IVF pregnancy induction

[Londongirl84]

Were any of your IVF babies induced just before or on EDD? I've heard that some hospitals do this and wondered why. I'm a real worrier and so would be keen to be induced around EDD to avoid going overdue. Please let me know experiences x

[Londongirl84]

Anyone?

[FlipFantasia]

Why would they do this? Is it another issue like maternal age? I can't see why an IVF conception would lead to an early induction on its own.

I was induced at 42 weeks with my IVF pregnancy and it was an awful experience I wouldn't wish on anyone. Wish I had waited and gone naturally.

[marzipanned]

Sorry, not an IVF baby here, but I do recall reading a thread about this previously. The OP had been told she'd have to be induced because she'd conceived through IVF and the general consensus was - why on earth?! Although your conception may have been assisted, your body has done everything else by itself. So try having a bit of a search on MN, you might well find that same thread.

Tbh if you were born in 1984 then your age is not a concern and they would probably be quite unwilling to induce you at EDD. That said some people do request ELCS for anxiety reasons and those tend to be done at 39 weeks so the woman doesn't go into labour spontaneously. If you are really having anxiety about this, do talk to your consultant.

[NinjaHaggisHunter]

Yes, my IVF baby was induced day after due date, but really only because I was considered high risk (I am 40). I only needed the pessaries as I was pretty much ready to go anyway.

[keepitgoing]

this was never mentioned to me, I'm 31 and it was an ivf pregnancy. I had her spontaneously at 37+1 anyway I wouldn't be induced if no risk factors until v overdue

[Jcb77]

It's not an absolute rule as I understand it but a pragmatic risk balance. The still birth rate in normal pregnancy rises after 40 weeks. After 42 weeks it rises even more, which is why 42 weeks is the usual cut off for induction. With IVF pregnancies the rates seem to rise at the same sort of dates, but even more steeply. Hence a lot of obstetricians not wanting ivf to go past term. No-one seems to know why this is the case, might be because the women pregnant with IVF tend to be a bit older (have spent years trying, fertility declines with age) or because there's something tied up with the whole fertility thing that necessitates the IVF in the first place. Either way, the general stillbirth risk post 40 weeks is higher than a non IVF pregnancy. There's no way of predicting if you will be 'high' or 'low' risk on that curve. So frequently, it's recommended that getting LO out as soon as they're cooked is a pragmatic thing to do (and with IVF there's no issue about exact dating). Yes, an induction sounds potentially pretty miserable and increases the chances of further interventions being needed (syntocinon infusion, epidurals, section etc) but..... You might well end up with these anyway and you might consider it a small price to pay to decrease the other risk. It's a balance, with no definite answer, as is so much of medicine. You don't have to say yes but do ask your HCP why they recommend it.
I am somewhat grumpily accepting that this is probably the only chance I'm ever going to have to be pregnant/deliver, and my initial ideas of gently labouring at home with telly and pets and dh for distraction til the last moment are probably not going to happen. It'll be pessaries at dawn and the whole works after that. Harrumph. But, almost certainly, a well baby at the end of it.
Depends what your own risk tolerance is really.

[FlipFantasia]

Jcb interesting post. Do you have links to any of the research you mention? I'd love to read more, as not a single consultant, registrar or midwife (at the large London teaching hospital I delivered at) mentioned this to me when I went overdue with my IVF pregnancy and was induced at 42 weeks. It was also never mentioned to me as a risk of IVF/ICSI when we were having private treatment.

[hazchem]

The risk of still birth post dates isn't higher then pre dates until you get to 44 weeks.

• 6/1000 at 38 weeks
• 2/1000 at 40 weeks
• 2.3/1000 at 41 weeks
• 3/1000 at 42 weeks
• 4/1000 at 43 weeks
• 7/1000 at 44 weeks
theunnecesarean.com/blog/2009/10/3/postdates-separating-fact-from-fiction.html

this is also a good blog about it the author is both a midwive and Phd researcher midwifethinking.com/2010/09/16/induction-of-labour-balancing-risks/

[hazchem]

first link

second link This second link translates what the risk mean much better then the first one.

[Trooperslane]

I was.

I am ancient.

And the experience was great. Would do it again in a heartbeat.

[Frozennortherner]

I was induced too. I'd gone 15 days over and had the drip. Fab birth, very slow to start but over and out in 2 hours. Loved every minute of it.

[Jcb77]

Hi flip. No - haven't got any numbers specifically - am not an obstetrician and tbh haven't looked in detail other than a quick google when it was suggested that supported the general concept - but this is what I've been told in my situation. By several obstetricians that I've queried (because I wasn't and still am not overly keen on the idea).
Hazchem- interesting numbers. Thank you :). Are they for IVF or normal pregnancies? Seems to show that the 'ideal' time to be born is 40 weeks, much before is too soon (hence not scheduling elective sections much before unless necessary) and by 42 weeks the risk has increased by 50% and doubled by 43. If these are naturally conceived rates then what I was told suggests that the increase in rates for IVF happens even more steeply. If they're IVF then natural conceptions are even 'safer' to go over dates (and you can never be certain of ovulation/conception dates in that situation given the limits of biological precision. With IVF/icsi, you know to the hour when 'ovulation' and fertilization occurred).
As I said - not everyone does it (suggests induction), the numbers are small and you don't have to say yes if you'd rather not. I was offered it as an option and when I asked why, that's what I was told. By my ongoing obstetric team, not my original IVF team (hence my surprise!). I am pretty risk averse and given my specific situation, don't really want to increase my risk any more than necessary.

[Jcb77]

A footnote - statistics can only ever tell you so much. They are usually presented in a way that supports (or refutes) an argument - hence the 'lies, damn lies and stastistics' quote. We tend to like hard facts and absolutes when dealing with difficult decisions, but I'm not sure there are any, particularly when dealing with medicine and biological diversity. There are just so many variables that you don't know about, let alone are difficult to control for. Population studies can tell you about what the population trends are, but can't tell you where YOU fall on that line. Are you a 'norm'? Are you an outlier? For those of us that like certainty and control (and I put both hands up to being one of those) it can be very hard to integrate the 'EQ' with the 'IQ' part of decision making. Especially as out pesky reptilian brain do so much or the thinking under the covers as it were.
Some stuff is just wrong - the BellyBelly website has some facts stated that are plain wrong, and some statistics taken from references that are 40 years old and refuted by more current research/changes in practice, which makes me doubt the validity of the rest of it.
Anyway, I'm getting off topic. The reasons for inducing IVF babies seem to be to reduce an admittedly small increase in risk of still birth by going over dates. Induction itself brings in an increased set of risks and it's an individual decision as to what you want to do.