Bleeding is fairly common after in vitro fertilization (IVF), just as it is during any pregnancy. Up to 30% of all pregnancies occur with some bleeding, and only about half of these women end up having a miscarriage. Bleeding after IVF may yield slightly higher numbers than this, partially because of all the vaginal exams performed during this time. There is a higher risk of miscarriage in some IVF mothers, with statistics for pregnancy loss after in vitro being between 20% and 40%, depending on various factors.
A large percentage of women who experience bleeding after in vitro will go on to have healthy, full-term babies. There are myriad reasons for vaginal bleeding during pregnancy. Vaginal or cervical exams in which a speculum is used may cause light spotting, especially during pregnancy when blood vessels are potentially swollen and hormones cause tissues to become more sensitive. Sometimes, bleeding is a good thing, as it could signal that the embryos are attaching to the uterine wall. This is known as implantation bleeding, and occurs because small blood vessels burst to make room for the tiny embryos to attach.
Another cause of bleeding after IVF is vaginal infection. Both yeast infections and bacterial infections, also called bacterial vaginosis, are very common in early pregnancy. They cause irritation inside the vagina and sometimes on the cervix itself, making bleeding more likely to occur. Spotting is most common after an internal exam, such as a trans-vaginal ultrasound, or after intercourse. Medications are generally effective at clearing up any infection.
Sometimes, vaginal bleeding during pregnancy has no known cause. Some speculate that it could be due to old blood being forced out of the body as the uterus grows and stretches to accommodate the growing baby, but it is not really certain. Most times, as long as the baby is growing normally, the placenta is firmly attached, and the cervix is closed, the pregnancy is not considered to be in danger.
Of course, in up to half of all cases, bleeding after IVF could signal an impending miscarriage. If bleeding is heavy, bright red in color, and/or accompanied by cramping or severe abdominal pain, medical attention is needed right away. Pain that occurs on only one side of the abdomen could be a sign of ectopic or tubal pregnancy, which is a medical emergency. Other signs of miscarriage include a sudden loss of pregnancy symptoms, passage of blood clots, or cessation of fetal movements once they become noticeable.
Tests for miscarriage include ultrasound, checking for fetal heart beat, and blood tests to check if pregnancy hormones are going up or down in quantity. If a miscarriage is diagnosed, there are generally three options mothers can choose from as next steps. They can wait and see if the miscarriage completes on its own, take medications to induce uterine contractions, or have the uterine contents surgically removed.
Many times, bleeding happens as the result of the embryos failing to attach to the uterine wall. This would result in a normal monthly menstrual period. In some places, up to 50% of all IVF treatments fail, although this number varies based on multiple factors.
With all statistics considered, up to 85% of all women may experience some spotting or bleeding after IVF. Most of these cases are due to failure of embryonic attachment, which would result in a normal menstrual period. The rest are miscarriages and normal bleeding during pregnancy. Those with physical uterine or cervical abnormalities may be more at risk for a failed IVF attempt or miscarriage, as are those with hormonal issues that have not been resolved.