IS IVF PAINFUL?
Dr. Sweta Gupta Clinical Director and Sr. Consultant – Fertility Solutions, Medicover Fertility, New Delhi
Most woman seeking infertility treatment when advised IVF, would refuse undergoing same due to fear of pain. During counseling the couple would ask HOW PAINFUL IS IT? To answer this question for ease of all I put this together. During an IVF cycle there can be several stages where one expects to experience pain.
The first part where one anticipates pain is as the women starts her injections for development of eggs. These are usually done with either needles with small bores or the newer injectable pen devices. Almost everyone dreads the first injection for the fear of unknown, but after the initial anxiety is over, most women report that there was minimal or no pain. Compare this to a diabetic on insulin who injects themselves with similar kind of needles sometimes even up to 3- 4 times a day.
The next step where one complaints of pain is as the eggs starts to develop and the ovaries begin to enlarge, causing in some lower abdomen pain and bloating. This only when a very large number of eggs start to develop and the ovaries are overstimulating. It’s where the doctors have to use their discretion to use drugs judiciously to limit the number of eggs that grow and individualize the treatment.
This part most women would hate, but in reality, with a well-controlled stimulation many don’t even experience any pain, but merely discomfort that they are able to cope with and lead a normal life and even continue to go to work. This discomfort can extend, only in a few, for about a week after the egg retrieval.
The third phase where woman expects pain is during the procedure of the egg retrieval itself. As the patients during counseling are made aware that the eggs are removed by piercing the ovaries through the vagina using a thin long needle, many women anticipate great pain. But in reality, there is no pain during the procedure as it is done under anesthesia.
In our centre, we have anesthesiologists who you would meet once before the procedure for a check up to see that you are fit for anesthesia. They would ensure at that the time of retrieval you are pain-free and comfortable throughout the procedure. The anesthesia used at our centre is for a short duration only and medicines used do not even slightly affect the eggs.
The next step where usually the couple enquires if the woman can have pain is at the time of embryo transfer. Usually three to five days after the egg retrieval, the embryos are transferred back into the uterus. The transfer of the embryos is almost painless, but you may feel discomfort only during insertion of a vaginal speculum as you may have felt during taking a pap smear.
After the embryos have been transferred back into the uterus, you would begin on progesterone, which are suppositories, gels or injections. The progesterone injections are oil-based injection and hence the needles used are larger bore and therefore more painful. Some patients find it bearable and others may complaint of severe pain. The ones who cannot tolerate it at all can use tablets or vaginal gels without any effect on the outcome.
So in summary, there are various situations during an IVF procedure that one can expect pain, in actual most patients at the end would always inform that it was one of the procedures where there experienced minimal pain.
