Side effects and complications in IVF (test tube baby procedure) are usually mild, but they can be troublesome if you are not aware of them. The side effects vary significantly between women and mainly depend on the type of hormones used to stimulate/trigger during stimulation cycle and on the individual patient. In rare situations, they may even be life-threatening. Hence, understanding the possible side effects will help the couple cope better and seek medical help as earlier as possible. Possible side effects of injectable fertility medicines include: Mild bruising and soreness at the injection site Skin reddening/ itching at the injection site Nausea and occasionally vomiting Breast tenderness and increased vaginal discharge Mood swings and fatigue Ovarian hyperstimulation syndrome (OHSS) Most of these sides effects except OHSS are usually mild. Within a few days after the egg collection, they often subside without treatment. Changing the site of injection frequently may help in reducing injection site skin reactions. OHSS occurs when your ovaries over-respond to fertility injections. When a large number of follicles are produced ovaries will enlarge and release chemicals into your bloodstream that make blood vessels leak fluid into the body. OHSS is classified as mild, moderate or severe. Mild cases of OHSS are usually managed on an out-patient basis without any life-threatening complications. Severe OHSS present with enlarged ovaries, dehydration, trouble breathing and severe abdominal pain. Very rarely (<1% of patients) women with severe OHSS can have coagulation failure & kidney failure. Hence, severe OHSS patient’s need to be admitted in ICU and managed carefully. Some of the other risks associated with IVF is surgical injuries, higher chances of miscarriage, ectopic pregnancy, multiple pregnancies, pre-term deliveries, and increased psychological burden. With the advent of the latest treatment protocols like antagonist protocol, freezing all embryos in the stimulated cycle, frozen embryo transfers it is possible to reduce the chances of OHSS to a larger extent. Good clinical expertise, well-equipped fertility center will help reduce complications like surgical injuries, ectopic pregnancy. Use of embryo selection technique like PGS (preimplantation genetic screening) will reduce the incidence of miscarriage. Good embryo grading & proper planning on the number of embryo’s to be transferred will reduce the chances of multiple pregnancies and eventually pre-term deliveries.