IVF births more troubled: study

By JEREMY LAURANCE

Doctors have found that IVF babies face a more troubled birth than those conceived naturally.

Babies born to women following fertility treatment are twice as likely to be premature and three times more likely to be very small, with a birthweight below 1500 grams, are more likely to be born by caesarean section, to need care in the intensive care unit and have a 68 per cent greater risk of being stillborn or dying in the first week of life (up from eight to 12.4 deaths per 1000 pregnancies).

Treatment is known to increase the risks of a multiple pregnancy which results in problems at birth because of the extra burden of sustaining two babies in the womb and delivering them.

The new research is the first to show that women carrying single babies conceived with the help of fertility treatment are also at greater risk at birth.

Authors, from the Leiden University Medical Centre in the Netherlands, reviewed 25 studies which compared the outcome of pregnancies following fertility treatment and natural conception published over the past two decades.

In addition to the higher risks for single babies, they found twins conceived through fertility treatment were more likely to be admitted to intensive care, and had higher rates of premature birth, caesarean delivery and low birthweight.

The differences were much less marked than between the groups of single babies, and death rates among twins conceived with fertility treatment were lower.

Authors, whose findings are published online by the British Medical Journal (www.bmj.com), say that 25 years after the birth of the world's first test-tube baby challenges remain. Research has focused on successful conception, but the focus should switch to achieving a successful birth, they say.

Patients have regarded twins or even triplets as a success. But the time may have arrived when it is appropriate to consider any multiple pregnancy "a failure of that technology to achieve what it set out to achieve".

Those having fertility treatment should be made more aware of the risks to the babies at birth and more work should be done on reducing the risks, the report says.

The single biggest risk was from multiple pregnancies, which the Human Fertilisation and Embryology Authority in Britain has curbed by limiting the maximum number of embryos that may be transferred into the womb to two in women under 40.

Areas of concern include the growing use of frozen embryos and eggs and the practice of injecting a single sperm directly into an egg known as ICSI (Intra Cytoplasmic Sperm Injection).

Lord Winston, the IVF pioneer of Hammersmith Hospital, West London, said that not enough research had been done on many of the new technologies introduced into IVF clinics.

"I am not arguing that IVF is dangerous. What I am arguing is that there isn't actually any form of properly informed consent ... " he told the British Association for the Advancement of Science last September.

There are no reasons to believe that children born as a result of fertility treatment suffer worse health, but many specialists feel that the field has been allowed to grow unchecked while its long-term effects remain unknown.

- INDEPENDENT