November 3, 2004

Taking A Closer Look at IVF

Liza Mundy went to the American Society For Reproductive Medicine conference last week in Philadelphia, and all she got was a bunch of unanswered questions about how IVF kids turn out. And a sperm-shaped pen.

Despite phenomenal growth over a quarter century of in-vitro fertilization--over 40,000 IVF babies were born in the US in 2001--Mundy says there are still too many under-researched scientific, developmental, health, and genetic issues.

Besides the big questions of long-term health, cognition, etc., the "uncle with the stinky cigar" in the IVF world is multiple births. To increase probability of success, US doctors regularly implant three or more embryos. One result: 1/3 of IVF births are multiples, and over half of IVF kids are multiples.

Another controversial topic: infertile men. New single-sperm-injection techniques mean even the most infertile guy with the weakest sperm ever can now father a child. It's positively "anti-Darwinian," says one doctor [who'll happily take that cup from you and cash that check anyway.]

How Do IVF Babies Turn Out? [Slate]


As the father of ivf twins, I have to wonder why the prospect of multiples is considered a "risk" and especially why someone would think it was an undiscussed or unknown one. It is almost all ivf hopeful parents talk about, after wondering whether they'll conceive at all.
[Similarly for ICSI--everyone I know who has considered this procedure is scared stiff of its possible effects on the embryo, and this definitely includes those who choose to go ahead with it. Do we really think people are unaware of or unconcerned with these issues?]
There may be some increased risks in carrying multiples, but there are such wonderful things in store for the twins themselves and the parents that it is weird to consider this a "risk."
In my view, the Slate story is a simplistic and typical recap by a non-scientist of complicated science. The largest and most rigorous studies consistently fail to find significantly increased risk in IVF that is not accounted for by the average greater age of the parents at time of conception, or similar. If there is increased risk of disease or defect, it's pretty small. And, I think we all are terribly aware--probably over aware--of these risks.

I came away from the Slate piece with the notion that there weren't enough formal studies being done that focus on the longterm health and development of IVF kids.

Your points about multiples and the risks that are readily associated with other factors (parental age, etc) are well-taken. They get a mention in the article, but not enough emphasis.

Anyone know how I can get preliminary research reports from ASRM meeting 2004 Philly - by Croughan "Childhood Outcomes Following Infertility and INfertility Treatment"?

Forget all that. Where do I get one of those sperm-shaped pens?

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