Risks During And After Pregnancy With Assisted Reproduction

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Main Category: Fertility
Also Included In: Pregnancy / Obstetrics;  Pediatrics / Children's Health;  Endocrinology
Article Date: 27 Jul 2007 - 1:00 PDT

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In comparison to natural conception, the risks of complications during and post-pregnancy through ART (assisted reproduction techniques) are significantly higher. It is essential that long-term follow-up of children born through ART take place, says an article in this week's edition of The Lancet .

Dr Alastair Sutcliffe, Institute of Child Health, University College London, UK and Dr Michael Ludwig, Endokrinologikum, Hamburg, Germany, examined data that had been published between 19080-2005 on IVF and intracytoplasmic sperm injection - they used 3,980 articles to compile their analysis. They concentrated mostly on ART single births, as multiple births have their own set of problems.

"In-vitro fertilisation has been done for nearly 30 years; in developed countries at least 1% of births are from ARTs. These children now represent a substantial portion of the population but little is known about their health," the authors say.

The authors explain that several points should be taken into account when couples are counseled for fertility treatment. The main ART risk is that multiple births may occur. Nevertheless, there are a number of additional risks that come with ART.

Spontaneous abortions are 20-34% more probable among ART couples, compared to those who spontaneously conceived. There could be several reasons for this, among which is the age of the average ART couple - most of them are usually older. Other possible factors include endocrine disorders, organic abnormalities and the extent of ovarian stimulation.

A woman who becomes pregnant as a result of ART has a higher risk that the following occur, when compared to a woman who became pregnant naturally:

-- Pre-eclampsia - 55% higher risk
-- Still birth - 155% higher risk
-- Low birthweight - 70-77%higher risk
-- Very low birthweight - 170-200% higher risk
-- Small baby for gestational age - 40-60% higher risk

The risk of cerebral palsy in children born to ART couples is also higher, mainly because of the elevated risk of premature birth.

"Some of the risks to children born after ART do not arise as a result of the techniques but from the background biology of the subfertile couple… many unknowns exist about the health of children conceived after ART as they grow, which remain to be fully addressed. Long term follow-up of children born after ART to reproductive age and beyond is necessary," the authors concluded.

http://www.thelancet.com

Written by: Christian Nordqvist
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