Sections

Services

Information

UK United Kingdom

No need for alarm about birth defects after assisted conception

Some people may be wondering whether it’s wise to undergo assisted reproduction after recent media headlines about these technologies increasing the risk of birth defects. In fact, millions of babies have…

Millions of babies have been born after the use of assisted reproductive technologies, and nothing has gone wrong with the vast majority. Chiceaux Lynch

Some people may be wondering whether it’s wise to undergo assisted reproduction after recent media headlines about these technologies increasing the risk of birth defects. In fact, millions of babies have now been born worldwide after use of assisted reproductive technologies, and nothing has gone wrong with the vast majority.

The technologies used to help people conceive are mainly in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). In IVF, the woman’s eggs are collected, as is sperm from the male partner or donor. Both are left in a culture dish in a laboratory to allow the egg to be fertilized by the sperm.

ICSI involves use of a single sperm to inseminate the egg, not millions of sperm as are used in conventional IVF. This procedure is often used when the male produces small numbers of sperm or when conventional IVF has not worked for unknown reasons.

There have been many studies in Australia and overseas designed to assess the safety of these technologies. It’s generally found that about one in 20 babies conceived naturally will have a birth defect. And, if IVF or ICSI is used to conceive, the risk of defects goes up – but by not very much.

In a recent Victorian study of 3,312 IVF and 3,634 ICSI pregnancies with a single baby rather than twins, we found the risk of birth defects was slightly higher for ICSI (one in 15) than for IVF (one in 16). So for every 100 babies conceived with use of either IVF or ICSI, 93 or 94 will not have a birth defect.

We didn’t find the difference between outcomes for IVF and ICSI that the South Australian study responsible for recent headlines did. Neither have many other people who have done research in this area.

In fact, the SA study’s finding of an increased risk after ICSI (but not IVF) is unexpected and difficult to explain. Their numbers were not as large as ours for IVF and ICSI and they lumped together many minor defects with the more severe ones.

Ekem/Wikimedia Commons

Unlike the SA study, other researchers have concluded that the micro-injection procedure used in ICSI to mix a single sperm with an egg, didn’t add to the risk of the fetus having a birth defect over and above that associated with IVF.

The Victorian study was large enough to allow for examination of specific types of birth defects after IVF and ICSI. We found that there was a particular group of birth defects occurring and they were ones that formed during the first four weeks of pregnancy, before organs start developing. These are called blastogenesis defects and can affect the formation and fusion of the spine, the gastrointestinal tract (gut) and other parts of the body.

The frequency with which these specific defects usually occur is very low, but can be as high as one in 110 babies after assisted reproduction. What seems to reduce this risk and the risk of other birth defects is the timing of the embryo transfer from the laboratory to the woman’s uterus.

Our study showed very clearly that a fresh embryo transfer (usually occurring within days of the egg pick-up for IVF or ICSI) carried a far greater risk of birth defects than an embryo that had been frozen and thawed prior to transfer. Thawed embryo transfer usually occurs in a natural menstrual cycle, months after the egg-pick up – well beyond the time when all the hormones required to retrieve the eggs for IVF or ICSI have disappeared from a woman’s body.

The frequency of blastogenesis defects with a fresh embryo transfer was one in 100 but if a thawed transfer was used, only one in 250 births was affected.

People seeking treatment to improve their chance of having a baby need to be aware of the slightly increased risk of birth defects. Australian data are providing strong evidence for the use of embryos that have been frozen after IVF and then thawed before their transfer to the womb. At the moment, there’s not very convincing evidence to suggest that IVF is safer than ICSI, so expect to hear more.

Articles also by This Author

Sign in to Favourite

Join the conversation

51 Comments sorted by

  1. Dale Bloom

    Analyst

    It seems nothing is certain about artificial reproduction technology. Articles such as this one say that birth defects are similar to natural conception, while other articles say the rate of birth defects are higher.

    http://theconversation.edu.au/fertility-treatments-linked-to-higher-risk-of-birth-defects-6879

    This website tries to encourage male sperm donors “To help assist another couples dream come true - in creating a new life and a family”

    http://www.spermdonorsaustralia.com.au/faqs

    And then elsewhere in the website it states “Fertility treatments are available to single women”.

    So a single woman is regarded as equal to a couple, and any donated sperm may not go to a couple at all.

    I don't think much can be trusted with the industry of artificial reproduction, but right throughout the taxpayer is asked to foot the bill for over 50% of costs.

    report
    1. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      "Articles such as this one say that birth defects are similar to natural conception, while other articles say the rate of birth defects are higher."

      This article actually stated: "the risk of defects goes up – but by not very much".

      As for the next point - this article was not examining the practices of private commercial fertility services but with the science behind risk assessment for IVF or ICSI artificial conception methods.

      report
    2. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      Yes, I know. Science and ethics don’t often mix, or ethics can be left to someone outside of science to contemplate.

      There is one major birth defect occurring in this country that is not often thought about. A person born through artificial reproduction may not know one of their real parents until the age of 18, and they may never actually meet that parent anyway.

      The psychological effects of that can be considerable, but is not considered a defect of artificial reproduction.

      report
    3. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      A person born of natural conception can have exactly the same problem Dale - Sometimes if it is a casual relationship the father may not be around.

      "Science and ethics don’t often mix"

      Really? try conducting ANY kind of study involving humans or animals. There are substantial ethical protections and considerations that need to be met before the study can be done.

      This would start with an application for a project then a risk asessment checklist - your course coordinator will need to complete a coordinators application as well as your personal student application. IF approval is granted then there are structures in place for reporting adverse events, amendments to projects, progress reports, reports when you close, extend or reopen a project and a final report - as well as reports for people to complain about breaches of ethical standards they observe.

      This is all governed by national standards and legislation.

      report
    4. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      Grendels,
      There are more ethical questions involving artificial reproduction than anyone can count, and legislation may not cover those ethical questions at all.

      For example:
      “Mostly WFC treats married or defacto couples as we concur with majority community opinion that this is in the best interests of the potential child. However, we recognise under Commonwealth anti-discrimination regulation single women cannot be refused treatment.”

      So that university teaching hospital does “concur” with…

      Read more
    5. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      Dale - what are the ethical questions you are posing here?

      Here you have given a statement of your opinion - but it doesn't pose an ethical question - just outlines your view (which you are entitled to hold of course - its just these are not ethical issues, but opinions).

      "I do not believe it can be classified as treatment, as more often than not the single woman would be healthy. The taxpayer is of course asked to pay for the so-called “treatment”."

      "Freezing embroys is a direct human action…

      Read more
    6. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      Legislation takes a considerable amount of time to enact, and then it has to be enforced.

      There seems to be a grey area between what is possible, what can be done under legislation, and what a researcher considers ethical. The example of the clinic carrying out IVF on single women even though the clinic doesn’t actually approve or agree with it is an example of such a grey area.

      There has also been examples of bills passed in parliament concerning aspects of IVF that many would regard as completely abhorrent, but the bills were passed without any public consultation.

      http://www.abc.net.au/news/2009-03-26/bill-allows-human-egg-animal-sperm-research/1632040

      In all, the artificial reproduction industry is a highly suspect industry that should come under intense public scrutiny, and it should not be left up to some local ethics committee to decide what research should or should not occur in an artificial reproduction research lab.

      report
    7. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      That appears to be a circular argument Dale - you have expressed oppostion to the idea of artificially assisted reproduction - thus a technique to test the viability of human sperm (by allowing it to attempt to penetrate the ovum of an animal - any cellular material is destroyed) is obviously not something you would ever support. If parliament is not (in your view) being sufficiently vigilent in seeking public consultation - then that is where you need to raise an issue.

      "The example of the clinic…

      Read more
    8. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      If someone doesn’t agree with aspects of IVF, then they don’t do it, and there is no law stating that an IVF clinic has to actually operate.

      There is a question regards why people do choose IVF and not adoption, but perhaps it is easier for them to choose IVF because all they have to have is some money (and the taxpayer funds the rest).

      Adoption requires more proof that they will actually make a suitable parent.

      report
    9. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Dale Bloom - are you deliberately ignoring the fact that the overwhelming majority of people using IVF are heterosexual couples using their own ovum and sperm?

      Why might these couples choose IVF rather than adoption? Let's see...maybe because they want to raise their own biological children, like nearly everyone else does?

      For single women who want to be parents, there are much easier and cheaper ways of getting pregnant, which have existed for all of humanity.

      report
    10. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Sue Leraci
      How do you know all that, and where is the independent watchdog of the artificial reproduction industry?

      Also, as an important point, a single person cannot be “parents”.

      I am also concerned about designer babies, and will such babies be produced in an attempt to make the baby more healthy than normal?

      http://www.abc.net.au/abccontentsales/s1633488.htm

      report
    11. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Dale Bloom - are you serious? This is your "important point":
      "Also, as an important point, a single person cannot be “parents”. "?

      Did you know that the term "women" is plural? Hence woman - parent, women - parents.

      report
    12. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Just one more ethical issue amongst a plethora of ethical issues surrounding artificial reproduction. Is it healthy for single women/woman to purposely have a baby without a father?

      Or perhaps for women over 50 to be having babies through IVF, something that is highly unlikely to happen naturally?

      http://motherandbaby.ninemsn.com.au/pregnancyandbirth/pregnancy/8116338/women-over-50-becoming-mums-with-ivf

      The artificial reproduction industry seems to have minimal regard for what is naturally likely to occur.

      report
    13. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      Dale - I thought Sue raised some excellent points when she asked

      "are you deliberately ignoring the fact that the overwhelming majority of people using IVF are heterosexual couples using their own ovum and sperm?

      Why might these couples choose IVF rather than adoption? Let's see...maybe because they want to raise their own biological children, like nearly everyone else does?

      For single women who want to be parents, there are much easier and cheaper ways of getting pregnant, which have existed for all of humanity.

      You did not respond but just moved to another issue - and asked about an independent watch dog - that one I can answer. Yes there is such an organisation in each state. In NSW it is the HCCC. Naturally each medical procedure does not have its own particular watchdog.

      report
    14. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      So where is the data about artificial reproduction in Australia, or is so much just made up.

      There can be a dedicated watchdog authority specifically for the artificial reproduction industry, such as the UK’s HFEA

      http://www.hfea.gov.uk/index.html

      However it wasn’t able to stop the 100 women over 50 years of age having IVF in the UK, nor did it stop the artificial reproduction industry recently holding a lottery for free IVF in the UK.

      The artificial reproduction industry has shown itself to be highly commercialised and capable of anything, and it would be the time to either have a specific authority paying very close scrutiny of the artificial reproduction industry with full public consultation, or shut the artificial reproduction industry down completely.

      report
    15. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      "So where is the data about artificial reproduction in Australia"

      You seriously want someone else to do the search for you?

      Assisted reproduction is not "artificial" - the resulting human beings are made of real human cells, just like everyone else.

      report
    16. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Sue Leraci
      There is little that is natural about artificial reproduction, and future technologies may be completely removed from a natural union of male and female gamete cells.

      “Reproductive cloning is the best known but there are other potential ways in which humans could reproduce: formation of haploid cells from diploid cells, parthenogenesis, etc. Stem cell technology could be used to produces gametes, which would mean same sex couples could produce gametes through cloning and stem cell…

      Read more
    17. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      Sue didn't say she didn't know - just that you should do your own research. I currently have a lengthy report on my desk at work outlining data from assisted reproductive technology in Australia and New Zealand. Its really easy to find on the internet...

      report
    18. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      I suggest your google-fu needs refreshing - tip, search for assisted rather than artificial since Assisted is the proper term.

      report
    19. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      "There is little that is natural about artificial reproduction"

      Straw man - make up your own term, pull it down.

      Lots natural about assisted reproduction: ovum, sperm, fetus, uterus, baby.

      report
    20. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      I see.

      The term "artificial reproduction" is not PC in some quarters, and it has to be termed "assisted reproduction" to make it seem less artificial.

      "Artificial reproduction is the creation of new life by other than the natural means available to an organism. Examples include artificial insemination, in vitro fertilization, cloning and embryonic splitting, or cleavage.

      http://en.wikipedia.org/wiki/Artificial_reproduction

      Also look up "infertility treatment" for men and women, and you will find the majority of infertility problems can be quite easily overcome.

      So I wonder why so much money and attention is being given to artificial reproduction.

      report
    21. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Sue Larcey,
      Have a close look at the second picture in this article.

      That doesn't occur naturally.

      report
    22. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      There is no PC issue Dale - Assisted Reproduction is the accurate term given the various therapies that fall under the definition including:

      Medication to increase fertility (pills to assist ovulation etc)
      IVF
      In gamete intrafallopian transfer (GIFT)
      Pre-implantation techniques include PGD,
      Artificial insemination - using artificial means rather than by natural copulation. (also commonly referred to as the 'turkey baster method'
      Conception caps - used by placing semen into a small conception…

      Read more
    23. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      It does seem that most of the so-called "infertile couples" can actually have babies with some effort and changes to their habbits , but they are opting for artificial reproduction instead, and most of that is being paid for by the taxpayer.

      report
    24. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      "It does seem that most of the so-called "infertile couples" can actually have babies with some effort and changes to their habbits"

      Can you please outline the evidence for this - or did you just make it up?

      report
    25. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      No - it happens with assistance. Hence, assisted reproduction. And it results in the natural product in Picture A.

      (Answering on behalf of Sue Larcey - whoever that might be).

      report
    26. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      No - it happens with assistance. Hence, assisted reproduction. And it results in the natural product in Picture A.

      (Answering on behalf of Sue Larcey - whoever that might be).

      report
    27. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Sue leraci,
      Artificial reproduction does not occur naturally, and calling the articial reproduction industry "assisted reproduction" would be similar to calling the porn industry "assisted sex".

      Common causes of male and female infertility include smoking, drinking alcohol and taking drugs, diet, lack of exercise etc.

      All avoidable.

      http://www.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/causemal.htm

      http://www.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/Causefem.htm

      For a woman, the chances of becoming pregnant AND producing a healthy child also decline above the age of about 30.

      report
    28. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Diet and lack of exercise?? you have linked to some info-site that makes assertions without references.

      In our affluent society, one of the major causes of female infertility is female age. You can make all the value judgements you like about that, but it's part of our society. Just like fertility can be extended by assisted reproduction, so mobility can be extended by knee and hip replacements, and coronary artery patency can be extended by stenting or grafting. You can choose to reject any form of assistance with things that go wrong with your body, but the vast majority of people choose to accept that assistance, and don't call it "artificial" as a pejorative

      report
    29. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Here are the references

      http://www.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/referen.htm

      The artificial reproduction industry in Australia is highly commercial, propped up by taxpayer funding, with no overall governing body or independent watchdog, with an enormous number of ethical questions attached, and a minefield of legal issues.

      http://www.smh.com.au/lifestyle/diet-and-fitness/how-what-nicole-kidman-has-done-will-soon-be-a-crime-in-nsw-20110118-19v10.html

      Not exactly the sort of thing a couple should be involved in to form a family.

      report
    30. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Which of those references show that diet and exercise influence fertility?

      report
    31. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Sue leraci
      You don’t like Stanford as a reference source. Perhaps the Mayo Clinic is more to your liking.

      Risk factors: -
      “Many of the risk factors for both male and female infertility are the same. They include: “

      Age
      Tobacco smoking.
      Alcohol use.
      Being overweight.
      Being underweight.
      Too much exercise.

      http://www.mayoclinic.com/health/infertility/ds00310/dsection=risk-factors

      But of course if someone conceives a baby naturally, IVF clinics wouldn’t make much money, and they wouldn’t be getting their share of the taxpayer’s dollar.

      Not to mention the solicitors who could lose income with less legal battles surrounding artificial reproduction.

      Or the lose of jobs for researchers developing new and novel ways to carry out artificial reproduction.

      The whole industry of artificial reproduction could be destroyed if infertility risks were significantly reduced.

      report
    32. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Ah - I thought you had it back to front: it's TOO MUCH exercise. It is known that elite athletes - such as ballet dancers, who also have to tightly control their weight, don;t ovulate regularly. "Diet, not enough exercise" - doesn't work that way. Sorry. Limits one's ability to be self-righteous about diet and exercise, doesn't it?

      "But of course if someone conceives a baby naturally, IVF clinics wouldn’t make much money, ..." A surprise for you: almost all babies are conceived naturally; IVF can be difficult and unpleasant.

      The whole industry of assisted reproduction arose because previously infertile couples wanted to have children.

      report
    33. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      “IVF can be difficult and unpleasant”

      Odd how I have never seen that mentioned on the website of an artificial reproduction clinic.

      There are some clinics that make fertility recommendations such as
      • Make sure you eat a healthy diet
      • Maintain a healthy weight
      • Stop smoking and recreational drug use
      • Only drink alcohol in moderation
      • Exercise regularly
      http://ivf.com.au/about-fertility/how-to-get-pregnant

      Others don’t make such recommendations, and the concern is how many taxpayer funded artificial reproduction procedures are actually not necessary.

      report
    34. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      The site you linked to had several non-evidence-based recommendations, including "take multi-vitamins" (there is no evidence for benefit of vitamin supplements except in the presence of a deficiency, and except for folate and neural tube defects.)

      If you didn't find an assisted reproduction site that outlined the process and side-effects, you didn't look very hard.

      (Is this the two minute argument or the five minute argument?)

      report
    35. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Sue leraci
      Here is such an IVF clinic that advertises itself as “Life starts here”

      http://www.monashivf.com/

      That is bad advertising or simply bad ethics, because it should read “artificially reproduction starts here”

      That site does not list side effects or state what to do to reduce infertility other than women should have babies before the age of 35.

      report
    36. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      Grendels,
      Are you are calling me a misanthropist?

      report
    37. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      I'm suggesting it as a rational explanation for the fact that you seem to not want people to enjoy having a family - or are at least unwilling that some of your taxes might pay for it, even though some of theirs will cover some of your health costs at some point. See that tax issue is a kicker, we all pay them, and the government gets to allocate them so sometimes they will be spent on things we object to, and other times they are spent on things we love. It all balances out.

      report
    38. Dale Bloom

      Analyst

      In reply to Grendelus Malleolus

      Grendels,
      You seem to do a lot of name calling, and I was wondering what school or university taught you to do it?

      There can be a situation whereby the artificial reproduction industry attempts to manipulate people into thinking that artificial reproduction is natural and normal, and in fact the best way to go, (and mostly funded by the taxpayer of course), and any negative effects of artificial reproduction should be overlooked, ignored or hidden.

      report
    39. Grendelus Malleolus

      Senior Nerd

      In reply to Dale Bloom

      "There can be a situation whereby the artificial reproduction industry attempts to manipulate people into thinking that artificial reproduction is natural and normal, and in fact the best way to go, (and mostly funded by the taxpayer of course), and any negative effects of artificial reproduction should be overlooked, ignored or hidden. "

      Actually it is not "mostly" funded by the taxpayer. Depending on the procedure up to 1/3 of costs may be covered by Medicare but there are limits to what the…

      Read more
    40. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Perhaps that is because age is by far the most important factor.

      report
    41. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Dale Bloom - at what point does an embryo that resulted from laboratory fertilisation of an ovum transform into an independent "life"?

      report
    42. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      Sue Leraci
      There are laws concerning sperm, eggs and embryos, and the laws vary depending on states and countries. So you should consult the laws of your state or country.

      According to the IVF clinic that says “Life starts here”, that logo or moto could be a part of their business plan for growth strategy, stake holder buy-in, network growth, and the sustainability of revenue

      http://www.dcstrategy.com.au/case-studies/consulting-casestudies/monash-ivf/

      report
    43. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Dale Bloom - I am aware that there are laws. However, since you are alarmed about the IVF clinic proclaiming when life might begin, I was asking for YOUR opinion on when life begins.

      report
    44. Dale Bloom

      Analyst

      In reply to Sue Ieraci

      In many ways, my opinion doesn't count. I am only a mere male and a mere ant in the scheme of things.

      However, at least one IVF clininc claims that “Life starts here”, in a IVF clinic.

      I am opposed to that form of brainwashing and mental manipulation at every level and in every way.

      It is also noted that certain IVF clinics won't do certain procedures until payment has been received. So they must think life begins in an IVF clinic, but only after money has been handed over to the IVF clinic.

      report
    45. John Paul Corcoran

      Construction worker/Student

      In reply to Dale Bloom

      Hi Dale, I’m just wondering, would you consider the food that you eat to be artificial? I ask as I would like to understand your perspective in your coments.

      Thanks.

      report
    46. Sue Ieraci

      Public hospital clinician

      In reply to Dale Bloom

      Dale Bloom - if you are so strongly critical of the "life starts here" line, you must disagree with it. If you disagree with it, you must have an opinion about when life starts. So, when, in your opinion, does life start?

      (Or, for a cop-out, if you truly beleive that your own opinion counts for naught, why disagree so strongly?)

      report
  2. Joanne Burnett

    Student

    Women who wanted to have a baby but are having problems of conceiving are presented with a solution. IVF may help in their dreams of having their own little kid. Although the recent issues regarding this procedure have made them wary. Birth defects were seen to be rising during the past years. http://www.zoloftsertralinebirthdefects.com

    report