The Health of Children following Assisted Reproductive Treatment

The University of Adelaide's study Reproductive Technologies and the Risk of Birth Defects was presented over the weekend in Barcelona, Spain at the World Congress on Building Consensus in Gynecology, Infertility and Perinatology.

The study explored the question of whether the small increase in the risk of health problems for children born following ART is due to treatment or whether it is due to the inherent problem that has led to the couple being unable to conceive naturally due to unhealthy eggs, sperm or embryos.  

The paper confirms the previously widely reported association between babies being conceived through assisted reproductive technologies (ART) having a slightly higher chance of congenital anomalies.

The big question underlying the association between assisted reproduction and congenital anomalies is whether this is due to the laboratory process itself, or whether it’s a reflection of the fact that people who have to use ART to have their family already have pre-existing damage to their eggs and sperm that puts them at higher risk of having children with congenital anomalies.

Professor Davis’ findings suggest the latter explanation. He has, for the first time, looked at all children within a family comparing those conceived naturally with those conceived via some form of ART with parents who had trouble conceiving.

The significant finding is that children born from parents who have had trouble conceiving show a very similar risk of health problems in their early years whether they were conceived naturally or via ART.

The other interesting feature about Prof Davies’ results is the fact that, when he separates the two types of ART into IVF and to ICSI, his findings are that IVF children do not have a higher risk of congenital anomalies and that the risk is limited to children who have been conceived using ICSI. This is contrary to other findings in large studies in Europe.

The explanation for this is not at all clear. It may well be that the sort of families who have to use ICSI have extreme sperm damage, and this may be the explanation as to why there is a higher rate of congenital anomalies in this group.

The news in this paper is more good than bad for IVF patients in that it suggests IVF DOES NOT INCREASE abnormality rates but that the infertile population as a group do have a small increased risk of having an abnormality in a baby no matter how they become pregnant.

Patients should also remember that not all abnormalities are severe and many can be treated resulting in a child with normal activity and educational expectations and levels.

Dr David Molloy, Clinical Director Queensland Fertility Group

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