Health risks higher for assisted reproduction, but . . .

Although the health risks for mother and child are higher for assisted reproductive technologies (ART) than spontaneous conception, much of this is related to the underlying health risks of being infertile, according to a review of singleton pregnancies in the July 28 issue of the Lancet. Children born after ART appear to develop normally with normal family relationships.

Alastair G. Sutcliffe, MD, from University College London in the United Kingdom, and Michael Ludwig, MD, from Endokrinologikum in Hamburg, Germany, reviewed the risks of ART by searching the published medical literature and abstracts from 1980–2005, including 3,980 articles.

Couples undergoing intracytoplasmic sperm injection have a higher risk of sex chromosome abnormalities, possibly due to the high percentage of abnormal sperm in these couples. The risk of pregnancy complications is higher, including a 55% higher risk of preeclampsia, a twofold higher risk of preterm delivery, and a threefold higher risk of placenta previa.

"Some of the risks to children born after assisted reproductive technologies do not arise as a result of the techniques but from the background biology of the subfertile couple," Sutcliffe and Ludwig wrote. "Child development seems to be normal, and no adverse psychosocial effects are apparent for families who have undergone the sometimes stressful procedures involved."

Sutcliffe AG, Ludwig M. Outcome of assisted reproduction. Lancet. 2007;370:351-359.