay!
    *** Trigger Warnings ***

    TTC #1 since March 2011
    Dx = Unexplained IF
    1 medicated TI cycle & 4 clomid IUIs = all BFNs
    June 2013 IVF #1 = 6 frosties + BFP!
    DS1 born 2/14

    TTC #2 since December 2014
    May 2015 unassisted BFP ended in m/c at 7wks
    April 2016 FET #1 = BFN
    June 2016 FET #2 = c/p
    August 2016 FET #3 = BFP!
    DS2 born 4/17
  • OP- I just also wanted to add that you may want to Google Bishop's score for more info on inductions. You want to have a good score before doing an induction or it's more likely to fail and you end up w a Csection.

    With my induction at 40w4d, my score showed that I was favorable to induction and my OB already knew that I responded well to pitocin so it was easy to go ahead with it and I was really sick of being pregnant.

    Good luck!
    IVF, acupuncture, meditation and a miracle. 

    image

     Our sweet Valentine's Day FET.

    image

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