Twenty-five years after the birth of the first baby
conceived through in vitro fertilization, there remain many
unanswered questions about the health and well-being of
babies born following IVF.
While research exploring health outcomes for IVF has
increased substantially over the last decade, differences
in study design and study conclusions have sometimes led to
conflicting conclusions and to confusion among patients,
providers and the public. To clarify what is known and what
gaps remain, Kathy Hudson, director of the
Genetics and Public
Policy Center at Johns Hopkins, with funding from the
Pew Charitable Trusts, convened an expert panel to address
whether IVF babies are at increased risk for adverse health
outcomes.
The panel, co-sponsored by the American Academy of
Pediatrics and the American Society for Reproductive
Medicine, conducted a systematic review of studies
published in the medical literature that reported on
malformations and genetic anomalies, cancer, psychosocial
and developmental outcomes, and health outcomes beyond one
year. In addition, for neonatal outcomes, including
premature birth, low birth weight and perinatal mortality,
the panel considered a recent systematic review and
metanalysis.
So far, their systematic review of relevant published
data on the health of children born following IVF finds no
evidence to support increased risk of most malformations,
cancer or impaired psychosocial development. However,
singleton IVF babies are at increased risk for low birth
weight, prematurity and perinatal mortality.
There is a 10-fold increase in multiple births
following IVF compared to the overall population (32
percent and 3 percent, respectively), and multiple births
are at higher risk for adverse neonatal outcomes. However,
multiple births following IVF are not at increased risk
compared to naturally conceived multiple births.
The panel also identified a number of gaps in existing
knowledge and is developing recommendations for
well-designed research and surveillance efforts,
recommendations for clinicians and recommendations for
public policy.
The panel's preliminary findings were presented in
October at the American Society for Reproductive Medicine
meeting in Philadelphia and at the American Society of
Human Genetics meeting in Toronto.