Induction 39 weeks due to IVF?

[TryingToStayRational]

I’m 32 weeks and I’ve been told that I will be offered induction at 39-40 weeks due to having had IVF. No other risk factors and have been healthy and well throughout pregnancy and before (our infertility was unexplained).

When I asked why, I was told that there is a higher risk of placenta failure in IVF pregnancies that go beyond 40 weeks. I haven’t been able to find any evidence of this through literature searching so far. I’m a scientist, so I like to understand the evidence behind things so that I can make an informed choice. Obviously induction brings risks of its own, so I want to understand how that balances out against the risk of placenta failure.

Has anyone else been in this position and found any evidence? I’m seeing a consultant next week and will ask them, but my experience so far has been that they are super busy and don’t want to explain things - it’s just “hospital policy”.

Interesting. My friend who is currently training to be a midwife said that IVF pregnancies tend to be induced earlier, but she said that they tend not to want to risk the baby after so much effort.

My midwife says I have no other health issues and that she'll be treating my ICSI pregnancy as a normal one. I've not seen a consultant, not had t any suggestion so far that I'll need to. She's pushing for natural birth, at home if I want it.

I think I would push back on the consultant if you don't want to be induced.

My nephew is an ivf baby and SIL was told the same thing. Her consultant said it was because of risk. Some studies in the past have suggested that the chance of stillbirth with ivf pregnancies is significantly increased and I suppose with stillbirth risk increasing as the pregnancy lengthens, perhaps early induction is seen as a mitigating factor.

I've been induced with last 2 babies at 40 weeks because I was aged 40 or more. Not heard of it for IVF. Xx

My placenta started to fail with my second baby. This was an IVF baby. I didn't know there was a link.

I have an IVF and an ICSI baby and in both cases the placenta started to fail towards the end. With DD1 I was induced at 40+5 because of this. DD2 arrived at 38w.

I’ve never heard that there is a link between IVF and placental failure though. Even if there were, if may not be because of the IVF per se. I guess the average age of IVF expectant mothers is higher, and risk of placental failure increases with age so perhaps there’s something in that respect.

In any event if all is well with the baby I would push for increased monitoring over early induction.

how old are you? if over 35 I've heard of early induction being advised (my hospital was doing a research trial on outcome of this vs going to term + a few years ago so results may have been published by now?)

I have an ICSI baby (toddler now) and was 9 days overdue before my waters broke. No mention of earlier induction for IVF reasons. No placenta issues at all.

I’ve had an icsi baby and haven’t heard this. Midwife (and ivf clinic) said the pregnancy is treated the same as it was the getting pregnant part that we struggled with not the being pregnant part?

My IVF pregnancy was induced early but only as he was measuring big, he was IVF, donor eggs and I had a history of MMC plus was on a ton of meds including blood thinners,pio and steroids all the way through and they weren't bothered about inducing until the end when he was getting a bit big

Thanks for all the replies. I’ve been consultant-led from the start, purely because of the IVF apparently, so I was told right away homebirth wouldn’t be an option. I’m 36. They told me if I was 40+ then age would be an issue, but not yet. I will ask about monitoring. Yeah the thing about IVF is that by it’s nature it kinda skews things - lots of people have issues like endo, history of miscarriage, PCOS or are older as a result of trying for longer.... it’s a complicated picture. I know there’s no straightforward answer to the question really, as it’s highly unlikely there has been a study specifically about my exact circumstances, but it’s interesting that not everyone has been told the same thing. And I specifically asked the IVF clinic about risks in pregnancy and they said that there was a higher risk of ectopic, which is why they do early scans, but that after that we would be treated as per spontaneous conception. So it’s a bit frustrating. Will write down some questions to ask and see what they have to say and whether a compromise like some monitoring could still give me a chance of the natural birth I would prefer.

I had the same issue! Also a scientist and I scoured the literature and could find very little evidence for the IVF-placental deterioration link. It didn’t help that I kept seeing registrars rather than consultants, who didn’t have a clue either and just said it was policy and could not signpost me to a single piece of evidence.

I found it really stressful as I wanted an active/ water birth but every appt we had the registrars pushed the induction angle. It was only at a 39 week scan that I saw an actual consultant who was awesome and said it was entirely optional as the research was inconclusive. They just offer it as women who have had IVF may want to be super cautious. She also ok-ed an active/ water birth and encourages me to stay home as long as possible as other than the IVF I had an uncomplicated pregnancy. I went into labour naturally at 40+3 and babe was tiny; if they’d induced earlier he would have been super tiny!

My advice would be to take it all with a pinch of salt. I suspect it’s a population risk like you say, due to things that make people need IVF. But there’s no evidence for that either! If you haven’t seen an actual consultant at your appts, try to request one as the registrars were not quite on top of the science in my case. As lovely as they were.

Good luck!