The potential problems associated with IVF are outlined below.

Drug side effects

Most women will have some reaction to the drugs. Most of the time the side effects are mild and may include:

• hot flushes
• feeling down or irritable
• headaches 
• restlessness
• nausea and vomiting
• shortness of breath  
• abdominal bloating
• ovarian hyperstimulation syndrome (see below) - it may be necessary to cancel the cycle and restart with a lower dose of gonadotrophin

If you have these symptoms, see your doctor immediately, especially if you have abdominal pain and swelling.

Multiple births

If more than one embryo is replaced in the womb as part of IVF treatment, there's an increased chance of producing twins or triplets.

Having more than one baby may not seem like a bad thing, but it significantly increases the risk of complications for you and your babies:

• you have a higher risk of miscarriage, anaemia and heavy bleeding, and are more likely to go into early labour and need a caesarean section or assisted ventouse or forceps delivery
• up to 25% of multiple pregnancies cause pregnancy-related high blood pressure 
• you're two to three times more likely to develop gestational diabetes during pregnancy if you're carrying more than one baby 
• the risk of pre-eclampsia is three times higher for twin pregnancies and nine times higher for triplets

The 2013 NICE fertility guidelines recommend that double embryo transfers should only be considered during treatment in women aged 40-42. Younger women should only be considered for a double embryo transfer if there are no top-quality embryos.

Read further information on the risks of multiple births on the One at a time website.

Ovarian hyperstimulation syndrome

The ovarian hyperstimulation syndrome (OHSS) is a rare complication of IVF. It occurs in women who are very sensitive to the fertility drugs taken to increase egg production. Too many eggs develop in the ovaries, which become very large and painful.

OHSS is more common in women under 30 and in women who have polycystic ovary syndrome. OHSS generally develops in the week after egg collection.

The symptoms of OHSS are pain and bloating low down in your abdomen, and nausea or vomiting. Severe cases can be dangerous. Contact your clinic if you have any of these symptoms.

Ectopic pregnancy

If you have IVF, you have a slightly higher risk of an ectopic pregnancy, where the embryo implants in the fallopian tubes rather than in the womb. This can cause pain in the abdomen, associated with vaginal bleeding or bleeding into your abdomen.

If you have a positive pregnancy test, you'll have a scan at six weeks to make sure the embryo is growing properly and that pregnancy is normal.

Tell your doctor if you experience vaginal bleeding or stomach pain after having IVF and a positive pregnancy test.