Are ART Pregnancies at Higher Risk of Birth Defects? Here’s What a New Study Reveals
A groundbreaking Australian study sheds light on why pregnancies achieved through assisted reproductive technology (ART) may have a higher likelihood of birth defects compared to naturally conceived pregnancies. The findings highlight the role of certain medications used during fertility treatments and their potential impact on fetal development.
Medications and Birth Defects: The Link in ART Pregnancies
The study revealed that pregnancies achieved via in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) had higher exposure to teratogenic medications during the first trimester. These medicines, classified as Category D and X by Australia’s Therapeutic Goods Administration (TGA), carry risks of fetal harm:
- Category D medicines: May pose risks but are sometimes justified for treating conditions like
- Epilepsy
- Mental health disorders
- Category X medicines: Strongly discouraged due to their high potential for fetal harm
What Did the Study Find?
Researchers analyzed data from 57,000 pregnancies across four groups:
- ART pregnancies (2,041 cases).
- Pregnancies with ovulation-inducing medications (590 cases).
- Untreated sub-fertile pregnancies (2,063 cases).
- Naturally conceived pregnancies (52,987 cases).
Key findings include:
- First-trimester exposure to Category D medicines:
- 4.9% in ART pregnancies vs. 0.6% in natural pregnancies.
- Later trimesters:
- 3.4% in ART pregnancies vs. 0.6% in natural pregnancies.
Category X medicines exposure: Less than 0.5% across all groups and trimesters
Why Are ART Pregnancies More Exposed?
According to Dr. Anna Kemp-Casey, lead researcher from the University of South Australia, the higher exposure is linked to medications used to prevent repeat miscarriages or failed implantation rather than treating chronic conditions.
- ART pregnancies often involve progestogens like medroxyprogesterone acetate, prescribed for recurrent miscarriages or threatened pregnancies.
Common Category D/X Medications in Pregnancy
The study identified the five most frequently used Category D/X medications:
- Paroxetine (used for mental health conditions).
- Lamotrigine (for epilepsy).
- Valproic acid (for epilepsy and bipolar disorder).
- Carbamazepine (for epilepsy and nerve pain).
- Nicotine dependence treatments.
Expert Insights: What This Means for ART Babies
Professor Roger Hart, co-researcher and national medical director of City Fertility, emphasized that while ART pregnancies are meticulously planned, medications used during fertility treatments may inadvertently heighten risks during critical stages of fetal development.
However, he reassures:
- Most IVF babies are healthy, and the findings don’t imply ART pregnancies are unsafe.
- The study underscores the need for personalized medical care and close monitoring during early pregnancy.
What’s Next? More Research Needed
The researchers call for further studies to explore:
- The impact of Category D and X medications on ART pregnancies.
- The role of maternal health conditions in birth defect risks.
ART and Birth Defects: The Bigger Picture
Globally, ART has enabled the birth of over 10 million children since its inception in 1978. In Australia and New Zealand alone, 20,000 children were born using ART in 2022, according to the latest ANZARD report.
However, studies, including a 2021 U.S. analysis of 1.2 million births, have highlighted:
- An 18% higher risk of birth defects in IVF babies.
- A 36% higher risk in ICSI pregnancies, with variations based on the cause of infertility.
IVF vs. ICSI: What’s the Difference?
- IVF: Sperm is added to a dish containing eggs, allowing natural fertilization.
- ICSI: A single sperm is directly injected into each egg, often used for male infertility or unexplained infertility cases.
Final Takeaway: ART Is Safe, But Vigilance Is Key
This study reaffirms that while ART has revolutionized fertility treatments, personalized care and careful medication use are crucial for minimizing risks. For couples undergoing ART, open communication with healthcare providers ensures the best outcomes for both mother and baby.
By staying informed and proactive, families can navigate the journey of ART with confidence and care.
Source: Inputs from various media SourcesÂ
