IVF Doubles The Risk of Birth Defects

The risk of major birth defects in babies conceived using IVF is nearly double compared with those conceived naturally, a world-first study by Australian researchers has found.

Groundbreaking Adelaide University research has shown that the risk for couples using IVF is 7.2 per cent, compared with a 5.8 per cent risk for babies conceived naturally.

But when sperm is injected into an egg – a procedure called Intracytoplasmic Sperm Injection (ICSI) used to overcome male infertility – there is a 9.9 per cent risk of birth defects.

The study used records on nearly 303,000 babies conceived naturally and 6,163 conceived by IVF in Australia from 1986 through 2002, plus records on birth defects detected by age 5.

Researchers counted heart, spinal or urinary tract defects, limb abnormalities and problems such as cleft palate or lip, but not minor defects unless they needed treatment or were disfiguring.

Another study recently published in the Fertility and Sterility by the Nanjing Medical University in China found that this technique increased the risk of birth defects by 37%.

But what experts don’t know yet is whether the problems are caused by the treatment, or the fact couples having it are at higher risk of defects anyway.

One theory is that it’s possible people who have trouble conceiving naturally and try fertility treatments may somehow be at increased risk for having children with birth defects anyway.

Another school of thought is that rough handling of the embryos during the actual process of fertilisation, or the drugs involved in fertility treatments – or both – may be at fault.


What is ICSI?

Intracytoplasmic Sperm Injection (ICSI) was developed to treat male infertility.

It involves injecting a sperm directly into an egg with a fine glass needle.

It can help couples who were previously unable to conceive because the man’s sperm count was low or they were of too poor quality to swim up to the egg.

But more often than not, it is not done for that reason but to improve the odds that at least some embryos will be created from an IVF attempt – many clinics do it in all cases.

It could be that the extra jostling of egg and sperm does damage. Or that other problems lurk in the genes of sperm so defective they must be forced to fertilise an egg.


Clomiphene Warning

Another major finding in the Australian study was the discovery of a tripling of the risk in women using a widely available low-cost fertility treatment – the steroid clomiphene citrate – to stimulate ovulation at home, without the supervision of a clinic.

The results found that when this steroid is used while pregnant (mostly in the first few weeks of pregnancy), foetal malformations may be caused.

Clomiphene, marketed as Clomid, is used to trigger Follicle Stimulating Hormone (FSH) to start the ovulation process resulting in an 20-25% increase in fertility.

Clomiphene is also used as an alternative to testosterone replacement therapy in men and is often used by body builders to increase muscle development.


Does IVF Alter Genes?

Currently the genetic implications of IVF treatments are unknown and under researched.

It poses the question: does growing an embryo in a petri dish for several days cause subtle changes in gene expression?

One place to look might be the broth, known as the culture medium, in which embryos grow.

The broth affects how quickly embryos grow and embryos grow much more slowly in the lab than they do in the body.

One thing the culture medium provides is chemicals that can be used to add methyl groups to genes.

The presence, or absence, of the methyl groups can control whether genes are active or not, a process known as epigenetics.

Epigenetic changes not only cause rare disorders like Beckwith-Wiedemann syndrome but also are associated with low-birth-weight babies and an increased risk of a variety of cancers.

This does not mean that growing embryos in petri dishes will have such effects, but it does raise questions about how much we do not know about this procedure.


Emed Comment

Assisted reproductive technology is sometimes the only viable option for infertile couples.

Worldwide, more than 3.7 million babies are born annually as a result of assisted reproductive technology, such as IVF, ICSI and ovulation induction.

Fertility treatments are a multi million dollar business and this is some much needed research in the field of infertility and fertility treatments.

The big question from this research is – are the abnormalities caused by the method of fertilising the embryo or is the already damaged sperm predisposed to producing children with birth defects?

Further research needs to be conducted in this area so we can fully understand the health implications of this fertility method.


Final Word

Taking all this into account it seems fair to say that IVF should only be used once other options have been exhausted.

Couples with fertility issues should be aware of the side effects of IVF and leave it as the last option, after they have optimised their natural fertility which will only make them healthier in the long run and improve their odds of conception.

Talk to an Emed Practitioner today about a tailored natural fertility program.


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