Infertility Treatments Linked to Poor Birth Outcomes
Conceiving with the help of infertility treatments can double the risk of adverse birth outcomes including stillbirth, low birth weight, preterm birth and neonatal death, a new study says. The study, published in the journal PLOS ONE, looked at more than 300,000 births in South Australia. Researchers from the University of Adelaide identified 4,300 cases conceived with the help of different types of artificial methods currently available to help people who experience difficulties to conceive naturally, including in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), ovulation induction and cryopreservation of embryos.
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Results showed that babies conceived with the help of fertility techniques were at a greater risk of being born dead, born early before the due date, weigh low at birth and die within the first 28 days of birth, compared to babies conceived naturally. Severity of the outcome varied with the type of treatment the women underwent to become pregnant. Interestingly, using frozen embryos was found safer while undergoing the intracytoplasmic sperm injection (ICSI) method, as it helped avoid the severe complications while using fresher ones. The severe birth outcomes associated with the treatments may be actually caused by the infertility itself than the assisted methods used to conceive, lead study leader Professor Michael Davies, said.
"Women in this group who eventually conceived without the help of invasive assisted reproduction gave birth to babies who were nine times more likely to have very low birth weight, seven times more likely to be very preterm, and almost seven times more likely to die within the first 28 days of birth," Professor Davies said in a news release.
"This may be due to the underlying medical conditions related to their infertility, or the use of fertility medications or therapies that are not recorded."The findings come at a time when infertility has become a major problem among Indian couples, including the young generation. Safety of using different techniques to conceive has long been a hot topic of discussion around the world. Several studies in the past have linked infertility treatments to breast cancer, blood clots, skin cancer melanoma in women; birth defects, asthma and cancer in children.
By Roshni Mahesh | January 9, 2014 2:31 PM IST
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Shop Now →Does the FDA regulate infertility treatments like IVF and ICSI?
Yes, the FDA regulates fertility clinics and assisted reproductive technology (ART) procedures in the United States. However, the American Society for Reproductive Medicine (ASRM) notes that regulation focuses primarily on laboratory practices and equipment safety rather than clinical outcomes. All fertility clinics performing ART must report their success rates and safety data to the CDC's National ART Surveillance System.
Why do frozen embryos appear safer than fresh embryos according to this study?
The study found that using cryopreserved (frozen) embryos resulted in fewer severe complications compared to fresh embryos, particularly with ICSI procedures. This may be because frozen embryo transfer allows the uterus more time to recover from ovarian stimulation, or because the selection process for freezing viable embryos creates a healthier population of embryos for transfer.
Is the increased risk from IVF treatment itself or from underlying infertility conditions?
According to the study's lead researcher, the elevated risks may primarily stem from underlying medical conditions causing infertility rather than the assisted reproduction techniques themselves. Women with fertility challenges who conceived naturally without treatment showed similarly high rates of adverse outcomes, suggesting the infertility diagnosis—not the treatment—may be the primary risk factor.
What does ASRM say about the safety of fertility treatments in the US?
The American Society for Reproductive Medicine continues to support ART as a safe and effective treatment option, noting that serious complications from IVF are rare. ASRM recommends that fertility clinics maintain transparent reporting of outcomes and that patients discuss individual risk factors with their reproductive endocrinologist before beginning treatment.
Will my insurance cover infertility treatments if there are health risks?
Insurance coverage for fertility treatments varies significantly by state and individual plan; only 20 states currently mandate some level of fertility coverage. The decision to cover treatments is typically based on medical necessity rather than reported risks, but you should discuss potential complications and your personal risk profile with both your fertility specialist and insurance provider before proceeding.
Should I be concerned about birth outcomes if I'm considering IVF?
While this study identifies an increased statistical risk, it's important to discuss your individual circumstances with a reproductive endocrinologist who can assess your specific medical history and infertility diagnosis. Many successful IVF pregnancies result in healthy births, and your doctor can help you understand whether the benefits of treatment outweigh the risks based on your personal situation.
Are there lifestyle changes I can make to reduce adverse birth outcome risks with fertility treatment?
Yes, maintaining healthy habits before and during fertility treatment—including prenatal vitamins with folic acid, avoiding smoking and alcohol, managing stress, and maintaining a healthy weight—can support better pregnancy outcomes. Your fertility clinic may also recommend preconception counseling or additional monitoring based on your health history to optimize your chances of a healthy pregnancy.
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