A group of Australian scientists have found that premature infants born after in-vitro fertilization (IVF) have higher chances of disability due to adverse brain development when compared to children born after natural conception.
A collaborative group of scientists from eight medical Institutions of Australia compared brain related development in premature infants (born before 29 weeks of gestation) conceived by assisted conception with infants conceived spontaneously. The study was conducted in 1473 infants born between 1998 and 2004. The result of the study showed severe disability like cerebral palsy (unable to walk without aids), deafness (bilateral hearing aids or cochlear implant) or blindness in these infants. The study is published in medical journal Archives of Disease in Childhood Fetal Neonatal edition, May issue. (Image Nina Mathews Photography)
“Previous studies showed that infants born after assisted conception have poorer developmental outcome and greater resource utilization when compared to infants conceived spontaneously. Percentage of minor and major disabilities also continues to be controversial hence we thought to investigate this issue further”, said Dr. Mohamed, Abdel-Latif, principal investigator of the study, Department of Neonatology, Centenary Hospital for Women and Children, Australia.
Today 32 years after the first test tube baby IVF techniques have become popular worldwide. But unfortunately there is hardly any information available in public domain about IVF pregnancies and development of IVF children. The scientific data on IVF proves increased risks in these children like multiple pregnancies (twins/triplets or more at a time), premature birth (birth before 37 weeks of gestation), low birth weight (less than 1500 grams) and child death. When compared with normal population, probability of cesarean section is higher; probability of early birth is three times more and probability of low birth weight is four times more in IVF.
Scientists say there is chance of one twin out of hundred births and one triplet out of ten thousand births in natural conception. But according to European IVF monitoring program report, out of 100 IVF pregnancies there is probability of 30 multiple pregnancies. Out of these 30, approximately 10-12 children will be twins and 2-3 will be triplets.
The high probability of multiple pregnancies in IVF is responsible for adverse outcomes like high incidence of respiratory diseases, abnormal genetic make-up, neural tube defects and oesophageal atresia which leads to medical, social and financial consequences.
The gestation age in some IVF cases is five days shorter as compared to ideal gestation age. Though this difference looks insignificant it might be the reason for low birth weight and related complications. “The ideal gestation for birth is 38 weeks to 40 weeks. Birth before that and especially very preterm birth like below 29 weeks gestation may associate with increased risk of death and complications due to prematurity in infant,” said Dr. Latif.
Infertility in patients, maternal age, medical history of miscarriages and anxiety are some of the known factors for adverse outcomes in IVF. To reduce the chances of multiple pregnancies and further complications, embryos can be removed artificially but there are reports that show enhanced risk of miscarriages and advancement of complications after embryo reduction.
“Our findings showed that despite the advances in medicine, infants conceived by infertility treatment and born early/preterm are at increased risk of disability. These infants need specialised follow-up by pediatricians so that abnormalities can be detected early and interventions like physiotherapy can be started if needed. There is need to do more exploration in this field”, said Latif. Follow up study on these children is still restricted to physical level but there is need to see the intellectual, emotional and psychological development in these children.
“Use of these technologies is increasing and there are many center’s specialising in this treatment. The success rate may vary from couple to couple and from center to another. It is essential that patients understand the entire process of IVF including financial cost and monitory factor should be considered in decision making. After delivery, they should arrange follow-up with their Pediatrician especially if their baby is born early”, he added.
By Jaimini Sarkar