IVF-related birth defects may originate with moms, not treatment
May 5th, 2012
06:01 AM ET

IVF-related birth defects may originate with moms, not treatment

Babies conceived through in vitro fertilization (IVF) have a higher risk of birth defects than those conceived naturally, but the increased risk may stem from the parents rather than the treatment itself, according to a study published today in the New England Journal of Medicine.

In the study, among the largest of its kind to date, researchers analyzed more than 300,000 births in Australia and found the risk of birth defects to be 26% higher with IVF than with natural, or unassisted, conception - a finding consistent with previous research.

IVF involves combining - but not injecting– a woman's egg with sperm, usually in a laboratory dish, then transferring the resulting embryo into the woman's uterus.

But virtually all of the increased risk associated with IVF could be attributed to the health and demographic profile of the mother, including her age, body mass index, socioeconomic status, and any health conditions (such as diabetes) she may have experienced before or during pregnancy.

The direct influence of IVF on the risk of birth defects appears to be "very modest," says lead researcher Michael J. Davies, Ph.D., an associate professor of obstetrics and gynecology at the University of Adelaide, in Australia.

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"It's important to counsel couples regarding the risk of conception [with] in vitro, but, controlling for all confounding factors, there's not really an increased risk for babies conceived with IVF," says Dr. George R. Attia, director of reproductive endocrinology and infertility at the University of Miami Miller School of Medicine, who was not involved in the study.

However, the same may not be true of all infertility treatments. Intracytoplasmic sperm injection (ICSI), another so-called assisted reproductive technology the researchers examined, was associated with a 77% higher risk of birth defects versus unassisted conception. That figure fell to only 57% after the parents were taken into account, suggesting the procedure itself conferred some of the risk.

ICSI involves removing an egg from the body, injecting it with one carefully selected sperm, and implanting the embryo into the mother. Compared to IVF the procedure is "mechanically more invasive, and bypasses a number of selection processes that may otherwise preclude that sperm from fertilization," Davies says.

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In all, roughly 18,000 babies in the study were born with one or more birth defects, such as cerebral palsy or heart abnormalities. The rate of defects was about 7% with IVF and about 10% with ICSI, compared to about 6% with unassisted conception.

Although the findings would seem to suggest that IVF is less risky than ICSI, the two procedures aren't entirely comparable. Unlike IVF, ICSI is primarily used when the male has a fertility problem, such as a very low sperm count.

As the study notes, it's possible - as with IVF - that birth defects associated with ICSI may stem from the underlying causes of male infertility, not the treatment. The researchers weren't able to test this theory, since the current study focused on mothers and took into account the father's occupation only.

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Previous studies have linked IVF to birth defects, as well as to an increased risk of autism and childhood cancer, but it hasn't been clear how much of the risk can be directly attributed to the procedure.

The new findings regarding IVF should be "reassuring for patients," said Dr. Glenn Schattman, president of the Society for Assisted Reproductive Technology, a professional organization for doctors who provide infertility treatments, in a statement.

In another finding, the study confirmed previous research on the practice of freezing and storing embryos for future use, known as cryopreservation. With both IVF and ICSI, babies born from frozen embryos were less likely to have birth defects than those born from fresh embryos, perhaps because the freezing process helps weed out weaker embryos.

The "fittest and healthiest [frozen embryos] tend to survive, thereby reducing the risk during subsequent stages of development," Davies says.

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The study had a key shortcoming that will need to be addressed in future research. All of the participants underwent their infertility treatments between 1986 and 2002, so the findings don't reflect new advances in the field that may have affected the risk of birth defects, theauthors say.

Davies and his colleagues presented their findings today at the World Congress in Building Consensus in Gynecology, Infertility and Perinatology, in Barcelona, Spain.

Copyright Health Magazine 2011

soundoff (37 Responses)
  1. hamsta

    sure,blame everything on the parent.

    May 5, 2012 at 15:57 | Report abuse | Reply
  2. Research Board

    Not really as surprising association. If you take people who are infertile (for whatever reason that is, genetics, age, etc) and use science to try to overcome whatever nature intended, there are going to be problems. But those problems aren't necessarily from the scientific techniques, but with the substrates you use.

    May 7, 2012 at 11:03 | Report abuse | Reply
  3. Amanda

    This study is absurd. No matter your feelings regarding IVF, the study has so many flaws. If you took basic statistics you'd know this study is ludicrous! For instance, they studied around 303,000 naturally conceived births. Then, studied 6,163 births that were created via IVF. 931 of those were IVF with ICSI. Of course the rates will be higher when using those ridiculous numbers! This study is so flawed and terrible journalism as well.

    How is comparing 303,000 natural conception children to 931 IVF ICSI deemed a study?

    You really have to READ the article (and other publications since this article left out important numbers) to understand the results!!!

    May 7, 2012 at 14:18 | Report abuse | Reply
    • KJC

      Actually, one misconception about statistics is that the sample size changes depending on the population size. Actually, the sample size is entirely independent, if it is random. (Of course, these research studies could not necessarily choose a random sample of IVF families, but it should be fairly close.) Usually about 1,000 candidates in any study is enough to make a comparison to an entire population, regardless of the entire population size. The sample size determines the margin of error and the confidence interval, apart from the size of the population, and if you do the calculations, 1,000 is pretty strong. So this study has a lot of relevant data. http://stattrek.com/sample-size/simple-random-sample.aspx

      May 7, 2012 at 17:24 | Report abuse |
  4. Kurt

    Hm. This is a hard question. For us we had no fnzeors our first fresh cycle so when it didn't work we HAD to do another fresh. I was able with my clinic to just get one period in between. So the first one failed in Feb and I was able to do another fresh in April. I wish that I would have had fnzeors to do after the first failed fresh, but I didn't have that choice. We also had to pay for EVERYTHING but the meds out of pocket. So of course the frozen would have been less expensive. The second fresh cycle we got pregnant and now we have fnzeors for a sibling. I would personally say pay for the fee to freeze. Fresh cycles are so hard. And for me even though it may make me sound greedy I didn't want to donate any of my embryos until I knew we were DONE. I have an egg queality issue too so I wanted to keep all of my embryos that I could until I know for sure we are done trying. But of course that is just my opinion. You should do what you feel the most comfortable with doing. 🙂

    July 1, 2012 at 06:23 | Report abuse | Reply
  5. anna

    I was born IVF seventeen (almost 18) years ago, and I didn't have any birth defects. Im trying to find out if you were born IVF, if it can mean anything when I try to get pregnant one day (like when i'm much much older). My mother was unable to conceve, and I can't find any information to find out if I may have trouble too since my mother did. Any help?
    Please email me: annamorgan1374@gmail.com

    July 30, 2012 at 19:25 | Report abuse | Reply
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    • Marrinel

      Hi Mrs Jerome, My best advice is for you and your pnreatr to optimise your health and fertility. Being in optimum health will help to boost your natural chances of conception but it will also increase your odds of IVF/ICSI working if you need to go down that path. In order to get yourself ready I like to suggest to begin acting pregnant now to get pregnant "later". And remember that 120 days is usually the amount of time it takes for the egg to mature and the sperm to form so give yourself the amount of time necessary whilst doing all the specific things you can to boost your natural fertility and your chances of creating a truly healthy baby. For more information on exactly what you need to do and how exactly to get yourself ready I'd recommend The Fertility Alignment Breakthrough Program you will find at

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    Infertility Treatment IVF is an acronym for in vitro fertilization ('in vitro' meaning 'in glass'). Simply put IVF is adding a man's sperm to his female partner’s eggs in the laboratory to produce embryos. In vitro fertilization is an option for many couples who cannot conceive through conventional therapies. These embryos are put back into the female partner's uterus (womb) after 3 to 5 days of being in the incubator, hopefully they will then grow into a baby.

    March 14, 2014 at 02:19 | Report abuse | Reply
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