Complications of Assisted Reproduction

Abstract

The practice of assisted reproduction has evolved significantly since the birth of Louise Brown, the world’s first baby born as a result of in vitro fertilization (IVF), in 1978. Since then, more than 1 million babies have been born as a result of assisted reproduction around the world. The changes in practice are many; among them: daily blood tests and abdominal ultrasound have been replaced by infrequent transvaginal scans; laparoscopic oocyte retrieval under general anesthetic has been replaced by transvaginal ultrasound-controlled oocyte collection with sedation analgesia. In addition, advances include elective transfer of 1 to 2 embryos and introduction of new laboratory techniques such as intracystoplasmic sperm injection (ICSI), in vitro maturation (IVM), preimplantation genetic diagnosis, and new techniques in cryopreservation. While these changes have led to an increase in pregnancy rates, they have also been accompanied by well-known complications such as multiple pregnancies, ovarian hyperstimulation syndrome, and possible adverse neonatal outcome. Other complications associated with assisted reproduction may arise during different phases of treatment, from ovarian stimulation, from surgical procedures such as oocyte and sperm retrieval, and from embryo transfer, and may affect long-term outcome among the offspring. This chapter does not include complications related to laboratory practice.