Fancy a cuppa? Humble cup of coffee may 'prevent IVF complication'

Researchers today suggested a life-threatening complication of fertility treatment could be prevented by a cup of coffee, after a study identified a possible cause.
In vitro fertilisation has resulted in the birth of many babies since the first 'test tube' baby in 1978.
But around 5 per cent to 10 per cent of women undergoing IVF experience a condition known as ovarian hyperstimulation syndrome (OHSS).
Although the majority of cases are mild, with symptoms including abdominal bloating, nausea and weight gain, in its most serious form it can cause blood clotting disorders, kidney damage and chest pain.
Scientists from Middlesex University and Barts and The London School of Medicine and Dentistry who analysed fluid around the human egg reported finding surprisingly high levels of the chemical adenosine.
They believe OHSS is caused when IVF drug stimulation creates high levels of adenosine, causing the blood vessels to dilate and blood fluid to leak into tissue.
The authors of the study, published in Metabolism Journal, wrote: 'Although adenosine has been detected in follicular fluid before, we were surprised at the extremely high levels detected in this study.'
They described the chemical as a 'significant contender as the molecular cause of OHSS'.
To detect adenosine in blood samples, the scientists used a technique called metabolomics, which involves the study of chemical evidence of cellular processes.
The researchers said a solution could lie in caffeine, which acts as a block to adenosine.
Ray Iles, professor of biomedical science at Middlesex University, said: 'It may be that a cup of strong coffee with every IVF cycle could reduce the chances of OHSS.
'Caffeine competes with adenosine for the same receptors, effectively blocking adenosine's action, and it could therefore potentially treat the cause of this condition.'
Further research is under way at Barts and The London Centre for Reproductive Medicine with IVF patients who have suffered OHSS to find out if caffeine could help avoid the complication

Risks Associated With Fertility Medications

The controlled "superovulation" techniques used in IVF are designed to stimulate the ovaries to produce several eggs (oocytes) rather than the usual single egg as in a natural cycle. Multiple eggs increase the potential availability of multiple embryos (fertilized eggs) for transfer and ultimately increase the probability of conception. The medications required to boost egg production may include, but are not limited to the following: Lupride/Gonapeptyl (gonadotropin releasing hormone-agonist), Antagon or Cetrotide (gonadotropin releasing hormone-antagonist), Menopur, Bravelle or Gonal-F (FSH, follicle stimulating hormone), GMH(combination of FSH and LH, luteinizing hormone), and Choragon or Ovidrel(hCG, human chorionic gonadotropin). Each is administered by injection only. Most medications are given subcutaneously (beneath the skin), though some are intramuscular injections (into the muscle). Risks associated with injectable fertility medications may include but are not limited to, tenderness, infection, hematoma, and swelling or bruising at the injection site. Risks associated with the medications may include, but are not limited to, allergic reactions, hyperstimulation of the ovaries (mild, moderate or severe), failure of the ovaries to respond and cancellation of the treatment cycle.

There are situations that can occur during a stimulation that may necessitate canceling your IVF cycle and stopping treatment for a period of time. This occurs because the ovaries produce either too many or too few eggs in response to drug stimulation protocol. Although we realize that this can be a big disappointment, at times it is necessary to discontinue the use of the medications to avoid the possibility of complications and to afford you the best chance of future success. If canceling the cycle becomes necessary, you will be told to stop your injections. No hCG injection will be given and no egg retrieval will occur. You will be asked to schedule an appointment with your physician to make decisions regarding future treatment cycles.

When ovulation induction medications are used in fertility therapy, the ovaries are coaxed to produce more than one egg to the point of maturity. Consequently, hormone levels of estrogen and progesterone reach much higher than normal values. When the estrogen level becomes mildly to moderately elevated, side effects that may be experienced include, but are not limited to, fluid retention with slight transient weight gain, nausea, diarrhea, pelvic discomfort due to enlarged cystic ovaries, breast tenderness, mood swings, headache and fatigue.

If the estrogen level rises excessively and hCG is administered to trigger final maturation of the eggs, the following more serious complications may result:

Excessive fluid retention with fluid in the abdomen and/or chest cavity;
Thrombosis of arteries and/or veins (formation of blood clots) which may lead to stroke, embolus, or potentially fatal complications;
Abnormally enlarged ovaries, which have the possibility of rupturing or twisting (a surgical emergency)
Any of the three problems listed above may require prolonged hospitalization.

Given the potential for such severe complications, it is important that we carefully monitor the response to these medications. This monitoring also allows your physician to determine when the eggs are ready for the next stage, oocyte (egg) retrieval. Monitoring includes frequent blood drawing for estradiol (estrogen) and possibly progesterone, LH and FSH levels. These blood tests will take place over approximately a twelve-day period. Risks associated with blood drawing may include, but are not limited to:

Pain at the site of needle stick
Tenderness or infection of the skin
Bruising or scarring of the site of blood draw
Development of a blood clot in the vein (thrombosis, thrombophlebitis)

The second portion of the monitoring phase in IVF involves the use of intravaginal ultrasound to track follicular growth. The eggs develop inside fluid-filled cysts of the ovaries called follicles, which enlarge as the eggs mature. Ultrasound studies usually begin after an estrogen response has been measured and continue on a frequent basis until oocyte (egg) retrieval. The ultrasound studies are performed using a vaginal probe. Vaginal sonograms carry no appreciable risk but may cause slight discomfort, particularly as you near the point of ovulation.