Medical risks during in vitro fertilization (IVF) depend on the stage of treatment and the individual characteristics of a woman’s body.

Ovarian Hyperstimulation Syndrome (OHSS)
One of the most common risks during ovulation stimulation is ovarian hyperstimulation syndrome (OHSS). It occurs due to an excessive ovarian response to hormone therapy, leading to the development of a large number of follicles (more than 15) and a high level of estrogen in the blood. This can cause increased vascular permeability and fluid accumulation in the abdominal and pleural cavities.

• Mild OHSS occurs in about 30% of patients and usually resolves with limited physical activity and pain relief.
• Moderate OHSS includes abdominal fluid accumulation and gastrointestinal pain. Outpatient monitoring is usually sufficient, though recovery may take longer during pregnancy.
• Severe OHSS (1–2% of cases) requires hospitalization and is characterized by significant fluid and electrolyte imbalances, thrombosis, and breathing difficulties. Abdominal fluid aspiration may be necessary.

Thanks to new stimulation protocols, OHSS is no longer observed in our clinic.

Ovarian Enlargement and Torsion
After stimulation and puncture, ovaries remain enlarged (1.5–2 times) due to corpus luteum formation. Rarely, ovarian torsion may occur, requiring emergency laparoscopy. Intraperitoneal bleeding from cysts is also possible and may require surgery.

Risks After Embryo Transfer
 After embryo transfer, patients are advised to:

• avoid physical exertion;
• abstain from sexual activity during the first two months of pregnancy;
• monitor their health carefully.

Ovarian Puncture
Ovarian puncture is performed under anesthesia and carries risks similar to other minor surgeries:

• low risk of bleeding;
• infection;
• damage to nearby organs (bladder, intestines, blood vessels).

 Fewer than 0.1% of patients require surgical treatment for complications.

Pregnancy and Delivery After IVF
Special attention is needed in cases of multiple pregnancies. While twins may seem like a favorable outcome, they increase the risk of premature birth, neurological disorders (e.g., cerebral palsy), and the need for neonatal intensive care. Triplets or more significantly raise complication rates.
Some couples consider selective reduction to lower risks. This is performed under ultrasound guidance but carries a risk of losing all embryos (up to 10%).\

First Trimester Risks
 Bleeding in the first trimester may indicate a miscarriage threat or ectopic pregnancy. Such bleeding is more common after IVF, but does not always mean pregnancy loss. Self-discontinuation of prescribed medications is strictly prohibited.\

Genetic and Oncological Risks
 Modern studies do not confirm a link between ovulation stimulation and the development of ovarian or other cancers. The likelihood of congenital disorders in children born via IVF is no higher than with natural conception. However, with ICSI (intracytoplasmic sperm injection), there is a potential risk of passing on genetic abnormalities from the father, especially in severe cases of male infertility.

Emotional and Financial Aspects
 IVF can be highly stressful. Patients may experience:

• anxiety;
• depression;
• loneliness;
• disappointment in case of failure.

 Support from loved ones is crucial. Psychological help from specialists in reproductive medicine can also be beneficial.