Recommendations made for new research to settle questions on in vitro fertilization (IVF)

Twenty-five years after the birth of the first baby conceived through in vitro fertilization (IVF), there remain many unanswered questions about the health and well-being of babies born following IVF.

While research exploring health outcomes for IVF has increased substantially over the last decade, differences in study design and study conclusions have sometimes led to conflicting conclusions and to confusion among patients, providers and the public. To clarify what is known and what gaps remain, Kathy Hudson, Ph.D., director of the Genetics and Public Policy Center at The Johns Hopkins University, with funding from The Pew Charitable Trust, convened an expert panel to address whether IVF babies are at increased risk for adverse health outcomes.

The panel, co-sponsored by the American Academy of Pediatrics and the American Society for Reproductive Medicine, conducted a systematic review of studies published in the medical literature that reported on malformations and genetic anomalies, cancer, psychosocial and developmental outcomes, and health outcomes beyond one year. In addition, for neonatal outcomes, including premature birth, low birth weight and perinatal mortality, the panel considered a recent systematic review and metanalysis.

So far, their systematic review of relevant published data on the health of children born following IVF finds no evidence to support increased risk of most malformations, cancer or impaired psychosocial development. However, singleton IVF babies are at increased risk for low birth weight, prematurity and perinatal mortality.

There is a tenfold increase in multiple births following IVF compared to the overall population (32 percent and 3 percent respectively), and multiple births are at higher risk for adverse neonatal outcomes. However, multiple births following IVF are not at increased risk compared to naturally conceived multiple births.

The panel also identified a number of gaps in existing knowledge and is developing recommendations for well-designed research and surveillance efforts, recommendations for clinicians, including what information should be provided to patients, and recommendations for public policy.

The panel's preliminary findings will be presented at the American Society for Reproductive Medicine meeting in Philadelphia on Oct. 19 and at the American Society of Human Genetics meeting in Toronto on Oct. 27.

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