In the Netflix show Kohraa 2, actor Mona Singh's character Dhanwant Kaur is shown dealing with nausea during fertility treatment preparation for IVF. Renowned fertility expert Dr Anjali Malpani explains that modern techniques have made the IVF process safer and less painful. She details side effects from hormone injections to egg retrieval.
In the Netflix show Kohraa 2, actor Mona Singh's character Dhanwant Kaur excuses herself mid-conversation due to nausea from fertility treatment as she prepares for in-vitro fertilisation (IVF), an assisted reproductive procedure where a woman's egg and a man's sperm are fertilised in a laboratory dish to form an embryo. Celebrities such as Jennifer Aniston and Farah Khan have described IVF as a painful and difficult experience, now increasingly discussed publicly.
"It’s important to know that IVF is a safe procedure and modern technology means that the pain threshold has gone down substantially. What you need is a good clinic that has expertise to deal with the procedure with minimal discomfort," says Dr Anjali Malpani, Emeritus Professor of Gynaecology and Obstetrics at KEM Hospital, Mumbai.
Women undergo hormone-stimulating injections for 8–12 days before egg retrieval to prompt ovaries to produce multiple mature eggs in one cycle, rather than the usual single egg. Side effects include minor pinching, bruising at the injection site, bloating, and mood swings. Previously, progesterone injections were intramuscular, but now they are administered via vaginal suppositories, causing no pain and better absorption.
Recombinant follicle stimulating hormone injections, used to stimulate egg production, are subcutaneous and delivered through pre-loaded pen devices with fine needles, similar to insulin pens, resulting in minimal pain.
Egg retrieval involves a minor surgical procedure under sedation or light anaesthesia, with a slight risk of bleeding, infection, or damage to the bowel, bladder, or blood vessels. Some cramping follows the procedure. Embryo transfer uses a catheter and typically causes little to no pain, though light cramping may occur for some.
Complications can arise from fertility drugs overstimulating the ovaries, leading to swelling, abdominal pain, bloating, and nausea. In severe cases of ovarian hyperstimulation syndrome (OHSS), when more than 20 eggs are produced, symptoms include vomiting, diarrhoea, and shortness of breath. Mild cases require only bed rest at home, while rare severe instances need hospitalization to drain fluid. With proper monitoring, hyperstimulation can be prevented.
To manage discomfort, specialists emphasize correct techniques to minimize issues from the start. Over-the-counter pain relievers help with post-procedure cramping. Medications can reduce ovary size and egg numbers, and patients should drink at least three to four litres of water daily. In complicated cycles, eggs can be collected and embryos frozen for transfer in a future cycle.
