Risk of congenital malformation to children born after assisted reproduction

For some years now there have been big question marks relating to the overall safety of assisted reproductive technology, and whether the children born have any increased risk of poorer health outcomes than those conceived naturally.

The processes involved in sperm selection and subsequent fertilisation procedures (ICSI), as well as pre-implantation testing of the embryo (PGD) involving the removal of one or two early cells, are two aspects of modern IVF which are already under scrutiny.

A French study (*www.eshg.org/13.0.html), the largest to date confronting this problem, was presented in Gothenburg (Sweden) today, 14 June 2010, at the annual conference of the European Society of Human Genetics.  The study suggests that there is an increased risk of congenital malformation following IVF, but fortunately not as high as has been suggested by other smaller studies.

The risk factors are nevertheless significant, some occurring more frequently in boys (heart disease and malformations of the urogenital system) and others in girls, who have a five times higher rate of benign tumours near the skin.

UK legislation which governs the practice of assisted reproduction (HFE Act 2008), stresses the importance of the welfare of children in relationship to these new technologies, and we should all take very seriously this latest research.

CORE has always argued that IVF should be the last and not the first port of call when patients present with infertility problems, and every effort should be made where possible to restore fertility so that prospective parents do not automatically end up at the IVF clinic.

The biggest questions need to be raised in relationship to the use of IVF for purely social reasons – single women or post-menopausal conceptions for example.

Could it ever be ethical to expose future offspring to such risks, or any, in circumstances where true infertility is not even involved?    As a just society surely our duty should always be towards the best interests of the children.

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