IVF and Child Health
by Ren Chats
Steps of In Vitro Fertilization
In Vitro Fertilization has gained huge acceptance, in spite of consistent reports on increased risk of rare birth defects in IVF babies.
To be parents need to know all possible consequences of different forms of in vitro fertilization treatments on child health well in advance
IVF. in vitro fertilization, gives hope to many; is only partly true. People desire designer babies too!
But Nature is complex.
No medical procedure is free of risks, side effects, failures and complications. And in vitro fertilization is No exception.
Over last 35 years millions of IVF babies are born worldwide, of which almost 1 in 10 suffer from birth defects. Several predisposing factors are linked to increased risk of birth defects, developmental disorders and childhood malignancy in babies born of IVF pregnancy.
The study published in JAMA of July’2013
Extensive analysis of anonymous data of more than 2.5 million birth records from 1982 and 2007 from the Swedish national registers, showed only 0.914% chance of neurodevelopment disorder seen as Autism spectrum defect or IQ of less than 70. Incidence of Autism spectrum defect was at par with that seen in naturally conceived infants, but intellectual disability showed a small increase of 18% among babies born of in vitro fertilization.
Possible causes for increased risks in IVF babies
Twins and triplet pregnancies:
Multiple embryo transfer is done to increase success rate in severe cases of infertility. Often parents also opt for it in hope of reducing the cost of the procedure. Multiple pregnancies are documented to be a major cause of developmental disorders in the offspring. Therefore, researchers from Canada have called for policy in favor of mandatory single embryo transfer during IVF treatment.
Intra cytoplasmic sperm injection (ICSI)
ICSI is an IVF procedure. It is recommended for severe form of male infertility or after traditional IVF failures. In this type of IVF a single sperm is extracted (surgically or from ejaculation sample) and is injected directly into an egg. ICSI IVF procedure are particularly associated with cerebral palsy, intellectual disability, autism and other variety of neuro developmental disorders.
Adverse effect on fetal development is attributed to:
• Natural selection of sperm is not at all allowed.
• Accidental unnoticed physical damage of the egg.
• Along with sperm insertion incidental contamination of egg cytoplasm with culture media.
Hormonal therapy given to stimulate desired maturation of egg is noted to be associated with increased risk of autism spectrum disorders.
Parental factor that may pose risk in optimal fetal growth and development.
• Advanced age of the parents.
• Obesity in mothers.
• Underlying cause of infertility.
• Extent of infertility treatment received.
• Number of IVF cycles required for successful pregnancy.Preterm births.Low birth weight babiesEpigenetic influence on brain development and neuronal plasticity.
In response to environmental inputs the network of nerves in the brain is constantly molded to help brain perform optimally for each individual’s needs. This is called neuronal plasticity.
During fetal, neonatal
and early childhood brain growth and development
is the result of interplay between sensory inputs and genetic potential. And IVF leads to both, altered gene expression and unnatural sensory inputs.
It therefore arouses the concern; does epigenetic influence on fetal and newborn brain development place IVF babies at neurodevelopment disadvantage! Ponder before… References:
1. Autism and Mental Retardation among Offspring Born After In Vitro Fertilization;
Sven Sandin, Karl-Gösta Nygren, Anastasia Iliadou, Christina M. Hultman, Abraham Reichenberg: JAMA, 2013;310(1):75-84. DOI: 10.1001/jama.2013.7222
2. Cancer Risk in Children and Young Adults Conceived by In Vitro Fertilization;
Bengt Källén, Orvar Finnström, Anna Lindam, Emma Nilsson, Karl-Gösta Nygren and Petra Otterblad Olausson: Pediatrics 2010;126;270; DOI: 10.1542/peds.2009-3225
3. Epigenetic inﬂuences on brain development and plasticity;
Michela Fagiolini, Catherine L Jensen and Frances A Champagne: Current Opinion in Neurobiology 2009, 19:1–6 DOI 10.1016/j.conb.2009.05.009