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IVF Is Safer than Any Other Medical Treatment
a blog by CHR, June 7, 2012
You may have seen the media hype over an Australian study that supposedly showed that “common fertility treatments (like IVF) raise the risk of birth defects.” Although headlines of this type appear to dominate the reports on the Australian study, if you read the study itself, what the researchers found is exactly the opposite: Fertility treatments do NOT raise birth defect risk. Babies born after fertility treatments do have a slightly higher rate of birth defects, but it is because of the underlying medical issues involved in the parents’ infertility, NOT due to fertility treatments themselves.
It is rather disappointing to note how little has changed in more than 30 years in how the media present the technique of in vitro fertilization (IVF) to the public. When the first IVF baby was born in the UK in May of 1979, some media predicted an epidemic of “monsters.” Ever since, no opportunity has been lost to exaggerate the negative and to ignore the positive of IVF treatment.
With publication of a new study in the May 5, 2012, issue of the New England Journal of Medicine, the pattern continues. In this paper, researchers from Australia, in an effort to offer a long-term outcome control study, did what every drug and medical device manufacturer should do for their medical products (and, unfortunately, only rarely does!): they followed up on the outcome of babies born after IVF treatment. Since the inception of IVF, professionals in this field all over the world have been doing this routinely in innumerable studies, small and big, and have found ABSOLUTELY NO SIGNIFICANT INCREASES IN ABNORMALITIES attributable to IVF procedures!
In contrast to how this study was, unfortunately, once again presented in the media, this Australian study, in essence, reconfirmed this age-old finding. There is absolutely nothing in this study that was not known before, based on many such follow-up studies performed on different patient populations (such divergence is important because medical consequences can differ in different populations) all over the world.
It has been known for many years that children born after any form of infertility treatment will demonstrate a small increase in birth defects. However, as the authors of this Australian study also noted in their comments, this increase has repeatedly been shown NOT to be the consequence of IVF itself, but overwhelmingly due to the fact that infertile women and men have underlying medical conditions, which, once they are overcome by IVF, converting an infertile couple into a fertile one, will increase certain parental birth defect risks for the offspring. Probably quantitatively the most significant is the association of an increased risk of urogenital birth defects, mainly in male offspring, after intracytoplasmic sperm injection (ICSI) to overcome severe male infertility.
Some infertility clinics have developed informed consent procedure to inform IVF patients of the risks. Some clinics have also produced publications that (Gleicher N. Modern obstetrical and infertility care may increase the prevalence of disease: an evolutionary concept. Fertil Steril 2003; 79:249-52) repeatedly point out that this principle about “increased risks” to offspring also applies to many medical diseases.
For example, diabetic women until only a few decades ago almost never had children because uncontrolled diabetes usually resulted in infertility or, if women did conceive, resulted in miscarriages. With the advent of insulin therapy, this started to change, and over the last two to three decades the chance of fertility of a diabetic woman is basically the same as that of a non-diabetic female. But the risk of the child of a diabetic woman to become diabetic is, of course, much higher! Moreover, the poorer a diabetic woman’s blood sugar is controlled during the first few weeks of her pregnancy, the higher her risk for birth defects.
The same applies to women with autoimmune diseases and practically all other medical diseases (Gleicher et al., The impact of abnormal autoimmune function on reproduction: maternal and fetal consequences. J Autoimmun 2006;27:161-5).
In an evolutionary sense, infertility can, in many ways, be viewed as nature’s way to prevent inheritance of genetic risks into the next generation. By overcoming infertility, we overcome this nature’s block, and, inadvertently increase certain risks of diseases (and birth defects) for the next generation. Fortunately, these increases in risk are relatively small, because, while genetic in nature, these diseases and defects are usually multifactorial and not related to just one gene. Such multifactorial risks are assumed to be the consequence of multigenetic combinations, in association with environmental factors, and usually hover in the single digit range.
We hope that all of these examples point out the media presentation of this most recent IVF paper was, once again, sensationalism at its best. The study, once more, confirmed what now has been known for many years: IVF, in itself, with absolutely minimal exceptions, does not increase risks for birth defects. Having said this, IVF, of course, indirectly, does increase risks to offspring because IVF allows infertile women (and their male partners) with genetic predispositions toward certain risks to become genetic parents, and that automatically means increased risks for their offspring.
After over 4 million IVF births worldwide, we, however, can state with a high level of confidence that IVF is, likely, much safer a treatment than most other major medical treatments administered, about which you never hear in the media. One wonders why!