In vitro fertilization (IVF): what are the risks?

Revised 2015


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IVF is a method of assisted reproduction in which a man’s sperm and a woman’s eggs are combined outside of the body in a laboratory dish. One or more fertilized eggs (embryos) may be transferred into the woman’s uterus, where they may implant in the uterine lining and develop. Serious complications from IVF medicines and procedures are rare. As with all medical treatments, however, there are some risks. This document discusses the most common risks.

What kind of side effects can occur with IVF medicines?

Usually, injectable fertility medications (gonadotropins) are used for an IVF cycle. These medicines help stimulate a number of follicles with eggs to grow in the ovaries. A more detailed discussion of fertility medications can be found in the ASRM booklet, Medications for inducing ovulation.

Possible side effects of injectable fertility medicines include:


  • Mild bruising and soreness at the injection site (using different sites for the injections can help)
  • Nausea and, occasionally, vomiting
  • Temporary allergic reactions, such as skin reddening and/or itching at the injection site
  • Breast tenderness and increased vaginal discharge
  • Mood swings and fatigue
  • Ovarian hyperstimulation syndrome (OHSS)

Most symptoms of OHSS (nausea, bloating, ovarian discomfort) are mild. They usually go away without treatment within a few days after the egg collection. In severe cases, OHSS can cause large amounts of fluid to build up in the abdomen (belly) and lungs. This can cause very enlarged ovaries, dehydration, trouble breathing, and severe abdominal pain. Very rarely (in less than 1% of women having egg retrieval for IVF), OHSS can lead to blood clots and kidney failure. For more information about OHSS, see the ASRM fact sheet Ovarian hyperstimulation syndrome (OHSS).

Earlier reports from several decades ago suggested a link between ovarian cancer and the use of fertility medicines. However, more recent and well done studies no longer show clear associations between ovarian cancer and the use of fertility medications.

What are the risks of the egg retrieval?

During the egg retrieval, your doctor uses vaginal ultrasound to guide the insertion of a long, thin needle through your vagina into the ovary and then into each follicle to retrieve eggs. Possible risks for this procedure include:

  • Mild to moderate pelvic and abdominal pain (during or after). In most cases, the pain disappears within a day or two and can be managed with over-the-counter pain medications.
  • Injury to organs near the ovaries, such as the bladder, bowel, or blood vessels. Very rarely, bowel or blood vessel injury can require emergency surgery and, occasionally, blood transfusions.
  • Pelvic infection (mild to severe). Pelvic infections following egg retrieval or embryo transfer are now uncommon because antibiotic medicines are usually given at the time of egg collection. Severe infection may require hospitalization and/or treatment with intravenous antibiotics.
  • Rarely, to manage a severe infection, surgery may be required to remove one or both of the ovaries and tubes and/or uterus. Women who have had pelvic infections or endometriosis involving the ovaries are more likely to get IVF-related infections.


What are the risks associated with the embryo transfer?

A catheter containing the embryos is used to gently place them into the uterus (womb). Women may feel mild cramping when the catheter is inserted through the cervix or they may have vaginal spotting (slight bleeding) afterward. Very rarely, an infection may develop, which can usually be treated with antibiotics.


If I conceive with IVF, will my pregnancy be more complicated (than if I conceived on my own)?

Having a multiple pregnancy (pregnancy with more than one baby) is more likely with IVF, particularly when more than one embyro is transferred. These pregnancies carry significant risks, including:

  • Preterm labor and/or delivery: premature babies (regardless of whether or not they were conceived naturally or with IVF) are at higher risk for health complications such as lung development problems, intestinal infections, cerebral palsy, learning disabilities, language delay, and behavior problems
  • Maternal hemorrhage
  • Delivery by cesarean section (C-section)
  • Pregnancy-related high blood pressure
  • Gestational diabetes
The more embryos that are transferred into the uterus, the greater the risk. Your doctor should transfer the minimum number of embryos necessary to provide a high likelihood of pregnancy with the lowest risk of multiple pregnancy. For more information about multiple pregnancy, see the ASRM booklet titled Multiple pregnancy and birth: twins, triplets and highorder multiples. One way to avoid multiple pregnancy is to choose to transfer only one embryo at a time. For more information about this, see the ASRM fact sheet Single embryo transfer.


Will IVF increase the risk of my child having a birth defect?

The risk of birth defects in the general population is 2%-3%, and is slightly higher among infertile patients. Most of this risk is due to delayed conception and the underlying cause of infertility. Whether or not IVF alone is responsible for birth defects remains under debate and study. However, when intracytoplasmic sperm injection (ICSI) is done along with IVF, there may be an increased risk of birth defects.

In addition, there may be a slight increased risk of sex chromosome (X or Y chromosome) abnormalities with ICSI. However, it is uncertain if these risks are due to the ICSI procedure itself or to problems with the sperm themselves. Men with sperm defects are more likely to have chromosomal abnormalities, which can be transmitted to their children. However, these disorders are extremely rare. Rare genetic syndromes called imprinting disorders may be slightly increased wtih IVF.


Miscarriage and ectopic pregnancy

The rate of miscarriage after IVF is similar to the rate following natural conception, with the risk going up with the mother’s age. The rate of miscarriage may be as low as 15% for women in their 20s to more than 50% for women in their 40s.

There is a small risk (1%) of an ectopic (tubal) pregnancy with IVF; however, this rate is similar to women with a history of infertility. If an ectopic pregnancy occurs, a woman may be given medicines to end the pregnancy or surgery to remove it. If you are pregnant and experience a sharp, stabbing pain; vaginal spotting or bleeding; dizziness or fainting; lower back pain; or low blood pressure (from blood loss), and have not had an ultrasound confirming that the pregnancy is in the uterus, call your doctor immediately. These are all signs of a possible ectopic pregnancy. There is a 1% risk for a heterotopic pregnancy after IVF. This is when an embryo implants and grows in the uterus while another embryo implants in the tube, leading to a simultaneous ectopic pregnancy. Heterotopic pregnancies usually require surgery (to remove the ectopic pregnancy). In most cases, the pregnancy in the womb can continue to develop and grow safely after the tubal pregnancy is removed. 

Fact Sheets/Booklets

View more fact sheets and booklets written by the ASRM Patient Education Committee.
Patient Factsheet teaser

Hormonal Contraception

Hormonal contraceptives contain a progestin (progesterone medicine) with or without an estrogen.
Patient Booklet teaser

Third-Party Reproduction

The phrase “third-party reproduction” refers to involving someone other than the individual or couple that plans to raise the child (intended parent[s]) in the process of reproduction.
Patient Factsheet teaser

Menopausal Transition (Perimenopause): What Is It?

The menopausal transition (perimenopause) is the period that links a woman’s reproductive (childbearing) years and menopause.
Patient Factsheet teaser

Stress and infertility

It is not clear how exactly stress impacts fertility.

Resources For You

The American Society for Reproductive Medicine (ASRM) is committed to providing patients with the highest quality information about reproductive care.

In Vitro Fertilization (IVF)

Advocacy Icon

Advocacy in Action

Join the ASRM Advocacy in Action 2024 campaign by making a tax-deductible charitable gift before July 31!  Be part of Advocacy in Action
PR Bulletin Icon

Order your FREE Vot-ER badge to encourage your friends to vote!

ASRM) is pleased to announce our partnership with Vot-ER, a grassroots organization dedicated to driving civic engagement among healthcare professionals.

View the Press Release
PR Bulletin Icon

ASRM Responds to Senate Vote on IVF Bill

ASRM is disappointed that a filibuster prevented the passage of the Right to IVF Act.

View the Press Release
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ASRM Calls for Passage of Family Building Bill

It would increase access to IVF treatments for all Americans, including active-duty service members, veterans, and federal employees.

View the Press Release
PR Bulletin Icon

ASRM publishes IVF one-pagers for media use

The documents lay out the clinical IVF process, summarize oversight of IVF in the U.S., and explain how lawmakers can support access to IVF. 

View the Press Release
PR Bulletin Icon

ASRM Reacts to Cruz/Britt OPED

We are pleased to see Senators Cruz and Britt express their interest in protecting access to IVF.

View the Press Release
PR Bulletin Icon

ASRM Files Amicus Brief in Texas Embryo Case

ASRM has filed an amicus curiae (friend of the court) brief in the case of Antoun v Antoun, which is pending before the Texas Supreme Court. 

View the Press Release
PR Bulletin Icon

Survey shows strong support for increased access to fertility treatments

A new public opinion poll reveals strong support for improved access to In Vitro Fertilization (IVF). 

View the Press Release
PR Bulletin Icon

National Infertility Awareness Week 2024: Leave Your Mark

Next week is National Infertility Awareness Week, a federally recognized health observance founded to increase awareness of infertility.

View the Press Release
PR Bulletin Icon

IVF-assisted pregnancies constitute 2.5% of all births in 2022

In 2022, the number of babies born from IVF increased from 89,208 in 2021 to 91,771 in 2022. This means that 2.5% of births in the US are a result of ART.

View the Press Release
PR Bulletin Icon

ASRM provides testimony to Senate Judiciary Committee on threats facing IVF

ASRM shared with the Senate Judiciary Committee the dangers to reproductive medicine nearly two years after the Dobbs decision.

View the Press Release
Announcement Icon

ASRM reacts to Alabama legislation

We are pleased that the legislation passed into law by the Alabama General Assembly will at least allow our members in the state to care for their patients.

View the Press Release
Announcement Icon

IVF at the SOTU: Fertility care expected to be major focus at State of the Union

Protecting access to IVF care is expected to be a major theme of the State of the Union on Thursday.

View the Press Release
Announcement Icon

ASRM Responds to Proposed Alabama Legislation

We are proud of our Alabama members and their patients, who have been such incredible advocates working to motivate their legislators to protect IVF.

View the Press Release
Announcement Icon

Senate Budget Hearing is Well Timed Following Alabama IVF Ruling

ASRM statement regarding the Senate Budget Committee’s hearing entitled: No Rights to Speak of: The Economic Harms of Restricting Reproductive Freedom.

View the Press Release
Announcement Icon

ASRM Responds to Senate’s Failure to Pass Access to Family Building Act

We are disappointed by the Senate’s failure to meet the moment and pass federal legislation protecting access to in vitro fertilization (IVF).

View the Press Release
PR Bulletin Icon

Society of Reproductive Biologists and Technologists (SRBT) Condemns Recent Court Decision in Alabama

The recent ruling by the Alabama Supreme Court that frozen embryos are legally considered people has sparked controversy and concern.

View the Press Release
Announcement Icon

ASRM Condemns Profoundly Misguided and Dangerous Court Decision in Alabama

In LePage v Mobile Infirmary Clinic, the Alabama Supreme Court made a decision that flies in the face of medical reality and the needs of the citizens.

View the Press Release
PR Bulletin Icon

ASRM applauds introduction of Access to Family Building Act of 2024

ASRM is thrilled by the introduction of the Access to Family Building Act 

View the Press Release
Podcast Icon

SART Fertility Experts - Recurrent Pregnancy Loss and Implantation Failure

"I can get pregnant, but I can't stay pregnant," is echoed by patients with recurrent pregnancy loss.   Listen to the Episode
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SART Fertility Experts - Navigating IVF as a Couple

Mary Casey Jacob, PhD is interviewed by Dr. Daniel Grow, and together they explore the emotional and practical support that couples need. Listen to the Episode
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SART Fertility Experts - Recurrent Pregnancy Loss

Candace discusses her experience with infertility, IVF, multiple pregnancy losses and ultimately a successful delivery with Dr. Julia Woodward.
Listen to the Episode
Podcast Icon

SART Fertility Experts - Infertility Advocacy and Government Affairs

In today's episode, Dr. Mark Trolice interviews Sean Tipton about the fact that many infertility patients do not have insurance coverage for treatment. Listen to the Episode
Podcast Icon

SART Fertility Experts - Behind the Scenes in the IVF Lab

Dr. Sangita Jindal,  helps patients understand the importance of the IVF lab when choosing an IVF program.   Listen to the Episode
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SART Fertility Experts - Your Infertility Nurse: Partner in Your Care

Infertility nurse practitioner and health coach Monica Moore explains the essential role of the infertility nurse in the IVF process.  Listen to the Episode
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SART Fertility Experts - Genetics and IVF

Genetics is a significant part of advanced reproductive technology screening.  Listen to the Episode
Podcast Icon

SART Fertility Experts - Fertility and LGBTQ

In this episode, Dr. Daniel Grow interviews Dr. Mark Leondires, the founder of Gay Parents To Be.  Listen to the Episode
Podcast Icon

SART Fertility Experts - What is an REI?

These experts in infertility lead IVF programs, perform reproductive surgery, and perform research to enhance the field of reproductive medicine. Listen to the Episode
Podcast Icon

SART Fertility Experts - What is IVF?

In this episode, we discuss the ins-and-outs of in vitro fertilization (IVF).   Listen to the Episode
Videos Icon

Start with SART

The very first thing you should do when evaluating a clinic is verify that it is a member of SART. Watch Video
Videos Icon

Preparing for In Vitro Fertilization (IVF): Lifestyle Factors

This SART micro-video discusses lifestyle factors that may affect in vitro fertilization, or IVF, outcomes.   Watch Video
Videos Icon

The Difference Between IUI and IVF

It is important to know Intrauterine insemination (IUI) or In vitro fertilization (IVF) can both be successful at helping grow your family.  Watch Video
Videos Icon

Understanding the SART Clinic Report

During this video we will discuss the SART Clinic Report concepts and demonstrate some of the report features. Watch Video
Patient Ed Icon

Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
Patient Ed Icon

Progesterone supplementation during IVF

Progesterone is a hormone produced by the ovary. View the fact sheet
Patient Ed Icon

What is intracytoplasmic sperm injection (ICSI)?

A procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) if a sperm cannot penetrate the outer layer of an egg. Read the Fact Sheet
Patient Ed Icon

What is In Vitro Maturation (IVM)?

In vitro maturation (IVM) is when a woman’s eggs are collected and matured outside the body. This is done as part of an in vitro fertilization (IVF) procedure. View the fact sheet
Patient Ed Icon

Fertility Rights and Responsibilities

Can a fertility program or clinic deny treatment to patient(s) if there is concern about the ability to care for the child(ren)? Yes. Fertility programs can withhold services if there are signs that patients will not be able to care for child(ren). View this Fact Sheet
Patient Ed Icon

Hydrosalpinx

The fallopian tubes are attached to the uterus (womb) on the left and right sides. View the Fact Sheet
Patient Ed Icon

Preimplantation genetic testing (including preimplantation genetic diagnosis and preimplantation genetic screening)

Your embryos can be tested for abnormal chromosomes before they are transferred to the uterus. View the fact sheet
Patient Ed Icon

What do I need to know about conceiving after tubal surgery?

Fallopian tubes connect the ovary (where the eggs are stored and grow) to the uterus (womb), where the fertilized egg develops into a baby (fetus). View the fact sheet
Patient Ed Icon

Side effects of injectable fertility drugs (gonadotropins)

Gonadotropins are fertility medications given by injection that contain follicle-stimulating hormone (FSH) alone or combined with luteinizing hormone (LH). View the fact sheet
Info Icon

SART FAQ About IVF

Created by the Society for Assisted Reproductive Technology (SART) the following are answers to frequently asked questions concerning in vitro fertilization (IVF). Learn the facts
Patient Ed Icon

Kristen Ritchie's Story

I spent seven years navigating infertility, which was tumultuous but also a period of tremendous personal growth in hindsight. Read the story
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In Vitro Fertilization Infographics

ASRM has prepared infographics to illustrate the subject of in vitro fertilization (IVF) better. View the infographics
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It takes more than one

Why IVF patients often need multiple embryos to have a baby View the advocacy resource
Advocacy Icon

What support for IVF looks like

Bipartisan support for IVF, that is responsible for the birth of over 2% of all babies born in the USA each year, will ensure that families continue to grow. View the advocacy resource
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Oversight of IVF in the US

In the US, medical care is regulated by a complex and comprehensive network of federal and state regulations and professional oversight. View the advocacy resource

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