Professor Nygren reviews current state of IVF safety

Some 4 million children have now been born, following IVF treatments worldwide. It is generally regarded as a safe technique, but some scientific and press reports have noted an increased rate of problems following IVF in comparison to 'natural' conception and birth. Now a review by the Chair of the international body which collects data on IVF concludes that IVF is generally safe, although he stresses that patients need to be made aware of the slight risks, and that we need to continue to monitor the results of the technique.

Professor Karl-Gösta Nygren (Stockholm, Sweden) is Chair of ICMART, the International Committee Monitoring Assisted Reproductive Technologies, which has data on around 75% of all births from IVF worldwide. Speaking at the World Congress of Fertility and Sterility in Munich, Professor Nygren reviewed the current state-of-the-science on the safety of IVF.

Delivering the IFFS's inaugural Jean Cohen lecture, he concludes that there are increased incidences of certain problems, but these are at a low level. At the same time, he notes that while there are some higher incidences of problems related to IVF, these might be due to the fact that all patients undergoing IVF procedures are patients who already have reproductive problems.

In addition, Professor Nygren shows that the introduction of Single Embryo transfer (SET) contributes to the safety by preventing the complications which go with multiple births

Prof Nygren said

"To pronounce IVF to be safe or not would be an oversimplification.  Nothing is totally safe. For example, there is, of course, no such thing as a zero risk-level for pregnancy and childbirth.

Safety also needs to be balanced against what people find acceptable. For example, there is no doubt that Single Embryo Transfer is safer for the mother and child than is Multiple Embryo Transfer. However, some people and some cultures are willing to take the higher risks in return for a greater chance of a pregnancy.

Ideally we would want safety for IVF children and mothers to be as good as safety for any other child or mother. Our studies have shown that that this is not completely achievable. IVF has been shown to have increased risks for example, pre-eclampsia, neonatal deaths, and some birth defects, such as the rare condition Beckwith-Wiedemann syndrome. There are also some areas where new techniques have only recently been developed, and which need to be monitored. Vitrification might be an example here.

In some cases higher risks may be due to the IVF techniques themselves. But we suspect that in many cases the greater risks are due to the fact that people who come for IVF already have difficulties in reproducing, and so by definition, reproduction is more difficult for them.

In summary, if we ask is IVF safe, then the real answer must be 'safe enough from what we know'. The risks are small, and need to be kept in perspective, especially when set against the potential benefit of having a child. But we can't be complacent, we need to keep monitoring especially with new techniques, and although the risks are low, they always need to be explained to prospective parents".

Professor Nygren is Associate Professor of Obstetrics and Gynaecology, Stockholm, Sweden. 

Source: International Committee Monitoring Assisted Reproductive Technologies

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