By Margarita Nahapetyan
Babies who are conceived with the help of some methods of fertility treatment are at more risk of birth defects than babies who are born to parents with no history of infertility, a large new research by Australian scientists has found.
Nearly 4 million babies are born every year with the aid of fertility treatments. But scientists say that it is not quite clear whether it is these treatments or some sort of underlying medical problems that cause infertility, are to blame for an increased risk of birth defects. The new study set to examine whether this risk for birth defects is linked to the various types of assisted reproductive technology, such as in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). During IVF, eggs are being taken from a woman's ovaries and fertilized by sperm in a laboratory. After that, they are being placed in the uterus. ICSI is a form of IVF during which a single sperm is being injected into a mature egg, and then implanted in the uterus or fallopian tube.
The study has been carried out for 16 years and looked at more than 308,974 births that happened between January 1986 and December 2002 in South Australia. Researchers also monitored the child's development for the subsequent 5 years. Of all the births in the study, 6,163 were the result of assisted conception and nearly 18,000 kids were found to have some form of a birth defect. Scientists took into consideration only major defects, such as heart, lungs, spinal or urinary tract defects, limb abnormalities and problems such as cleft palate or lip, but not minor defects unless they required medical interference or were disfiguring.
Birth defect rates were analyzed based on the type of fertility treatment. Researchers also divided women into three different groups: those who got pregnant naturally; those who had history of infertility; and those who previously used help in order to conceive. The study has found that nearly 10 per cent of women, who opted for ICSI method in order to get pregnant, gave birth to a baby with some form of defect, such as cerebral palsy, bowel and urinary tract problems, as well as problems with heart and lungs. Women who chose to use IVF treatments were found to be at a slightly less risk of delivering a newborn with some form of defect, with a 7.2 per cent defect rate. Risk of giving birth to a baby with a health problem was tripled among women who used Clomid to induce ovulation outside of a doctor's office.
Michael Davies, scientist at the University of Adelaide in Australia and a study's principal author, said that he and his team did not have any intentions to scare people because the majority of babies are born healthy. According to Davies, all the birth defects could be happening because a sperm, that is being used during the ICSI procedure and is being forced to conceive, might not be normal. Couples could opt for a simple IVF procedure without any sperm injection, freeze the embryos and implant only one or two at a time, he said. All of those can significantly reduce the risk of having a baby with a birth defect.
During the study, embryos that had been frozen before, were less likely to result in birth defects when compared to fresh ones which were utilized shortly after being created. Defective embryos may have less chance of surviving freezing and thawing, so the fittest ones result in pregnancies, Davies explained. Children, who were born to mothers with a history of infertility, but who became pregnant naturally, or those who had natural pregnancies after assisted ones, also showed higher rates of birth defects. This means that infertility itself could be playing a role.
In the USA, more than 60,000 children were born from 146,000 in-vitro fertilization attempts in 2009. Nearly 75 per cent of them used ICSI. ICSI was initially developed because of male infertility. The price for IVF procedure is between $10,000 and $12,000 per attempt and another $2,000 for sperm injection.
The findings of the study are published in the New England Journal of Medicine.
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