Detailed information on possible side effects, complications and responsibilities involved with assisted conception treatments In this Delhi IVF informs you

1. IVF and GIFT are intensive treatments

IVF (in vitro fertilization gamete) as medical treatment for infertility are very intensive forms of treatment. Treatment usually includes injections, tests, multiple-egg-development, and an egg recovery operation, as well as collection of sperm samples from your husband or partner at critical times.

2. The chance of getting pregnant

Past results indicate that the pregnancy rate is up to about 40-50% per cycle-of-treatment for IVF.

In addition to age, results will depend on the condition of your uterus, the number of eggs obtained, the number of eggs fertilized, and the number of eggs or embryos transferred. If spare eggs are fertilized and stored, the overall chance of pregnancy from one round of stimulation will be higher.

But the chance of pregnancy for some people can also be a lot lower than our previous results might indicate. For some people the chance will be close to zero.

The chance of pregnancy with IVF is highest if all your eggs are exposed to sperm. This means that there will be a maximum number of fertilized eggs from which to choose those that will be transferred to the uterus.

With transfer of 3 to 4 eggs or embryos, twins are relatively common (above 30% of pregnancies) and triplets are not rare (up to 5-10%). The chance of multiple pregnancy is higher if you are relatively young (less than 30, for example) and it is much lower if you are over 40. Rarely you can have a higher-multiple than expected from the number of eggs or embryos transferred because of spontaneous ovulation and conception, or because a fertilized egg can sometimes divide to produce 2 or more embryos, creating identical twins or triplets.

Possible problems

Please note that, occasionally,

• the exact time for follicle maturation could be misjudged, or could be unpredictable, or could happen (in non-Lucrin or Synarel cycles) at a time when it's impractical to carry out egg collection, or it could happen before the time egg collection is scheduled, or it might not happen at all in the monitored cycles (this happens mainly among women over 43),

• an apparent follicle might not yield an egg, or

• a medical or surgical complication or emergency could happen that prevents your doctor proceeding to collect a mature egg or eggs.

If the ovaries seem to have been over-stimulated, your Delhi IVF gynecologist may be so concerned about the risk of serious ovarian hyper stimulation syndrome (OHSS) that either (a) the cycle is stopped or (b) hCG is given and the eggs collected but that no eggs or embryos are transferred that cycle (instead the eggs can be fertilized and placed in cryostorage for later transfer). This is a decision for you and your Delhi IVF gynecologist, as it does mean a fee for the cryostorage, with a refund for the foregone embryo transfer.

3. The hazards of treatment and pregnancy IVF and GIFT procedures are not without hazards. Please remember that while you are at Delhi IVF you are the private patient of your Delhi IVF gynecologist, whom you should consult about all these matters before starting with treatment. We can help you arrange another appointment with your gynecologist at short notice if you would like us to. Payment of costs associated with the diagnosis and treatment of any complications that might occur during treatment or during pregnancy would be your responsibility, as it is with any medical or surgical condition for which you would usually see a doctor. Some of these costs might not be covered by Medicare, due to their strict guidelines on reimbursements during an IVF cycle. FOR THE WOMAN, SHORT-TERM SIDE EFFECTS/HAZARDS Stimulation   Ovarian enlargement from over-stimulation (a controlled degree of over-   stimulation is intentional, but this can be a very serious condition).

Transvaginal egg pick-up   Also carries a small risk of serious internal bleeding from the iliac blood vessels in   the pelvis, as well as the risk of an over-reaction to the pethidine we provide for   sedation. Less serious but more common untoward events during transvaginal egg pick-up include:

a vasovagal reaction (a 'faint'), associated with slowing of the pulse and   sweating, which can be treated with a drug (atropine) or by administration of fluids bleeding from the vaginal mucosa, which settles and stops with pressure from a   swab Ovarian hyper stimulation     infection after egg collection (about 1 in 1000 chance)     multiple pregnancy (typically two or three eggs or embryos are transferred),     ectopic or tubal pregnancy (the treatment of which involves operation and, removal of the affected tube or tubes),     miscarriage, which may sometimes need special treatment (and which can have   risks of its own), and the usual risks and hazards of pregnancy.