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Assisted reproduction associated with elevated risk of birth defects

23 November 2008
Appeared in BioNews 485

A study published last week in the journal Human Reproduction found an elevated risk of birth defects amongst babies conceived through assisted reproductive techniques, including IVF. The research, headed by Dr Jennita Reefhuis of the US Centre for Disease Control and Prevention, used data from the National Birth Defects Prevention Study to compare the health of babies born to women who had used the techniques with infants born to women who had conceived naturally.

Dr Reefhuis and colleagues found that babies conceived using assisted reproductive techniques are between two and four times more likely to have certain birth defects than those who were conceived naturally. They are twice as likely to be born with a cleft lip, four times as likely to have abnormalities of the oesophagus or rectum, and two to three times as likely to have cardiac defects. The researchers point out, however, that even with the increased risks birth defects are still uncommon in these babies.

All the births included in the study were single births, though multiple births are relatively common in assisted reproductive techniques. Multiple births in general are known to be at higher risk of birth defects, and this is one of the reasons that techniques such as IVF have previously been thought to be associated with a higher incidence of birth defects. This study also corrected for other factors such as the age of the mother, folic acid use and alcohol intake.

The researchers are explicit in their report that they do not know the cause of the elevated risks. 'Our findings could have been because of underlying infertility, small (sample) numbers or chance,' they said. Dr James Grifo, director of the fertility clinic at New York University Medical Center, US, agrees. He feels that due to the small sample size (281 assisted reproduction babies, 14,095 babies conceived naturally) more research is needed to confirm the findings. He also said that if the association with birth defects was real, the underlying cause was more likely related to the patients' infertility than to the treatments they had undergone.

'Any couple who is considering these treatments wants to be aware of all the pros and cons of the treatment,' Dr Reefhuis said, adding 'I think it's important for couples to be aware that there may be some increased risk for birth defects as well.' Professor Michael Chapman, a senior fertility specialist with IVF Australia, said 'There's no question that the evidence shows a slight increase, and responsible IVF doctors are saying that to their patients. But if your only way forward is IVF, then an increase in risk from one in 100 to two in 100 for most people is an acceptable risk.'

Assisted reproduction and the risk of birth defects
LA Times |  18 November 2008
Birth defect risk raised by in vitro fertilisation
Reuters |  17 November 2008
Birth defects tied to fertility techniques
The New York Times |  17 November 2008
Fertility treatment linked to rise in risk of defects
The Age |  19 November 2008
19 November 2012 - by Dr Nicola Davis 
Infants conceived by IVF are at significantly greater risk of birth defects compared to naturally conceived babies, announced scientists at a conference last month...
26 May 2009 - by Ben Jones 
Two studies have provided an insight into the health implications of using assisted reproductive technologies (ARTs). The first finds that twins conceived by ART are more likely to be born preterm, be of low birthweight and to be 60 per cent more likely to be admitted into...
23 March 2009 - by Ailsa Stevens 
The UK's Human Fertilisation and Embryology Authority (HFEA), the government's fertility watchdog, is updating its guidelines to recommend that doctors make couples aware of the potential risks to children conceived by IVF. The decision follows the publication of a study by the Centers for Disease Control and...
23 February 2009 - by Sarah Pritchard 
A large study has investigated the potential genetic risks to children conceived by in vitro fertilisation (IVF). It confirms earlier research indicating that babies born following assisted conception have a small increased risk of certain genetic health problems. The New York Times reports that in November last...
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