Women navigating infertility deserve clear information about their treatment options, including blood clot risk. Most women undergoing IVF will not develop a blood clot. Risk varies with the treatment approach, personal health history, ovarian response, and pregnancy.
When risk may change
IVF often begins with medications that stimulate the ovaries to develop eggs. This can raise estrogen levels, which may affect clotting risk.
Some women develop ovarian hyperstimulation syndrome (OHSS), an excessive response to ovarian stimulation. The ovaries enlarge, and fluid can leak out of blood vessels into the abdomen. More severe OHSS can make blood more likely to clot. Fertility specialists can adjust treatment strategies to reduce the likelihood of OHSS.
Pregnancy brings its own changes in clotting risk. Research has found increased risk during early pregnancy after IVF, particularly following fresh embryo transfer. A large observational study did not find the same first-trimester increase after frozen embryo transfer. These findings support discussing the specific treatment plan rather than assuming every IVF cycle carries the same risk.
Care should reflect your history
Before treatment, tell your fertility care team about any previous blood clot, family history of clots, known clotting disorder, or current medications. Previous OHSS and other health conditions may also affect planning. Your team may recommend coordination with a hematologist when your history warrants it.
Useful questions to discuss with your healthcare provider include:
- How does my health history affect my risk?
- What steps will you take to reduce the likelihood of OHSS?
- Would I need additional monitoring or clot prevention during treatment or pregnancy?
- Which symptoms should I report, and whom should I contact after hours?
Blood-thinning medication is not routinely recommended for everyone undergoing fertility treatment. It may be appropriate in specific circumstances, including severe OHSS, following an individualized assessment.
Recognize symptoms and seek care
Contact your fertility team promptly for worsening abdominal swelling or pain, persistent vomiting, or reduced urination. These can signal OHSS or another complication requiring assessment.
Seek prompt medical care for new, unexplained swelling, pain, warmth, or discoloration in an arm or leg. These may indicate that a blood clot has developed in the deep veins of your arm or leg.
Call 911 or seek emergency care for sudden or unexplained shortness of breath, chest pain, coughing up blood, or fainting. These may indicate that you have a blood clot in your lung.
Learn more about blood clots here.
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