Risks of fertility treatment
Fertility treatments are generally very safe – most women are no more likely to experience problems with their health or pregnancy than women who have conceived naturally. However, there are some risks to be aware of, which range from mild discomfort to more serious conditions. Understand all the risks and what you need to look out for to have a safe and healthy pregnancy.
How safe is fertility treatment?
Fertility treatment is generally very safe. Most people experience no problems with their health or pregnancy. There are some risks to be aware of in relation to fertility treatment and pregnancy following fertility treatment:
Risks of fertility treatment:
- ovarian hyperstimulation syndrome (OHSS, a severe reaction to fertility drugs).
- infection, bleeding, and bowel perforation following IVF or IUI procedures (rare).
Risks during pregnancy following fertility treatment:
- having a multiple pregnancy or birth (twins, triplets or more)
- having an ectopic pregnancy
- a slightly increased risk of pre-eclampsia, gestational diabetes (diabetes occurring only during pregnancy), and high blood pressure (hypertension) compared to natural conception (these complications are rare, and research is still ongoing).
- some studies also found a slightly increased risk of post-partum haemorrhage (PPH) in patients who conceived following fertility treatment.
- some research has suggested that patients who undergo a programmed (medicated) cycle compared to a natural cycle frozen embryo transfer may be at increased risk of experiencing high blood pressure during pregnancy.
- possible birth defects (these are rare and research is still ongoing).
High blood pressure in pregnancy can be serious. You can find out more about high blood pressure (hypertension) and pregnancy on the NHS website.
It is important to remember that even when research suggests an increased risk of complications during pregnancy following fertility treatment, the overall risk to you individually remains low.
Your fertility clinic will give you information about the risks before your treatment. If you have any questions or concerns, please ask your clinic before you start treatment.
Why does pre-conception health matter?
Complications during pregnancy can sometimes be linked to the health of the patient before getting pregnant, known as pre-conception health. For example, those with pre-existing cardiovascular risk factor conditions, such as obesity, high blood pressure (hypertension), or diabetes, are at higher risk of complications during pregnancy.
There also appears to be increased maternal mortality in black and minority ethnic (BME) populations. This can in part be explained by factors such as having specific diseases or pre-existing health conditions, as well as health inequalities experienced by black and minority ethnic women.
Anyone wishing or trying to conceive, whether planning to undertake fertility treatment or not, should follow NHS health advice. This advice includes not smoking, not drinking alcohol, taking folic acid, maintaining a healthy weight, eating a healthy diet and being up to date on certain immunisations.
If you have any long-term conditions, such as high blood pressure (hypertension), epilepsy or diabetes, or if you have any other health concerns or questions, it is advisable to speak to a doctor before you start trying to conceive.
Further information on pre-conception health can be found here on the NHS website.
Risks associated with using donated eggs, sperm, or embryos, or having reciprocal IVF
Patients having fertility treatment using donated eggs or embryos have a slightly higher risk of complications during pregnancy, including pre-eclampsia and high blood pressure (hypertension), than those using their own eggs. These risks also apply to couples having reciprocal IVF, where the partner’s egg is used. There is no difference in the risk of pre-eclampsia during pregnancy for women who use donated sperm compared to those who use their partner’s sperm.
Risks associated with surrogacy
Research into complications during pregnancy for gestational surrogates (which is carrying a baby for someone else while using an egg from the intended parent or a donor), compared to non-surrogate pregnancies shows conflicting results.
Some studies have found that women acting as gestational surrogates may have higher risks of complications during pregnancy. These studies have found that surrogate pregnancies using an egg and sperm from the intended parents or donors can have a slightly increased risk of high blood pressure (hypertension), gestational diabetes (diabetes occurring only during pregnancy), pre-eclampsia, and post-partum haemorrhage.
However, there are also studies showing no significant difference in complications during pregnancy for gestational surrogates compared to non-surrogate pregnancies.
Your fertility clinic will provide you with information about the risks in advance of your treatment. If you have any questions or concerns, please raise them with a clinician at your fertility clinic before you start treatment.
What do I need to know about multiple births?
Multiple births (twin, triplet or more babies) can seriously harm the health of both mum and babies. At least half of twins are born premature and underweight, which can lead to serious (in some cases, long-term) health problems and even death. You’re also far more likely to have an early or late miscarriage if you’re carrying multiple babies.
Mums of multiples are also more likely to suffer from health problems such as high blood pressure, gestational diabetes, anaemia and haemorrhage than mothers of single babies. That’s why we say a single, healthy baby is always best.
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What can I do to reduce my chance of having a multiple birth?
Many women have what’s called an elective single embryo transfer (eSET). This means that only one embryo is transferred to your womb instead of two or three as has been common in the past.
This considerably reduces your chance of having a multiple birth and all the health problems that come with that. Any remaining embryos can be frozen for you to use in follow up treatment if you wish.
Find out more about embryo freezing
Having an eSET has no significant impact on success rates. However, it may not be suitable for everyone, particularly older women, so you should talk to your clinic to find out whether it’s right for you.
We’ve set clinics a target that less than 10% of their IVF births should be multiples. You can search for a clinic on our website here to see how they’re doing against that target.
What do I need to know about ovarian hyperstimulation syndrome?
Ovarian hyperstimulation syndrome (OHSS) is reaction to gonadotrophin fertility drugs taken to increase egg production. OHSS occurs in women who are very sensitive to the fertility medication resulting in too many eggs developing in the ovaries, which become very large and painful. Around a third of women will have mild OHSS, which can normally be effectively treated at home with pain relief.
Fewer women will develop moderate or severe OHSS but, in very rare cases, severe OHSS can be life-threatening so it’s very important you report any symptoms to your clinic.
Symptoms of OHSS include:
- swollen stomach and stomach pains (can be severe)
- nausea and vomiting
- shortness of breath
- faintness
- reduced urine output.
Patients who develop strong OHSS symptoms generally do so the week after egg collection.
If you experience any of these symptoms you should contact your clinic immediately. Never feel you are wasting the clinic’s time.
Find out more about OHSS on the Royal College of Obstetricians and Gynaecologists’ website
What do I need to know about ectopic pregnancies?
An ectopic pregnancy is when a baby develops outside of the womb, usually in the fallopian tube. Sadly, when this happens, it’s not possible to move the baby so the pregnancy will be lost.
In these cases it’s important to get medical help as quickly as possible, as ectopic pregnancies that are left for too long can cause rupturing in the fallopian tubes leading to internal bleeding.
All pregnant women are at risk of having an ectopic pregnancy but women having IVF may be more at risk. This is due to the possibility that whilst the embryo is being transferred to the womb it could travel to the fallopian tube instead.
Symptoms of an ectopic pregnancy include:
- a one-sided low abdominal pain
- vaginal bleeding or dark brown or red vaginal discharge
- diarrhoea or pain when you go to the toilet.
If you experience any of these symptoms you should contact your clinic immediately. Never feel you are wasting the clinic’s time.
Find out more about ectopic pregnancies on The Ectopic Pregnancy Trust website
What do I need to know about birth defects?
Some research has suggested that fertility treatment may be associated with an increased chance of birth defects. It’s not yet clear whether the birth defects are a result of the fertility treatment itself or fertility problems in the parents.
The main thing to know is that birth defects in the general population are low. If fertility treatment is associated with an increased chance of birth defects, the risk is still very low.
Research in this area is ongoing and we will continue to review and update our information as more evidence becomes available.
Information from our partners
Ectopic pregnancy (Ectopic Pregnancy Trust)
Review date: 6 October 2027
