Navigating IVF: Risks, Rewards, and Realities
By Dr. Sarah Običan, OBGYN, MotherToBaby
It’s noon. I just ran into my academic office to call back a few patients in between a packed schedule. I had just spent my morning seeing 17 patients and gauging by my afternoon schedule, the day was not going to get much easier. As a new OBGYN in an academic practice, I was navigating the challenges of a busy schedule while loving my job and my patients. Just as I sat down, my cell phone rang. It was my IVF doctor.
My husband and I had been dealing with infertility for over a year, and we decided to undergo testing. The call revealed that my anti-mullerian hormone was low, potentially contributing to our conception challenges. Stunned into silence, I realized I was part of the 10% of couples facing infertility.
According to a CDC survey, more than ten percent of couples trying to conceive experience infertility. This medical issue impacts not only individuals but entire families and marriages. The journey through infertility treatment, such as IVF, is emotionally and physically demanding, requiring resilience and support.
Since the birth of the first IVF-conceived child in 1978, IVF technology has evolved significantly. Even within the 3-year period and 11 cycles I went through, advancements have improved outcomes and counseling for patients.
Is IVF Safe?
Assisted reproductive technologies (ART) are generally safe, with studies showing no increased risk of breast or overall cancer. However, pregnancies conceived through ART have a higher risk of multiples, such as monochorionic twins, which carry increased risks of birth defects and preterm delivery. The average ART patient is older and may have additional health issues affecting pregnancy outcomes.
There is a slight increase in birth defects, particularly heart defects, in ART-conceived children. A 2012 Australian study of over 6000 ART-conceived children found a small increased risk of birth defects, though it’s unclear whether this is due to ART itself or the underlying issues of the higher-risk patient population.
Heart Defects and ART
Heart defect formation is a complex biological process, which may explain their prevalence among ART-conceived pregnancies. Women undergoing ART should have detailed ultrasounds and fetal echocardiograms to assess for potential heart defects. Folic acid supplementation is also crucial.
Limitations of Current Studies
Despite 60,000 U.S. infants born via ART annually, most studies focus on populations outside the U.S. and involve small sample sizes. More research on diverse U.S. demographics could enhance recommendations for couples.
For now, take a deep breath. Throughout my IVF journey, even with setbacks, I remained hopeful. After three years of trying, my son was born, filling my heart with joy.
About the Author:
Dr. Sarah G. Obican is an OBGYN and Maternal Fetal Medicine specialist at the University of South Florida. She serves on MotherToBaby’s Board of Directors and is a councilmember of the Teratology Society.
About MotherToBaby:
MotherToBaby, a service of the Organization of Teratology Information Specialists (OTIS), is an invaluable resource recommended by agencies like the CDC. For questions about exposures, call 866-626-6847 or text (855) 999-3525. Visit MotherToBaby.org for fact sheets and more information.
References:
- CDC Infertility Statistics
- Davies MJ, et al. Reproductive technologies and the risk of birth defects. N Engl J Med. 2012.
- Olson CK, et al. In vitro fertilization is associated with an increase in major birth defects. Fertil Steril. 2005.
- Hansen M, et al. Assisted reproductive technology and birth defects. Hum Reprod Update. 2013.
- Kelley-Quon LI, et al. Congenital malformations associated with ART. J Pediatr Surg. 2013.
