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In a scene repeated daily at fertility clinics across the country, doctors read off a checklist to anxious parents about every possible health risk to their future children conceived via in vitro fertilization. It can include low birth weight, premature birth, autism, birth defects, neurological disorders, mental retardation, leukemia, brain tumors, rare genetic syndromes, and attention deficit hyperactivity disorder. Many of the risks increase with multiples; some 30 percent of IVF pregnancies are twins, and 1.5 percent are triplets.
But intriguing new evidence presented last week at the American Society for Reproductive Medicine’s annual conference makes the dangers of IVF seem less daunting. One headline: Kids conceived through IVF outsmart their peers in school. Another: The fertility treatment may not be to blame for babies’ low birth weights.
Many studies exploring the health risks of IVF have been limited by a small number of subjects, as well as lack of a control group and long-term follow-up. As a result, their conclusions are often controversial, inconclusive, and contradictory. It seems that as soon as one study sounds an alarm by finding a higher incidence of one malady, other researchers claim they couldn’t find that trend in their population samples. As future research aims to find more definitive answers, these two new sizeable studies start to fill in some of the gaps.
In one of the largest reports to date on cognitive development, as yet unpublished, researchers from the University of Iowa Hospitals & Clinics found that 204 IVF singletons ages 8 to 17 scored higher on a popular standardized achievement test than a group of their randomly matched peers from the general population. The suggestion that kids made in the lab might be smarter is a bit hard to swallow, and the study acknowledges that social factors, such as parents’ level of education and maternal age—which are higher in couples pursuing expensive fertility treatments—affect test scores. In other words, IVF didn’t necessarily make these kids smarter; being born to motivated parents who surely fretted over every educational milestone and color-coded stimulation mobile probably did. The 186 IVF twin children and the 45 triplet kids scored slightly lower than the control group, though researchers said the difference was not statistically significant.
In the second study, a team from the Washington University School of Medicine set out to explain why IVF babies were routinely born smaller than babies conceived naturally. The researchers took an unusual approach. Instead of comparing the birth weights of babies born to infertile women who sought out IVF treatment to babies of fertile women who had no trouble getting pregnant, they decided to compare them to babies of other infertile women—“apples to apples,” explained the lead researcher, Dr. Amber Cooper. (Infertility is defined as the inability to become pregnant after one year of regular intercourse if a woman is under 35 or after six months if she is over 35.*) They compiled the birth weights of babies conceived by three different techniques among nearly 500 infertile women: IVF, ovulation induction through clomiphene citrate or hormone stimulation shots, and spontaneous conception.
If the babies created though IVF were smaller than those born to infertile women from the other techniques, then the research would point to IVF as the cause. Instead, the results showed that the babies born to infertile women were on average smaller than those born to fertile women, regardless of how they were created. The study design allowed researchers to suggest that IVF, a procedure responsible for 1 percent of births in the United States, may not be the problem. Instead, infertility may be.
Why would infertile women bear smaller babies than fertile ones? Do they have poorer quality eggs or other underlying health problems? Those are the next questions for future research.
Sarah Elizabeth Richards is the author of Motherhood Rescheduled: Five Women, Five Quests to Stop the Biological Clock to be published in summer 2010. Get the latest by joining the mailing list at www.motherhoodrescheduled.com.
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