Risks with IVF

ky29 · May 2014

My husband and I are trying to figure out how many more IUIs we are going to do before moving onto IVF. However, after having the IVF consult with the RE, he is not sure he wants to do IVF at all. I realize most people who are doing IVF have moved onto the IF board, but I know some are still here and maybe others can help.

What caught his attention was 1) the cost (but we have enough money saved up - just a lot to spend and once) and 2) the increased risk of birth defects. First let me say that he, well - we, are not shallow people and would love our child no matter what. It just makes him nervous being so unnatural.

From all the data we received from the RE, it looks like there is a slight increase with IVF babies. However, I wonder if that has to do with the age of the mother, just as any natural pregnancy? Again, I'm not trying to start a debate or sound shallow here. I'm just wondering what have you found if you've researched this? I'd like to have some other thoughts / facts to discuss with him on this topic vs just the numbers from my RE.

Or, what are your concerns about IVF? How did you get through them (if you've reached that point)?

MissEm15 · May 2014

I was just reading this part!! I just got our consent docs emailed to me... here is what mine said (it's long):

Reports on the risk of birth defects associated with ICSI (compared to those associated with conventional fertilization in IVF cycles) have yielded conflicting results. The most comprehensive study conducted thus far, based on data from five-year-old children, has suggested that ICSI is associated with an increased risk of certain major congenital anomalies. However, whether the association is due to the ICSI procedure itself, or to inherent sperm defects, could not be determined because the study did not distinguish between male factor conditions and other causes of infertility. Note that even if there is an increased risk of congenital malformations in children conceived with ICSI, the risk is relatively low (4.2% versus ~3% of those conceived naturally). The impact of ICSI on the intellectual and motor development of children conceived via ICSI also has been controversial. An early report suggested that development in such children lagged significantly behind that of children resulting from conventional IVF or those conceived naturally. However, more recent studies from larger groups, using standardized criteria for evaluation, have not detected any differences in the development or the abilities of children born after ICSI, conventional IVF, or natural conception. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

The prevalence of sex chromosome abnormalities in children conceived via ICSI is higher than observed in the general IVF population, but the absolute difference between the two groups is small (0.8% to 1.0% in ICSI offspring vs. 0.2% in the general IVF population). The reason for the increased prevalence of chromosomal anomalies observed in ICSI offspring is not clear. While it may result from the ICSI procedure itself, it might also reflect a direct paternal effect. Men with sperm problems (low count, poor motility, and/or abnormal shape) are more likely themselves to have genetic abnormalities and often produce sperm with abnormal chromosomes; the sex chromosomes (X and Y) in the sperm of men with abnormal semen parameters appear especially prone to abnormalities. If sperm with abnormal chromosomes produce pregnancies, these pregnancies will likely carry these same defects. The prevalence of translocations (a re-arrangement of chromosomes that increases the risk of abnormal chromosomes in egg or sperm and can cause miscarriage) of paternal origin and of de novo balanced translocations in ICSI offspring (0.36%) also appears higher than in the general population (0.07%).

The risk of birth defects in the normal population is 2-3 %. In IVF babies the birth defect rate may be 2.6-3.9%. The difference is seen predominately in singleton males. Studies to date have not been large enough to prove a link between IVF treatment and specific types of birth defects.

Pintobean39 · May 2014

To me that doesn't seem like a huge increase of risk of birth defects. Also not everyone does ICSI. We are doing ICSI and PGD to decrease any risk of chromosomal abnormalities. We don't have MFI we are only doing ICSI because sometimes with age the eggs may be harder and the sperm can't get in.

Lillovebug79 · May 2014

We decided to do IVF and will start cycling soon. Our decision was based primarily on that there is maybe a 1-2% increased risk of birth defects vs possibly never having a child at all. I can say that we are willing to take our chances with IVF. We did 8 IUIs while waiting for my husband to get on board with IVF/ICSI. His hesitation was mostly related to his ego and the cost (although we have the money in savings, he hates spending it). I wish we hadn't wasted so much money and time doing so many IUIs but DH had to be ready 100%.

My main concern with IVF is the discomfort of super ovulation and the risk with ER. These are small in the big picture but I'm nervous. My doctor does it in her office, no anesthesia, no iv sedation. But I will get through it because I am willing to do whatever I need to do.

Good luck with whatever you decide.

Pintobean39 · May 2014

@Lillovebug79‌ OMG no anesthesia or sedation???? That sounds scary. Are they going to give you something to at least calm your nerves?

Pintobean39 · May 2014

NariaDreaming said:

Pintobean39 said:

@Lillovebug79‌ OMG no anesthesia or sedation???? That sounds scary. Are they going to give you something to at least calm your nerves?

Oh my gosh, ditto to this! My RE is super conservative with sedation (fentanyl + versed) but I can't imagine having nothing at all!

See here is another question to add to my list. I never asked what they use to knock me out. It's still in the clinic so I'm sure it's not a complete knock me out. The paperwork just says anesthesia $750, but I never asked what drugs.

Lillovebug79 · May 2014

@NariaDreaming‌ and @Pintobean39‌ I will have oral meds for sedation, I think Valium and some sort of pain med. My RE said it's usually enough for most women to only feel mildly uncomfortable. She said "We have your husband hold your hand and tell you how brave and amazing you are" really?? I think I would rather have better drugs!!!! Lol But I also get sick under general anesthesia so I'm happy about not doing that (but if I wanted to I could for an extra $4,000). I just wouldn't mind a little IV conscious sedation!

MissEm15 · May 2014

Pintobean39 said:

Pintobean39 said:

@Lillovebug79‌ OMG no anesthesia or sedation???? That sounds scary. Are they going to give you something to at least calm your nerves?

Oh my gosh, ditto to this! My RE is super conservative with sedation (fentanyl + versed) but I can't imagine having nothing at all!
See here is another question to add to my list. I never asked what they use to knock me out. It's still in the clinic so I'm sure it's not a complete knock me out. The paperwork just says anesthesia $750, but I never asked what drugs.

I haven't asked what drugs yet either! I know I get valium, but I think I get anesthesia as well.. Good question!

MissEm15 · May 2014

@ky29 to go back to your question, my DH and yours sound like they share similar feelings. Mine is kind of bummed we are doing IVF bc he feels it's kind of against mother nature. I think its more the ICSI part he doesn't like. Like it's not an act of God anymore, it's all science. Right now we have insurance coverage which may end in a couple months. So that's why he feels better about the decision, to use our best chance while we still have it covered. However, he does think if we had the time to keep doing IUIs, that it would eventually work & I totally agree. Time is just not on our side. We'd rather do IUIs if we lose insurance. I feel bad bc I think he's not really ready yet but w/ the timing he has come to terms and we are moving forward.

katib77 · May 2014

We've determined that the risk is very small and one we're willing to take.

wishiwaspreggo · May 2014

Lillovebug79 said:

@NariaDreaming‌ and @Pintobean39‌ I will have oral meds for sedation, I think Valium and some sort of pain med. My RE said it's usually enough for most women to only feel mildly uncomfortable. She said "We have your husband hold your hand and tell you how brave and amazing you are" really?? I think I would rather have better drugs!!!! Lol But I also get sick under general anesthesia so I'm happy about not doing that (but if I wanted to I could for an extra $4,000). I just wouldn't mind a little IV conscious sedation!

If you're going to take an oral sedative I recommend Halcion. I use it for dental work. I am extremely frightened of dental work and I don't numb completely under Novocain. I had to have a cracked tooth replaced and they had to drill down into my jaw, put in a screw, and attach a new tooth. The whole procedure took 3 hours but it felt like I was only there for 20 minutes and I didn't have any fear. It was uncomfortable, sure, but I didn't care because of the medicine. It's pretty amazing stuff

KT416 · May 2014

We are moving to IVF with ICSI and IUI was not an option for us. I have read conflicting reports, so I'm sure there's still some unknowns, but from what I gather their is a higher number of birth defects but is not by much and is still under 1%.

I actually read a cute article a few weeks ago about a natural vs. ivf study sharing a bunch of differences. My takeaway from the article was that the birth defects were slightly higher but the parenting was better. I'm sure it's hard to measure effective parenting but I think it makes sense because we can appreciate our future children after all our efforts so much more

As soon as the RE told us our game plan my DH could have started IVF the next day. He was ready to go for it and I think I was more nervous and hesitant than him. Our insurance does cover about 80% of it, so that does make it easier.

Hopefully the HSG will do the trick and you won't have to worry about IVF! If not, hopefully your DH just needs some time to process everything.

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