Are the risks of extending IVF outweighing the benefits?

(Medical Xpress)—As the use of IVF expands to a wider range of fertility problems, experts warn that the risks could outweigh the benefits.

IVF was developed for women with fallopian tube disorders and severe male , but in recent years it has been applied to wider conditions, including unexplained infertility, writes Dr Esme Kamphuis and including the University of Aberdeen's Professor Siladitya Bhattacharya in BMJ today.

For instance, in the UK, the proportion of IVF cycles for tubal problems fell from 19% to 12% between 2000 and 2011, although the number of cycles remained around 7,000. The figures for unexplained infertility tripled from just over 6,000 to over 19,500 cycles.

They argue that the evidence underpinning the use of IVF for some of these newer indications is weak, and they question whether IVF is equally effective in these conditions and if the long term health risks for IVF can be justified.

Unexplained infertility accounts for up to 30% of all presenting for IVF, many of whom will conceive when not treated immediately. Indeed studies have shown considerable natural conception rates in couples with no obvious cause of infertility for two to three years.

Yet the authors point out that much IVF research often does not mention how long couples have been trying to conceive. And national fertility registries in many countries do not collect data on duration of infertility.

Extended use of IVF also increases the risk of harm, they add. Multiple pregnancies are associated with complications for mothers and infants, and even single babies born through IVF have been shown to have worse outcomes than those conceived naturally.

Concern has also been raised about the long term health of children born through IVF. Otherwise healthy children conceived by IVF may have higher blood pressure, body fat distribution (adiposity), glucose levels, and more generalised vascular dysfunction than children conceived naturally.

"Until these concerns are resolved, there should be caution about using IVF in couples when the benefit is uncertain or the chances of natural conception are still reasonable," say the authors.

They believe a lack of will to question the perceived success of IVF is preventing progress, and argue that the paucity of quality evidence on who should have IVF and when should be addressed.

"As a society, we face a choice," they conclude. "We can continue to offer early, non-evidence based access to IVF to couples with or follow a more challenging path to prove interventions are effective and safe and to optimize the IVF procedure. We owe it to all subfertile couples and their potential children to use IVF judiciously and to ensure that we are first doing no harm."

More information: Kamphuis EI ,Bhattacharya S ,van der Veen F ,Mol BWJ ,Templeton A. "Are we overusing IVF?" BMJ 2014;348:g252. doi: dx.doi.org/10.1136/bmj.g252

Related Stories

Women's age affects every stage of IVF

Dec 06, 2013

A woman's age affects the outcome of every single step of IVF treatment, according to a University of Aberdeen study published today in PLOS ONE. This is the first study of its kind to break down failure rates ...

Higher risk of birth problems after assisted conception

Jan 08, 2014

A University of Adelaide study has shown that the risk of serious complications such as stillbirth, preterm birth, low birth weight and neonatal death is around twice as high for babies conceived by assisted reproductive ...

Melanoma risk linked with IVF treatment and birth

Dec 03, 2013

An investigation into the association between IVF treatment and melanoma found women who had IVF treatment and gave birth to one or two children had an increased rate of invasive melanoma compared with those ...

UK may allow IVF for older women, same-sex couples

May 22, 2012

(AP) -- A powerful health advisory agency says Britain should extend free fertility treatments to women up to age 42 as well as same-sex couples, recommendations likely to be followed by many of the U.K.'s medical centers.

Good quality of life for couples who adopt

Nov 12, 2012

Couples who adopt after unsuccessful IVF treatment have a better quality of life than both childless couples and couples without fertility problems, reveals a study from the Sahlgrenska Academy, University of Gothenburg, ...

Recommended for you

Vitamin D may not prevent return of vaginosis after all

17 hours ago

(HealthDay)—A new study suggests that high doses of vitamin D may not help prevent the return of bacterial vaginosis (BV). The research was published in the November issue of the American Journal of Obstetrics and Gynecology.

Eating disorders linked to adverse perinatal outcomes

Oct 22, 2014

(HealthDay)—Maternal eating disorders are associated with adverse pregnancy, obstetric, and perinatal health outcomes, according to a study published in the October issue of the American Journal of Obstetrics & ...

Large variation in cesarean rates across US hospitals

Oct 21, 2014

Cesarean delivery is the most common inpatient surgery in the United States. US cesarean rates increased from 20.7% in 1996 to 32.9% in 2009 but have since stabilized, with 1.3 million American women having had a cesarean ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.