Induction for IVF pregnancy

[Ambn1]

Hello,

I had a meeting with the consultant the other day who said they would like to induce me at 39 weeks because our baby was conceived through IVF.

I’ve heard awful stories about induction and would really like to have as natural a birth as possible. The research around whether induction is needed in the case of IVF is all very inconclusive.

Has anyone else ever not accepted the induction in this case?

Would having the membrane sweep but not the drugs for induction result in a higher chance of going into labour naturally?

My sister and mum have always gone overdue in each of their pregnancies, so I’m not convinced I will go into labour naturally all that quickly if I am similar to them, which again is a risk factor.

I want the baby to just be born healthy and for everything to go as smoothly as possible, but feel really torn.

Have they given you the scientific basis around why they'd need to induce based on an IVF pregnancy? I understand the dates are more accurate of course, however not all babies grow to bang on 40 weeks anyway regardless. Some come early, some people know exactly when conceived and still come 2 weeks later.
Do you have any high risk factors they are taking into account?
I would always personally avoid induction, unless your body is in a favourable condition (I.e already dilated a bit, cervix not fully thick and high)
But many people do have positive induction stories. I'm just not one of them.
With my second child induction was off the table due to my first birth, but we discussed every different option and plan with the consultant beforehand.
They can offer monitoring of your placenta and baby weekly if you decline induction. But you would need to discuss this with your consultant first to determine any risks.

Makes no sense, why make a birth riskier than it needs to be with an induction?

If it's all about getting the baby out on a certain date with maximum predictability then they would suggest a C-section. Which you could ask for.

Just labour naturally if you want to and you could accept sweeps and maybe the first stage induction methods like the balloon or pessary when you get to 40w, but decline the drip.

As pp said it is possible to have a positive induction (usually when overdue and body is ready anyway) but there's no way round the fact that it often brings added complications.

Hello, I am 39 weeks and IVF pregnancy. I was told by one consultant that I should be induced at 40 weeks latest because IVF. Then another consultant said no, on its own IVF is not a reason to induce early (and this matches the current NICE guidelines). I am now due to be induced at 39+5 due to a very late diagnosis of gestational diabetes.

I've heard that from some but personally I had IVF and after being discharged from clinic to maternity I was treated as any other pregnant lady - would have been offered a sweep at 40 if requested or 41 and 42 as routine however I went in to labour on 40 exactly she came 40+1 early hours

The consultant didn’t really fully explain but said that from 39 weeks there was no longer a benefit for keeping baby in.

I know that there is evidence that says ivf babies are more likely to have stillbirth but the studies on this don’t measure the age of gestation this has happened. So there isn’t evidence that says that if an ivf baby goes beyond 39 weeks their stillbirth risk goes up. It just shows that more ivf babies die from 24 weeks gestation than babies conceived in the normal way so induction potentially would make no difference.

Apparently the NICE guidelines have been updated to say that induction should be offered from 39 weeks for ivf babies but again when I read it, it says there is no evidence so doctors have made an informed decision that this is t be right course of action.

Thanks everyone so much for your responses, it’s good to hear your experiences. @SprinkleRainbow how do they monitor your placenta once you go past 40 weeks?

@oliveandwell i think that’s what I might do, say that I will accept sweeps from 40 weeks to try and move things along but I want to stay away from the drip.

At my antenatal class they said that induction will only work if your baby is already on the route to being born anyway so it just all feels like added stress for nothing if she would’ve come in her own time anyway!

They can do monitoring of baby's heart rate and movements and do a placenta follow scan to keep an eye on the placental functionality.
Within safe reason I would explore what options you do have. A sweep is a form of induction, and non hormonal.
I would opt for as little hormonal interference unless it's medically necessary.

An induction if baby isn't favourable is a long process a lot of the time. On the other hand it can be a simple intervention that gets baby going.
You are always able to question why they want to do something even when in labour, your able to request that they adjust or change your treatment if you feel there's need to and your mostly able to say no if you dont feel its needed *examinations for example. They use a blanket process for certain risks, but they can work with you as long as baby and you are safe.

I recently gave birth to my baby boy it was an ivf pregnancy and I was also advised to be induced at 39 weeks. As they believe an ivf placenta ages quicker than a natural.
The Dr did however say there's no real evidence of this but it's their precautions.

I had a sweep at 38 weeks and lost my mucus plug a few days later. Still the labour didn't start and I Was induced a week later.

The induction was at 10.30 and by 1.30 I was having horrific contractions. By 4pm they were every 2 mins and I was in agony. When I got to the hospital I was only 1cm dilated! The stress my body was under caused the baby distress his heart rate dropped, i had mec in my waters and I had to have an emergency section.

I asked the drs in theatre after if there was a reason I was contracting so badly and they said it can happen when your body isn't ready for labour.

The section and recovery was 100 times better than the induction and I really wish I hadn't done it and just gone for an elective.

I know everyone's different but I do think they should do their research into this early induction thing before advising to go ahead. Xxxx

I had IVF and was induced at 38 weeks as they said baby was big. I wish I had said no, but it was my first (and only) pregnancy and I was just desperate to have my baby. It wasn't a fun experience and ended in an emergency c-section. If I had my time again, I would refuse.

I went in for an induction at 41 weeks but decided not to have it (and went into labour naturally that night and had a dream birth). Most of the induction stories I've heard ended in a c section and sounded pretty rough, so I wasn't keen. Anyway, my midwife said you can book one in to keep everyone happy, go in and get monitored, and then go home again. Don't get pressured into something you don't want!

Thank you so much for sharing your experiences. @Scarlett868 and @Ginger1982 that sounds really hard and is exactly what I’m worried about happening. I hope you and your babies are all good now. Thank you for your advice. I’m thinking of saying that I will hold out to 40 weeks then will have sweeps and additional monitoring and if there is any sign the baby is in any trouble I would want a c section rather than induction.

Iv not had an IVF pregnancy but Iv had 2 inductions at 37weeks due to IUGR and they were both very quick. 2 hour active labour and 1 hour active labour.

You don't need to be induced solely because it's an IVF pregnancy. Some trusts still follow old guidance/evidence - no idea why as it is not necessary. Speak with your treating team and come to an agreed plan but do not feel you have to be induced if that was the only reason given, many trusts don't apply that guidance any more. I went into labour naturally at 40+5 post-sweep with an IVF pregnancy. My treating team didn't bat an eyelid and no alterations to usual protocol for non-IVF pregnancies were mentioned throughout my pregnancy.

@Ambn1 thank you. My baby boy is absolutely perfect! 5 weeks old today :)

Defo chat to your consultant and wishing you lots of luck xxxx

Thank you! My son is now 6 so this happened a while ago now but I still think about it! Good luck! Xx

Hey @Ambn1 i hope you and your baby are doing well. Would you mind sharing your decision/what happened in the end?

Hi @Justrelax2022 I ended up having to have an induction because a growth scan showed the baby wasn’t growing as much as she should have been. I had a membrane sweep, then two days later went in for the proper induction. I had three pessaries over the course of two days before having my waters broken. While the pessaries were doing their work I was having some contractions but nothing major. I could still walk around and stuff. When I had my waters broken I was only just a cm dilated so it was quite painful but I had lots of gas and air which helped. I did go into labour after this but it didn’t progress enough in the first six hours and I ended up on the syntocin drip. They did give me the option to have an epidural before the drip so I did that as I’d heard it is really painful.

My epidural didn’t fully work so I could still feel a lot down one side but when it was working it was great! And I thought I would find them putting the epidural in difficult but that was fine as well and I’m a big needle phobic!

She was born the next day at 3.20 in the afternoon so about 10ish hours of proper labour. I ended up needing an episiotomy and lost quite a bit of blood. The baby has meconium in the water and the cord around her neck and needed a little bit of time in special care with oxygen but was back with me quite quickly.

The experience was quite traumatic and I don’t know if I did it again if I would have chosen to have a c section instead. But then again I have friends who have had a much tougher recovery after when they’ve had a c section so it’s difficult to say what is the best option.

On the positive side I have a lovely little girl now and the memory of it all is starting to blur a little bit now!