A recent large study confirms that children born through assisted reproduction techniques have 30-40% higher probability of suffering malformations at birth

The bioethical assessment of assisted reproduction moves between the undeniable good that it means to provide a child to a couple who want to have children and the adverse effects that this practice may have, both for the pregnant mother as well as for the embryos produced and for the child born. This is in addition to the moral problems that arise and that, essentially, affect those whose life has a transcendent vision, and who want their relationships to be in accordance with what the teachings of the Catholic Church or other religions advocate in this field.

In vitro fertilization children. Multiple pregnancies, premature births, low birth weight, congenital anomalies and other perinatal complications

Are the patients well informed?

Apart from the latter, though, the bioethical assessment of assisted reproduction can affect many other people: since 1978, the year in which the first child was born through in vitro fertilization (IVF), until the present day, more than 5 million children have been born using these techniques. Indeed its growth curve shows no signs of stopping, since, in addition to medical and social reasons, assisted reproduction — and the numerous clinics that fall under its umbrella — is a medical field that provides huge financial benefits, so its development is also facilitated by this pecuniary interest.

But returning to the bioethical reflection, we have indentified that there are basically three negative aspects that must be considered, the third being the adverse consequences that children born using these techniques may suffer, to which we shall  refer.

To that end, we will base our evaluation on a recently published comprehensive review of Journal of Developmental Origins of Health and Disease that approaches the matter with scientific rigor and extensive bibliographical information.

Before entering fully into the issue, we should make a preliminary clarification. Many studies that make reference to this topic attribute a large part of the adverse effects that occur in children born through assisted reproduction techniques (ART) to the high percentage of twin pregnancies that are produced using these procedures; however, in the paper discussed, these effects are analyzed in detail in singleton pregnancies, which gives it particular relevance.

IVF babies medical complications

In this Report, the authors analyze various aspects of the side effects that may occur in children born through ART. These include:

  1. Obstetric and perinatal complications

In this section, the authors analyze 14 studies, concluding that children born in these circumstances present a higher proportion of adverse obstetric and perinatal outcomes than those conceived naturally. These include low birth weight, preterm birth, small for gestational age, high percentage of stillbirths, increased perinatal mortality and a higher number of admissions to neonatal intensive care units. In the mother, hypertensive problems, preterm rupture of membranes, gestational diabetes, need for induction of delivery and even a higher percentage of caesarean sections are observed more often. Consequently, the authors concluded that there is indeed an increase in adverse perinatal outcomes using these techniques.


However, whether these are due to the technique itself or problems associated with the parents is not exactly clear, although if the children are born from donor gametes, the latter cause can be excluded.

The authors concluded that, taking into consideration the above, it seems that the parental characteristics and technical procedures used contribute to increasing the adverse effects in children after ART singleton pregnancies.

  1. Birth defects

Likewise, after analyzing several meta-analyses, the authors found that children born after ART have a 30-40% higher probability of suffering malformations at birth, when compared with children conceived naturally. Nonetheless, it is not completely clear whether this is due to technical aspects related with the ART procedure or problems associated with the parent’s infertility.

As in the previous section, the authors concluded by saying that, after assessing all the aspects evaluated, it may be said that children born after ART from a singleton pregnancy present an increased risk of birth defects, and that this could be related with disorders in the child’s parents, as well with the use of the technical methodology entailed in these practices.

  1. Growth and developmental disorders

A large number of studies evaluated the possibility that medical problems may present during the development of these children, showing conflicting results, although most detected no difference in the growth and development of children born after ART and those born following natural conception. Nevertheless, taking all the studies evaluated as a whole, there does seem to be a slight increase in cases of cerebral palsy in children born after ART, but this needs to be confirmed by larger studies.

  1. Increased cancer risk

The vast majority of studies evaluated showed that children conceived by ART do not show a higher risk of cancer during their lifetime than those conceived naturally.

  1. Possibility of suffering chronic diseases

Few studies have been conducted to date in this respect, and the conclusions obtained are not very clear. Additional studies are warranted to determine whether, as a result of various epigenetic mechanisms, these children show a higher incidence of chronic diseases throughout their lives than those conceived naturally (see HERE).

Conclusion

The higher number of twin pregnancies due to the use of assisted procreation techniques could certainly contribute to the existence of adverse problems in children born after ART, but, in addition, children born from singleton pregnancies also have an increased risk of obstetric and perinatal adverse effects when compared with children conceived naturally.

 

Justo Aznar

Director of the Institute of Life Sciences