You might think that pregnancy advice would be the same for every woman, regardless of how her baby was conceived. But an international study shows that parents who conceive through assisted reproductive technologies may be given different advice than those who conceive naturally.
Parents who undergo assisted reproductive technologies (ART) are exposed to the same pregnancy risks as those who spontaneously conceive, but a study, published in the Oxford Journal, Human Reproduction, suggests that clinicians may manage them differently.
The study points out that mothers of ART babies may be older and are more likely to deliver their infants by cesarean and explains that the term "precious baby" was coined to refer to such pregnancies.
Dr. Yaniv Hanoch, associate professor of psychology at Plymouth University in the UK, says:
"Some pregnancies are deemed by parents to be more valuable than others, particularly if conception has taken several courses of assisted reproductive treatment to achieve. But you might expect clinical recommendations regarding pregnancies to remain consistent, particularly when it comes to tests for serious medical conditions."
"However," he adds, "this study demonstrates there may be a tendency for clinicians to be affected by the nature of the pregnancy before determining the parents' wishes."
Helping parents conceiveThe Centers for Disease Control and Prevention (CDC) shows that the use of ART has doubled in the past decade, saying that over 1% of all babies born in the US each year are conceived using the technology.
The CDC's 2011 ART Fertility Clinic Success Rates Report states that ART pregnancies resulted in 47,818 live births (deliveries of one or more living babies), giving a total of 61,610 live born infants.
But ART is not an infallible treatment. Even if pregnancy is achieved, many women do not go on to deliver a baby. The American Pregnancy Association explains that the live birth rates for each cycle of ART in the US are:
- 30-35% for women under 35
- 25% for women aged 35 to 37
- 15-20% for women aged 38 to 40
- 6-10% for women over 40.
However, continued research looks promising - as Medical News Today reported earlier this year, endometrial scratching may increase success rates.
Avoiding invasive tests
A longed-for baby may seem even more 'precious' to parents and doctors if the pregnancy was achieved through ART.
To understand whether health care professionals manage ART pregnancies differently, researchers from Israel and the UK presented 163 obstetricians and gynecologists with a questionnaire based on a hypothetical case - a 37-year-old pregnant woman.
The National Down Syndrome Society says that babies born to women aged 35 and over have a higher risk of Down syndrome - a chromosomal condition that affects 400,000 people in the US. They estimate that 1 in every 691 babies are born with the condition.
Unfortunately, this test carries a small risk of miscarriage - the Mayo Clinic estimates between 1 in 300 and 1 in 500 if the test is carried out in the second trimester.
The study found that when physicians were aware of how a baby was conceived, they showed more reluctance to recommend the test. And even though most agreed the risks of amniocentesis are negligible, only 19.2% of clinicians recommended the test, compared with 43.5% when the pregnancy was spontaneous.
The researchers note that even physicians are not immune to the "precious baby" syndrome:
"When considering a procedure that may endanger a pregnancy, the value ascribed to loss of that pregnancy may seem greater if the pregnancy was achieved by tremendous effort, thereby swaying the decision toward avoiding the procedure so as not to incur even the smallest risk of endangering the pregnancy."