IVF and early induction at 40 weeks?

Yesterday I went to the hospital for the first membrane sweep. It failed. The consultant couldn’t reach my cervix, which is still long, closed and posterior. The baby also has not fully engaged. So all in all, the conclusion is that labour looks likely to be far off. The conditions are unfavourable as the consultant put it. At 38 weeks this is not really that surprising, but it does bring the prospect of medical induction to the forefront since the general practice at the hospital is to induce IVF pregnancies early at 40 weeks, i.e. on my due date the 17th August. They will attempt a sweep again on the 14th which is just 3 days before my due date, but with the way things are looking I have my doubts whether there is any chance that it will help trigger labour naturally. Consequently I’m also starting to doubt the planned medical induction at 40 weeks. This I wonder might pose greater risks than allowing the baby to go overdue. Especially if the next sweep attempt reveal that conditions are still unfavourable.

So I have been google searching like crazy to try to find evidence for why IVF pregnancies should be induced early at no later than 40 weeks. It seems to be common practice in a lot of hospitals in the UK going by forum posts and the like. Although there are also many examples of this not being the case. The advice women, who have gone through IVF, are being given is clearly very inconsistent. And the evidence for the risk of going over the due date is sketchy at best, as far as I can find out. The reasons given are usually similar to what we have also been told – namely that the risk of still birth is higher due to the placenta not functioning as well beyond 40 weeks in IVF pregnancies.

Based on the lack of evidence there seems to be good reason to question the plan of induction at 40 weeks if the cervix is still not showing signs of being ready. We have decided to wait and see whether we should postpone the induction date. Maybe things will start happening in the mean time. Move on downwards baby boy 🙂

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6 responses to “IVF and early induction at 40 weeks?

  1. Holding thumbs for you….I hope it all happens soon and on its own. I am sure you are ready to see this baby now! Hugs xx

  2. Fingers and thumbs crossed for you for everything to go well. And don’t let them pressure you into procedures you don’t feel comfortable with!
    Since I read about “induction at 40 weeks for IVF pregnancies” here and in other blogs, I asked the midwive teaching the birthing class I’m attending at the local university hospital regarding this practice. They have never heard about routine induction for IVF pregnancies at 40 weeks (or pregnancies with older birth moms close to 40) at any hospital here in Germany. The only reason she could think of for a greater risk of still birth is exactly what you found: the placenta not functioning well. But the risk for IVF pregnancies for that happening does not seem to be that much higher than the risk in the general population – especially so if there haven’t been any signs of “premature” placenta failure beforehand.
    In Germany, the procedure is as follows: starting with the due date, all over-due pregnancies are monitored closely for signs of placenta failure, with doctor’s appointments every 2 days. Induction is usually not done before 10 days or so overdue, unless there are complications (such as gestational diabetes) or signs of placenta failure.
    Maybe this helps…..

    • Thanks!! It’s good to hear about what the practice is in different places. I really wish that such close monitoring would be offered in the UK. What bothers me about this whole thing is precisely that they are not suggesting early induction based on specific evidence of problems in each individual case.
      Since I’m from Denmark, I have done some searching on the practice there as well and it also does not seem like they treat IVF pregnancies any differently there either. They have however changed the general practice of induction 14 days past the due date to 10 days past in order to reduce the risk of still births generally.

  3. Hope your little one gets moving so that you don’t have to make this decision! But I have heard of people asking to be better monitored past 40 weeks rather than induce to make sure baby is well and all is still functioning.

  4. My friend’s miracle IVF baby that she was finally pregnant with after 7 rounds of IVF was due last Friday. The doctors (she is in the U.K.) wanted her to wait a week past her due date to induce. She had pain last night, went to the hospital, and the baby had died in utero. They would have induced her tomorrow. All I know is 2 days ago, she would have had a healthy baby. I am in the U.S. and talked to my doctor about this today and she said in the U.S. IVF pregnancies are not allowed to go past 40 weeks due to higher risk. I myself had all my babies after IVF (singleton and twins, all of which came early), and knowing this information I would never let it go past my due date given the choice. Why take the chance? Sorry, if this sounds harsh but my heart is breaking right now.

    • I’m so so sorry to hear about your friend! You are absolutely right, there is no reason to take the chance. That is the conclusion we reached as well back then over a year ago and I was induced at 40 weeks exactly.
      Sending my deepest condolences to your friend!

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