Risks and Complications of IVF
In vitro fertilization (IVF) has helped countless couples build families when natural conception was not possible. For many, it represents real hope after years of struggle. At the same time, IVF is a complex medical process, and like any medical treatment, it carries certain risks and possible complications.
Understanding these risks ahead of time can help you make informed decisions and recognize warning signs early. Most people who undergo IVF complete treatment safely, but it is important to know what to watch for and when to reach out for help.
This article walks you through the main physical, emotional, and procedural risks of IVF, along with the halachic safeguards that protect the integrity of the process. As always, we at PUAH are here to support you through every stage.
Key Points
Ovarian hyperstimulation syndrome (OHSS) is the most common serious complication of fertility medication.
Egg retrieval is a minor procedure but carries small risks of bleeding, infection, and anesthesia reactions.
IVF increases the chance of multiple pregnancy, which raises risks for both mother and babies.
The emotional strain of treatment is real and deserves attention.
Rare laboratory errors can occur — and halachic supervision provides an added layer of protection.
Risks From Fertility Medications
IVF begins with hormonal medications that stimulate the ovaries to mature multiple eggs. These medications are powerful and, in some cases, can cause side effects.
Ovarian Hyperstimulation Syndrome (OHSS)
OHSS occurs when the ovaries overreact to stimulation medication. In mild cases, you may feel bloating, mild abdominal pain, and nausea. In more severe cases, fluid can build up in the abdomen and chest, leading to rapid weight gain, shortness of breath, and dehydration.
Severe OHSS is uncommon, but it requires prompt medical attention. Your treatment team will monitor your hormone levels and adjust medication doses to lower this risk.
Other Medication Side Effects
In general, there are no side effects from the medications that are used because they are natural hormones, similar to those already in your body. Some women experience headaches, mood changes, hot flashes, breast tenderness, and irritation at injection sites. These effects are usually temporary and ease once treatment is complete.
There are, however, some side effects that most women feel. These are fatigue (due to the need for frequent monitoring that is done to check for the response to medications) and anxiety (due to the emotional stress of infertility in general and the unknown outcome of any particular IVF treatment).
Most studies indicate that there are no long term effects from using these medications, which have helped hundreds of millions of women have children for over 50 years, including with treatments not involving IVF.
Risks From the Egg Retrieval Procedure
Egg retrieval is performed using a thin needle guided by ultrasound, usually under light sedation. While it is generally a safe procedure, it does carry small risks:
Bleeding from the needle puncture site.
Infection of the ovaries or surrounding tissue.
Damage to nearby organs such as the bladder or bowel, which is rare.
Reaction to anesthesia or sedation.
Most women recover within a day or two with mild cramping or spotting. Severe pain, fever, or heavy bleeding after retrieval should be reported to your doctor right away.
It is important to note that, although many eggs are typically retrieved during IVF, the number will vary according to a woman's innate ovarian function. In addition, the eggs that are retrieved are those that are particular for that specific cycle — egg retrievals will not hasten the depletion of your egg supply or the occurrence of menopause.
Pregnancy-Related Risks
Multiple Pregnancy
When more than one embryo is transferred, the chance of twins or higher-order multiples increases. Multiple pregnancies carry greater risks, including premature birth, low birth weight, and complications for the mother such as high blood pressure and gestational diabetes. To reduce these risks, most doctors now recommend single embryo transfer when appropriate.
Ectopic Pregnancy
An ectopic pregnancy occurs when an embryo implants outside the uterus, usually in a fallopian tube. This is a serious condition that requires immediate medical care. Although IVF places the embryo directly into the uterus, ectopic pregnancy can still happen.
Miscarriage
The risk of miscarriage with IVF is similar to that of natural conception and rises with the mother's age. This can be one of the most emotionally difficult parts of treatment.
Emotional and Psychological Strain
The risks of IVF are not only physical. The process can be emotionally demanding, with cycles of hope and disappointment, financial pressure, and the stress of frequent appointments and injections.
It is normal to feel anxious, sad, or overwhelmed. Seeking support — whether from a counselor, a support group, or trusted advisors — is a sign of strength, not weakness. Our advisors at PUAH understand these challenges and can help you find the support you need.
Laboratory and Procedural Errors
Modern fertility laboratories follow strict protocols to protect every egg, sperm sample, and embryo. Still, IVF involves many delicate steps, and human error — though extremely rare — remains a real concern.
In one widely reported case, fertilized eggs belonging to one couple were mistakenly transferred into another woman's uterus. The error was caught early, and doctors prevented an incorrect pregnancy. Cases like this, while uncommon, highlight why an additional layer of oversight matters.
Halachic Perspective
The complex and sensitive nature of fertility treatment requires, according to halacha, careful supervision in places where embryos and reproductive material are handled. While medical teams work hard to prevent mistakes, halacha values an additional set of eyes — independent of the medical system itself — to safeguard the process.
At PUAH, we provide this oversight through approximately 50 trained and certified supervisors who accompany the treatment process at the couple's request. We also developed a unique locking device — the "Pa'unit" — to secure embryos in the incubator during the IVF process. To date, more than a quarter of a million supervisions have been carried out in Israel and around the world, in hospitals and leading fertility laboratories. Through this careful work, many potential errors have been prevented.
Anyone undergoing fertility treatment in Israel can request our supervision. The major health funds — Clalit, Maccabi, and Meuhedet — arrange full or partial coverage of the cost through their supplementary insurance plans.
Specific questions should be discussed with a qualified rabbinic authority. Our team at PUAH is available to help you navigate these questions.
When to Speak With a Professional
Contact your medical team promptly if you experience any of the following during or after IVF:
Severe abdominal pain or rapid bloating
Unexpected fatigue or dizziness, or shortness of breath or significant weight gain over a few days
Fever, heavy bleeding, or signs of infection after egg retrieval
Severe or one-sided pain that could signal an ectopic pregnancy
Emotional distress that interferes with daily life
If you have questions about the medical, emotional, or halachic dimensions of IVF, reach out to PUAH. Our team of doctors and rabbis specializes in exactly these situations.
Summary
IVF is a safe and effective treatment for most couples, but it carries certain risks, including OHSS, procedural complications, multiple pregnancy, and emotional strain. Knowing the warning signs and seeking timely care help keep you safe. Halachic supervision adds an important layer of protection, and, along with your caregivers, we at PUAH are here to guide you through every step.
Disclaimer: This article is intended for educational purposes only and should not replace medical advice from a qualified healthcare professional. Personal halachic questions should be discussed with a qualified rabbinic authority.