May 16, 2012

Researchers reviewing Australian data regarding 302,811 pregnancies that occurred in Australia between January 1986 and December 2002 that resulted in live births, stillbirths, and terminations of the pregnancies found that the vast majority of the pregnancies were the result of “spontaneous conception” but that 6,163 were the result of fertility treatments. The researchers then studied the incidence of  birth defects diagnosed before the age of 5.

The researchers found a small but statistically significant increase in the risk for birth defects for babies who were conceived as a result of fertility treatments. The study involved both frozen and fresh embryos that resulted in pregnancies.

What Are Some Of The Techniques Used In Fertility Treatments?

The procedure known as “I.V.F.” (in vitro fertilization) involves multiple eggs being fertilized in a solution containing sperm after which the fertilized eggs are then implanted (some or all) into the woman. The procedure known as “ICSI” (intracytoplasmic sperm injection) involves a single sperm being injected into a single egg. The procedure known as “GIFT” (gamete intrafallopian transfer) involves transferring the eggs and sperm to the woman’s fallopian tubes before the eggs are fertilized.

The study found that the risk of birth defects varied according to which technique was used and whether the embryos used were fresh or frozen. Overall (for all techniques), there was a 28% greater risk for birth defects involving heart, muscle, urogenital, and gastrointestinal defects, as well as an increased risk for cerebral palsy.

Notably, ICSI (the most common technique presently being used) had an increased risk of birth defects when fresh embryos were used but the risk was not increased if frozen embryos were used. For I.V.F., there was no significant difference in the risk for birth defects whether fresh or frozen embryos were used. The incidence of birth defects was 32% less likely when I.V.F. was used compared to ICSI.

The risks for stillbirth, low birth-weight, and delivery prior to 32 weeks were greater for women who had any fertility treatment when compared to the spontaneous conception women. For women who had spontaneous conception after previous fertility treatments, there was a 25% greater risk for birth defects.

What Conclusions May Be Drawn From This Study?

Infertility alone increases the risk for birth defects. However, a cycle of a single fresh embryo transfer using I.V.F. followed by transfer of a frozen embryo, if necessary, does not result in a significant additional risk of birth defects when compared to spontaneous conception.


If you are pregnant or planning to become pregnant, it is imperative that you sit down with your health care providers to thoroughly discuss your medical situation, the options for care and treatment that are available to you, the risks and benefits associated with the options as they relate to you, their recommendations regarding your care and treatment (and their reasons for their recommendations), and any concerns or questions you may have regarding your current and future medical care and treatment. Other than hoping that competent health care providers are providing competent medical care at all times, the best means for avoiding a medical malpractice incident is a well-informed and pro-active patient participating in her own care and treatment decisions.

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