Since egg freezing became a widely available option in the 1980s, thousands of babies have been conceived using frozen eggs. The procedure is generally safe, but there are some risks and possible complications.
Risks and Complications of Ovarian Stimulation
Common side effects
PMS-like symptoms. The hormones that help you make eggs can cause symptoms that can make you feel like you have PMS. They can be stronger than the ones you feel during a regular period. They include:
- Bloating
- Hot flashes
- Headaches
- Moodiness
- Nausea
- Cramps
- Fatigue
- Weight gain
There are things you can do to help you manage these.
- Stay hydrated with liquids that contain electrolytes.
- Try a mild over-the-counter pain reliever like acetaminophen.
- Avoid intense physical activity.
- Weigh daily and monitor yourself for worsening symptoms.
Ovarian Hyperstimulation Syndrome (OHSS)
Up to 10% of women who are taking hormones for fertility treatments will develop OHSS. This is when your ovaries swell. They can also leak fluid into your belly.
Experts aren’t certain what causes OHSS, but it may be related to the fertility hormone human chorionic gonadotropin (hCG). You may get hCG in an injection called a “trigger shot” to stimulate the eggs to mature so they can be removed and frozen.
There are several other things that make OHSS more likely:
Symptoms of mild-to-moderate OHSS
OHSS symptoms that can be uncomfortable but are not usually serious include:
- Abdominal pain
- Bloating
- Nausea
- Enlarged ovaries
- Constipation
- Weight gain of 10 to 15 pounds
Treatment for mild-to-moderate OHSS
If your OHSS symptoms are not serious, you can usually manage them by staying hydrated, resting, and using mild pain relievers. Your doctor may also watch over you to see if your medication needs adjustment.
Symptoms and signs of severe OHSS
In about 1 out of 100 women, OHSS can become serious enough to need medical treatment. When OHSS becomes more serious, you may have one or more of these signs and symptoms:
- Weight gain of over 10 pounds in five days or less
- Severe and sudden abdominal pain, nausea, or vomiting
- Shortness of breath
- Reduced urination and dark urine
- Swollen legs
- Dizziness when standing up
- Fast, shallow pulse
- Fluid buildup in the belly or lungs
- Electrolyte imbalance leading to fatigue, muscle cramps, or weakness
Complications of severe OHSS
Ovarian torsion (twisted ovary)
Some of the symptoms of severe OHSS could mean that you have a serious complication called ovarian torsion, or twisted ovary. When the ovaries swell from the hormones, they can develop large cysts that can make them twist. That can cut off blood supply to the internal organs. You may need treatment right away, often including surgery, to save the ovary. Ovarian torsion can also happen in the weeks after you’ve completed the egg removal procedure.
Treatment for severe OHSS
Contact your doctor right away if you notice or think you have any of these symptoms. They may admit you to the hospital to watch over you carefully. They’ll use more active measures to treat your symptoms, including:
- IV fluids
- Medications to tamp down the function in your ovaries, such as gonadotropin-releasing hormone (Gn-RH) antagonist or letrozole (Femara)
- Surgery in the event of a ruptured cyst on your ovary
- Anticoagulant medicines to lessen the chances of a blood clot forming in your legs
- Intensive care for any liver or lung issues caused by clotting
Preventing OHSS
There are some synthetic hormone medications that may lower your risk of developing OHSS. Among them are:
Cabergoline (Dostinex). This medication can lower the level of the hormone VEGF, a hormone with a link to OHSS. It also reduces levels of prolactin, a hormone that stops ovulation.
Letrozole (Femara). This lowers the levels of estrogen and VEGF after your eggs are retrieved, two hormones that have a link to OHSS.
Leuprolide (Lupron). This treatment causes your body to make a surge of luteinizing hormone instead of hcG. This form of the hormone leaves your system faster than the synthetic one, making OHSS less likely.
There are other changes that your doctor can make in your medications and how you take them if they think you’re at high risk for severe OHSS. Talk to your doctor about any concerns you have.
Risks and Complications of Egg Retrieval
When your eggs are ready to be removed for freezing, you’ll have an outpatient procedure that usually takes about half an hour. It’s a minor surgery, but as with any operation, it carries some risks.
Reactions to anesthesia
An anesthesiologist will sedate you so that you feel drowsy and give you a local anesthetic so that you don’t feel anything. Sometimes they may use general anesthesia, where you become fully unconscious. Risks that come with anesthesia include:
- Allergic reactions
- Blood pressure changes
- Breathing problems
Complications of anesthesia are not common, and your anesthesiologist is trained to address any issues that might arise.
Needle injury
Your fertility doctor uses a small needle to withdraw the eggs from your ovaries. About 1% of the time, there can be an injury from the needle to the uterus, cervix, or other organs in the abdominal or pelvic area.
Infection
As with any surgical procedure, there is a small risk of infection.
Risks to Eggs and Embryos From Freezing
The risks to eggs from freezing and thawing are low. Some can become damaged, but an estimated 8 out of 10 eggs survive the process.
If you have your frozen eggs thawed and fertilized so that you can try to become pregnant, it has some of the same risks as using fresh eggs. The eggs may not attach to the uterus, or you may have a miscarriage. There is a chance of having a baby with abnormalities, but studies show it is not more frequent in babies born from frozen eggs than fresh eggs.
Show Sources
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SOURCES:
American Society of Anesthesiologists: “Anesthesia Risks.”
American Society of Reproductive Medicine: “Ovarian Hyperstimulation Syndrome,” “Prevention of Moderate and Severe Ovarian Hyperstimulation Syndrome: a Guideline,” “In Vitro Fertilization (IVF): What are the Risks?”
Cleveland Clinic: “Ovarian Hyperstimulation Syndrome (OHSS).”
Johns Hopkins Medicine: “Freezing Eggs: “Preserving Fertility for the Future.”
Journal of Clinical Medicine: “Outcomes of social egg freezing: a cohort study and a comprehensive literature review,” “Letrozole and Ovarian Hyperstimulation Syndrome (OHSS): A Promising Prevention Strategy.”
Journal of Human Reproductive Science: “Oocyte cryopreservation - current scenario and future perspectives: a narrative review.”
Mayo Clinic: “Ovarian Hyperstimulation Syndrome.”
Mt Sinai: “Ovarian Hyperstimulation Syndrome.”
Methodist Health: “Understanding ovarian hyperstimulation syndrome.”
NYU Langone Health: “Egg Freezing & Embryo Banking.”
Penn Medicine: “Egg Freezing.”
The Obstetrician and Gynaecologist: “Ovarian torsion: a modern approach to management.”
University of Washington Medical Center: “Ovarian Hyperstimulation Syndrome.”
Journal of Assisted Reproduction and Genetics: “Ovarian hyperstimulation syndrome: pathophysiology and prevention.”
University Hospitals Sussex: “Cabergoline Treatment.”
