The million-dollar question! Can IVF cause twins? The truth is, there is a possibility that twins could be conceived, but it depends on the number of embryos transferred. If multiple embryos are transferred, each one has the possibility of developing into an embryo. The greater the number of embryos transferred, the greater the chances of having more and more embryos successfully develop. These twins, triplets, etc. would be fraternal-meaning they did not originate from the same embryo and hence are not genetically identical. IVF cause twins has also been shown to increase the rate of monozygotic twinning by two- to twelvefold when compared with the spontaneous occurrence of 0.4% (Vitthala 2018; Blickstein 1999; Blickstein 2003)

Image by Society For Assisted Reproductive Technology

This image by the Society For Assisted Reproductive Technology says it all. Multiple births are on the decline, especially twin births. In 2017, only 13% of IVF births resulted in twins. If you were curious about the chances of conceiving twins, you must have also wondered about triplets, quadruplets and quintuplets! Their births through IVF are down to less than 1%.

That brings me to how genetically identical twins arise! When a single zygote splits into two separate ones, identical twins develop (one twin from each zygote). The chance of this split occurring is higher for those who have undergone IVF cause twins compared to those who have conceived the embryo naturally. 

Genetically identical twins

It is important to keep in mind that these days, only one embryo is often transferred into the patient. This is to avoid the chances of conceiving twins if the patient does not desire twins. Nevertheless, as we have seen, identical twins arise from a single zygote so it is still possible to have twins with one embryo transferred.  Additionally, it is to support the health of both the mother and the baby. Conceiving twins has its own risks and it is important for the parents to understand that prior to opting for IVF the chances of having twins isn’t exactly in their hands!

Is it possible to perform IVF and reduce the chances of having twins?

Yes, it is! As previously mentioned, these days single embryos are often transferred into the patient. Additionally, recent evidence shows that blastocyst transfer in fresh IVF cycles is associated with a significantly increased probability of monozygotic pregnancy in comparison to cleavage-state embryo transfers. (Mateizel 2016; Maheshwari 2016). Though the reason for increased risk of monozygotic twinning with IVF is debatable, there have been a handful of studies which have found other influencing factors including the oocyte age being < 35 years old, prolonging the embryo culture, micromanipulation of the zona pellucida after procedures such as intracytoplasmic sperm injection (ICSI) or assisted hatching (AH), and after fresh embryo transfer. (Tarlatzis 2002; Jian 2004; Knopman 2014; Kanter 2015).

Something interesting to note is that embryologists often try to perform the transfer at the blastocyst stage. This is for higher chances of a successful pregnancy and it is also to reduce the risk of having multiple embryos develop. However, this type of transfer has actually proven to increase monozygotic splitting (Kolibianakis 2002; Desolle 2010). Meaning that even if one blastocyst is transferred, it very well may split into two embryos. Blastocyst transfer has been shown in multiple studies to significantly increase the monozygotic twinning (MZT) rate, estimated at 1.7% which is 4.25 times higher than the natural pregnancy MZT rate of 0.4% (Nakasuji 2014).

One of the reasons it is though this happens is because culturing the blastocyst  We have to keep in mind however, that an IVF cycle is very expensive! One cycle will be at least around $10,000. A couple might not want to risk having to have a failed cycle and go through another one. (Remember that IVF is not only expensive, but emotionally exhausting too). Hence, the couple themselves might want several embryos transferred knowing that more than one might successfully implant. 

Another key aspect to remember is the statistics regarding single embryo transfer (SET). The probability of multiple embryos developing is 1.6%. This was discovered in a study involving 937,848 SET cycles and was published in Human Reproduction.

Speaking of SET cycles, check out the image below to see the gradual increase in SET cycles through the years! Embryologists are aware of the risk of having twins and want to ensure that they can do everything in their power to help an IVF cycle go the way you want it to! The image was obtained from the Society For Assisted Reproductive Technology which states that SET cycles are more common in women under the age of 38. This is most likely because of the decline in fertility as one ages. 

Image by Society for Assissted Reproductive Technology

What might increase the odds of multiple embryos developing?

According to the same study, researchers found that there are some procedures that might actually increase the chances of zygote. Some of these include using frozen-thawed embryos, maturing the fertilized egg for approximately 5 days in the laboratory prior to SET and assisted hatching. Assisted hatching is where an opening is created in the zona pellucida of an embryo. This is the outer coating of proteins. By doing this, it assists the embryo in hatching and attaching to the wall of the uterus for implantation.

What are the risks of having twins?

Twin babies are just precious! Two little bundles of joy! But it is important to understand some of the difficulties that could be faced when pregnant with twins. One of them is premature birth. 60% of twins are born prematurely before the 35th week of pregnancy. Being born prematurely leads to its own complications. For example, low birthweight is one. More than 50% of twins are born at a weight lower than 5.5 pounds. However, if the weight of a baby is as low as below 3.5 pounds the baby is also born before 32 weeks, the possibility of developing health defects is even greater. Some of these are mental retardation, cerebral palsy and vision or hearing loss. 

Another risk is the need for a cesarean section. Most women want to give birth naturally or want to avoid surgery unless very necessary. Unfortunately, when a patient is carrying twins, there is the risk of requiring surgery and as with most surgeries, there is a hefty recovery period that is certainly longer compared to that after natural birth. Cesarean also poses the risk of hemorrhage after the delivery. 

Something else to look out for is Twin-Twin Syndrome (TTS). This happens when a set of identical twins share a placenta. Because the placenta manages the blood flow into the fetuses and the exchange of materials from the mother to the baby, there is a risk of one baby obtaining more blood flow compared to its sibling. 

Pre-eclampsia is another risk. You might have heard about pre-eclampsia and pregnancy but do not know what exactly it is. It often occurs around 20 weeks into the pregnancy and is characterized by high blood pressure and damage to the liver and kidneys. When doctors diagnose pre-eclampsia, the most effective cure is to deliver the baby as it poses very high risks to the mother and baby. However, if the diagnosis is made very early on in the pregnancy, it becomes a little tricky because the baby requires more time to develop and grow inside the womb but also must be monitored very closely because of the pre-eclampsia. 

Conclusion

From the studies included in this blog post, it does seem that IVF may increase the likelihood of monozygotic splitting. Hence, when opting for IVF it is better to be ready for the possible situation of conceiving twins. As we’ve mentioned before, twins or no twins, every newborn is precious and absolutely perfect. The preparedness is rather for embracing some of the differences that may appear in finances and the health problems that occur in twin newborns and their mothers. However, as we have seen, it is not all black and white. Every IVF cause twins cycle does not have high chances of producing twins.

Influencing factors include the oocyte age being < 35 years old, prolonging the embryo culture, micromanipulation of the zona pellucida after procedures such as intracytoplasmic sperm injection (ICSI) or assisted hatching (AH), and after fresh embryo transfer. (Tarlatzis 2002; Jian 2004; Knopman 2014; Kanter 2015). I would suggest reading some of the studies we have referenced in this blog post to learn more. And more importantly, talk to your physician if you have any questions about the possibility of having twins and more information on how to reduce the chances of that happening if that is your desire. IVF has introduced around 42 years ago so there is still a lot we can learn and develop! ART is beautiful in that it makes the dreams of soon-to-be parents come true. The science behind it, however, is nearly equally and stunning and 

References:

1. Sundaram, Viji et al. “Multi-chorionic pregnancies following single embryo transfer at the blastocyst stage: a case series and review of the literature.” Journal of assisted reproduction and genetics vol. 35,12 (2018): 2109-2117. doi:10.1007/s10815-018-1329-8
2. Vitthala S, Gelbaya TA, Brison DR, Fitzgerald CT, Nardo LG. The risk of monozygotic twins after assisted reproductive technology: a systematic review and meta-analysis. Hum Reprod Update. 2009;15(1):45–55. doi: 10.1093/humupd/dmn045. 7. 
3. Blickstein I, Verhoeven HC, Keith LG. Zygotic splitting after assisted reproduction. N Engl J Med. 1999;340(9):738–739. doi: 10.1056/NEJM199903043400916. 
4. Blickstein I, Jones C, Keith LG. Zygotic-splitting rates after single-embryo transfers in in vitro fertilization. N Engl J Med. 2003;348(23):2366–2367. doi: 10.1056/NEJMc026724. 
5. Mateizel I, Santos-Ribeiro S, Done E, Van Landuyt L, Van de Velde H, Tournaye H, Verheyen G Hum Reprod. 2016 Nov; 31(11):2435-2441.
6. Maheshwari A, Hamilton M, Bhattacharya S Reprod Biomed Online. 2016 Feb; 32(2):142-6.
7. Tarlatzis BC, Qublan HS, Sanopoulou T, Zepiridis L, Grimbizis G, Bontis J. Increase in the monozygotic twinning rate after intracytoplasmic sperm injection and blastocyst stage embryo transfer. Fertil Steril. 2002;77(1):196–198. doi: 10.1016/S0015-0282(01)02958-2. 
8. 12. Jain JK, Boostanfar R, Slater CC, Francis MM, Paulson RJ. Monozygotic twins and triplets in association with blastocyst transfer. J Assist Reprod Genet. 2004;21(4):103–107. doi: 10.1023/B:JARG.0000029493.54929.be. 
9. Knopman JM, Krey LC, Oh C, Lee J, McCaffrey C, Noyes N. What makes them split? Identifying risk factors that lead to monozygotic twins after in vitro fertilization. Fertil Steril. 2014;102(1):82–89. doi: 10.1016/j.fertnstert.2014.03.039. 
10. Kanter JR, Boulet SL, Kawwass JF, Jamieson DJ, Kissin DM. Trends and correlates of monozygotic twinning after single embryo transfer. Obstet Gynecol. 2015;125(1):111–117. doi: 10.1097/AOG.0000000000000579. 
11. Nakasuji T, Saito H, Araki R, Nakaza A, Nakashima A, Kuwahara A, Ishihara O, Irahara M, Kubota T, Yoshimura Y, Sakumoto T J Assist Reprod Genet. 2014 Jul; 31(7):803-7.
12. Kolibianakis EM, Devroey P. Blastocyst culture: facts and fiction. Reprod BioMed Online. 2002;5(3):285–293. doi: 10.1016/S1472-6483(10)61834-2. 
13. Dessolle L, Allaoua D, Fréour T, le Vaillant C, Philippe HJ, Jean M, Barrière P. Monozygotic triplet pregnancies after single blastocyst transfer: two cases and literature review. Reprod BioMed Online. 2010;21(3):283–289. doi: 10.1016/j.rbmo.2010.04.011. 

Pooja is the content manager at ART Compass and works on the blog and social media content. She is an undergraduate student at Drew University pursuing a major in Biochemistry and Molecular Biology and minors in Business and Sociology. She has undertaken a literary research project on stem cell treatments for multiple sclerosis and wishes to continue stem cell research during her time at Drew. She is an associate member of the Tri-Beta Biology Honors Society and volunteers on an EMS squad and at the Red Cross. She hopes to attend medical school in the future.

A TTC journey is filled with making important decisions- and they aren’t easy. So, does IVF work?

“Should I opt for IVF?”

“Do I adopt?”

“Should I keep trying before I visit the doctor?”

“Do I try another IVF cycle?”

It isn’t like deciding between cookie dough or rocky road in the ice cream aisle. Being decisive isn’t easy. That’s why it’s so important that you have all the information you need! Knowledge is literally power. One of the things that might help you is knowing the success rate of IVF work, how it works and of course- does IVF work?

Image by Sarah Pflug

Assisted Reproductive Technologies (ART) have come a long way. Embryologists and lab technicians know how to maximize the chances of success for your IVF cycle. The Center for Disease Control (CDC) offers some statistics to support that! In 2018, The CDC reports that 306,197 ART cycles were performed by 456 reporting clinics in the U.S.A. This number did not include 8 cycles in which a new treatment procedure was being evaluated. This resulted in 73,831 live births (deliveries of one or more living infants) and 81,478 live born infants. Of the 306,197 ART cycles performed in 2018, 103,078 were performed using egg or embryo banking cycles where resulting eggs or embryos are frozen for later use.

Image by Society For Assisted Reproductive Technology

Now it’s time for some graphs and figures! Take a look at these graphs provided by the Society For Reproductive Technologies. It shows that the liveborn delivery rate for IVF was around 35%! In 1985 that was only 5%. This could only mean we will continue to see a rise in success rates of IVF.

Image by Society For Assisted Reproductive Technology

How often is ART even used?

ART hasn’t been around since the old ages. It is relatively new! Nevertheless, the CDC reports the usage of ART doubling in the last decade! In 2018, 1.9% of all infants were conceived with the help of ART! That might seem like a small number, but keep in mind that this percentage is of the whole infant population in the U.S.A and that not every couple experiences infertility or requires the use of ART.  

How far has IVF come?

A long way.

Today there are countless fertility clinics and apps that are ready to help someone who wishes to have a little bundle of joy! One of those apps is our very own ART Compass! When clinics use our app, they have access to amazing quality control and quality assurance measures that could be used in their lab! Embryologists are given tools via ART Compass to help them make the best decisions to create your baby! In other words, ART Compass offers services that can help an IVF cycle be more organized and easier to handle for embryologists.

After all, a patient’s data is all in one place! That makes the job of the physician easier as well. Lastly, there’s you- the patient! Have your IVF cycle’s data all in one place! Not only that, but view your cryostorage inventory. That’s simply how many eggs or embryos you have been frozen at the moment! With such apps out there making everyone’s jobs easier, it reduces the risk of error throughout the process. With greater accuracy and precision, there is almost bound to be better results!

Wrapping it up

In simplest terms, IVF and ART, in general, are great options to explore when deciding what your next step on your TTC journey should be. However, we always stress this- there are many factors that play into whether a specific form of ART may be the best choice for you. These include age, medical history, family history, expenses, and more. Every individual is different. And if there’s one thing we know, it’s that ART is certainly not a one size fits all! Make sure you talk to your doctor and seek their opinion on what may be some of the best options. 

Something else I would recommend is to take some time in reading people’s IVF success stories or experiences. It might help you understand what it was like going through IVF and whether it’s something you want to pursue. No one understands each other better than the TTC Tribe! There are many blogs out there that most people’s IVF stories in order for their voices to be heard. While it may not be a medical expert’s opinion, it’s a story that’s being shared by a fellow TTC Tribe member. Listening to what they found difficult, interesting, or joyful will help you paint a better picture as to what experiencing an IVF cycle may be like. Does IVF work?

References:

1. “Are IVF Twin Embryos a Risk?” Progyny
2. “ART Success Rates,” Centers for Disease Control
3. Society for Assisted Reproductive Technology

Pooja is the content manager at ART Compass and works on the blog and social media content. She is an undergraduate student at Drew University pursuing a major in Biochemistry and Molecular Biology and minors in Business and Sociology. She has undertaken a literary research project on stem cell treatments for multiple sclerosis and wishes to continue stem cell research during her time at Drew. She is an associate member of the Tri-Beta Biology Honors Society and volunteers on an EMS squad and at the Red Cross. She hopes to attend medical school in the future.

Is IVF painful?

Is IVF painful? It’s a good question! And the truth is, there really is not a great deal of pain involved in IVF. It may seem like it but, understanding the process of IVF and what exactly happens may make it seem less daunting! So let’s break down some of the steps of IVF is painful that may cause someone to panic! Before we move on, check out our “IVF Timeline” post on Instagram! We have a step-by-step layout of what happens in a single IVF cycle, how long each step takes, and how much time lies in between the steps! 

Image by Shopify Partners

Fear of needles?

One of the first steps in IVF is taking injectable fertility medications. These serve the purpose of ovarian stimulation. This is done for approximately 8-15 days. The injections do not seem so bad once you look at the bigger picture- your little bundle of joy that will soon be on its way! But if you have a significant fear of needles, you might want to think ahead of how you plan on administering the injections.

Think about whether you will want a support system nearby when you take them and if you will want someone to administer the injections for you. Also, try to brainstorm ways to distract yourself during it! During one of my trips to the doctor’s office, my physician told me to start coughing while she gave me the shot. Though I was incredibly confused, I gave it a try. And it worked! It helped decrease the pain a bit. Still facing Is IVF painful?

Egg Retrieval

This is one of the most important steps of IVF! You need the egg of course! Surprisingly though, it’s only a 30 minute procedure. Additionally, patients are normally given pain medication or sedated. So it should essentially be painless. The procedure is performed by placing an ultrasound probe into the vagina. This is to locate the follicles. A long thin needle is then inserted into the ultrasound probe so that the eggs can be retrieved from the follicles.

If Transvaginal ultrasound aspiration is not able to reach the ovaries, an abdominal ultrasound might be used. Because the needle is attached to a suction device, the eggs are able to be removed from the follicles. As mentioned before, this procedure is painless. However, after it is completed it is completely normal to feel sensations such as fullness or pressure or even cramping. If you happen to be feeling anything very severe, it is a good idea to check in with your physician to make sure everything is okay.

Embryo transfer

This is the other procedure that often worries patients. You may or may not be given a sedative for this procedure but similar to the egg retrieval, it is essentially painless! A catheter is placed in the vagina. It enters the cervix and then the uterus. A syringe containing the embryos is then attached to the catheter and the embryos are placed into the uterus. Mild cramping after the procedure is completely normal. Apart from that you really shouldn’t feel too much discomfort. If you happen to experience any severe pain, certainly confide in your physician. 

The pain of waiting

IVF is not a quick and rapid process. An IVF cycle requires time, precision, accuracy and most importantly patience. For example, the injections are taken anywhere from 8-15 days. That’s 2 weeks before procedures can actually begin to be performed! It takes patience to get through that period. Some time between day 8 and 12 (with day 1 being the first day of your period) you are required to take an hCG injection. Approximately 36 hours after the injection is when the egg retrieval is performed.

It is essentially three days of waiting and preparing yourself for the procedure. Another slightly difficult time period to wait out is that after the transfer of the embryos. It takes approximately two weeks to take a pregnancy test and know whether it is positive or not. It is crucial to not feel helpless during these waiting periods of IVF. Keep yourself distracted and remind yourself that you have done everything you possibly can. It can sometimes be difficult to push a thought out of your head or to not worry about what the pregnancy test will bring, However, understanding that you have done everything that you can makes it easier. 

Image by Sarah Pflug

What if things don’t go the way I want?

IVF is the work of countless embryologists, technicians, clinical staff, doctors, nurses- you name it! It really does take a village to grow an embryo. Each and every person performs each step so meticulously and with great care. Nevertheless, there is still the possibility of an unsuccessful IVF cycle. The emotional burden that comes along with IVF is very real and often misunderstood by those who have never experienced infertility. It involves great deals of stress but requires persistence as well.

It is essential that somebody understands that an unsuccessful IVF cycle is not the end of their TTC journey. You can always take control of your TTC journey. Unsuccessful procedures don’t define the journey. Always remember to have a support group who encourages you to keep trying and will support the decisions you make rather than try to make them for you. Additionally, never be shy to reach out to your physicians with questions and concerns. They want what is best for you and having all the information you need is crucial. It is what helps you make the best decision for your TTC journey.

Image by Matthew Henry

Powering through

You are STRONG! Getting through infertility is no easy feat. You’ve got the strength and grit to do it and that is incredibly impressive. Though there is not too much physical pain involved in IVF, there is clearly an emotional stress that is placed on the patient. It is important to keep that in mind when you decide to begin your cycle. During your cycle, ensure you take measures to take care of yourself and your mental well-being. Whether it is a daily walk in the park, a meditation session, cooking up some comfort food, find what puts you in your happy place. And ALWAYS reach out to your physician if you do feel severe discomfort at any point in the cycle or friends or family if your anxiety catched up with you. You’ve got this. And we’ll be here cheering you on.

References:

1. “In vitro fertilization (IVF)” Mayo Clinic

The Real Truth: Can IVF cause cancer

Are you slightly nervous about beginning fertility treatments? It’s completely normal! Having questions is completely understandable and we urge you to ask them! Learning more about the ways in which you can overcome infertility and gathering all the information you can is exactly how you can take control of your TTC journey! At ART Compass, we’re here to answer your burning questions!

The relationship between the risk of cancer and women who undergo fertility medications is a very grey area. While there has been some research performed, there is still more to know about the relationship if there is any. We’re here to provide you with a quick summary of the findings of these studies!

IVF and breast cancer

This relationship is a little blurry. Studies don’t outright prove that there is a relationship but there is some evidence. A study by Katz. et al.  portrays a relationship. It demonstrated that IVF treatment after the age of 30 years was associated with a greater risk of developing breast cancer. (Katz. et al. 2008) This might make it easy to say there is a correlation. However, another study by Williams et al. during 1991 and 2010 raised doubt among scientists. The study involving many participants showed that regardless of whether an infertile individual endures fertility treatments or not, they had 2x the chance of developing breast cancer. (Williams et al. 2018) Because of that statistic, it is difficult to credit IVF with directly influencing the probability of developing breast cancer.

Lastly, we’ve got a study by Gauthier et al. This study involved many women (98,997 women!) They were all aged between 45 and 60 years old. There was no relationship seen between the risk of breast cancer and infertility treatment, the type of treatment, the type of drug, the age of the person at the start of treatment, and the duration of treatment (Gauthier 2004). They inferred that a higher chance of developing breast cancer from ovulation inducing drugs is rather related to family history (Gauthier 2004). 

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IVF and ovarian cancer

Ovarian cancer is a more rare form of cancer compared to breast cancer. That does not mean it cannot be fatal. As for its connection to reproductive health, there are many studies about infertility drugs and their influence on developing ovarian tumors but not too many about IVF. A study published in the Journal of Cancer Research and Clinical Oncology andconducted by Kessous et al. from 1988 to 2013 demonstrated that the increased risk for ovarian cancer may be greater for those who have undergone IVF compared to the population that received ovulation induction and those with no history of fertility treatments. (Kessous 2015)

IVF and endometrial or uterine cancer

In a study performed by Venn et al., twelve cancers of the uterus and 13 cancers of the ovary and other uterine adnexae were identified in the 29,700 IVF patients involved. They were of the ages 28- 48 years. 5 of the cancers were diagnosed within 8 months of referral for IVF or IVF treatment while the remaining were diagnosed between 1 and 12 years later (Venn 2001). Two important cases this study chose to highlight are that a choriocarcinoma of the fallopian tube was diagnosed in a woman with a history of tubal infertility and that ovarian cancer was diagnosed in a woman with Bloom’s syndrome, a rare autosomal recessive disorder associated with increased cancer risk. (Venn 2001).

IVF and cervical cancer

This factoid is a bit surprising! Studies have shown that those who have undergone IVF reported lower risks of cervical cancer. This is the one cancer that has shown a completely different pattern in comparison to other cancers. It is also thought that infertility, number of IVF cycles, and treatment outcome do not affect the probability of one developing cancer. (Dor 2002)

IVF and colon cancer

Can IVF cause cancer? We’ve talked a lot about cancers related to the female reproductive system. However, it is important to also brush over a cancer that is not. A study by Brinton et al. was a 30 year follow-up of 9,892 women! They were all treated with pre-IVF fertility medications. These drugs were not proven to cause colorectal cancer (Brinton 2015).

Back to the question

So does IVF cause cancer? After digging through countless studies, we’ve found that there are instances where IVF may potentially increase one’s susceptibility to cancer, not affect one’s susceptibility and finally, even decrease one risk. There is no one right answer. There are a lot of factors that play into such relationships such as what specific cancer you are concerned with, the individual’s family history, pre-existing conditions, and the person’s environment. That’s what makes medicine mysterious.

There is always so many moving parts IVF causes cancer and that is what makes every patient different from one another. That’s what prevents there from being ONE answer. Because your TTC journey is one-of-a-kind, always ask your physician for guidance! If cancer is a major concern of yours and is what’s keeping you from giving IVF a try, convey that to your doctor. There’s no need for you to do this on your own! Find what is right for you and your TTC journey!

References:

1. Katz D, Paltiel O, Peretz T, Revel A, Sharon N, Maly B, et al. . Beginning IVF treatments after age 30 increases the risk of breast cancer: results of a case-control study. Breast J. (2008) 14:517–22. 10.1111/j.1524-4741.2008.00641.x

1. Williams CL, Jones ME, Swerdlow AJ, Botting BJ, Davies MC, Jacobs I, et al. . Risks of ovarian, breast, and corpus uteri cancer in women treated with assisted reproductive technology in Great Britain, 1991-2010: data linkage study including 2.2 million person years of observation. BMJ. (2018) 362:k2644. 10.1136/bmj.k264

1. Kessous R, Davidson E, Meirovitz M, Sergienko R, Sheiner E. The risk of female malignancies after fertility treatments: a cohort study with 25-year follow-up. J Cancer Res Clin Oncol. (2016) 142:287–93. 10.1007/s00432-015-2035-x
2. Gauthier E, Paoletti X, Clavel-Chapelon F. Breast cancer risk associated with being treated for infertility: results from the French E3N cohort study. Hum Reprod. (2004) 19:2216–21. 10.1093/humrep/deh422

1. Venn A, Jones P, Quinn M, Healy D. Characteristics of ovarian and uterine cancers in a cohort of in vitro fertilization patients. Gynecol Oncol. (2001) 82:64–8. 10.1006/gyno.2001.6209

1. Dor J, Lerner-Geva L, Rabinovici J, Chetrit A, Levran D, Lunenfeld B, et al. . Cancer incidence in a cohort of infertile women who underwent in vitro fertilization. Fertil Steril. (2002) 77:324–7. 10.1016/S0015-0282(01)02986-7

1. Brinton LA, Moghissi KS, Scoccia B, Lamb EJ, Trabert B, Niwa S, Ruggieri D, Westhoff CL Fertil Steril. 2015 Oct; 104(4):980-988.

The first ever “test tube baby” was born in 1978. Though that was 42 years ago, it is still relatively recent compared to other scientific discoveries. It’s understandable that you might have your questions about the efficiency of IVF and its outcome. So, are IVF babies healthy? One of the most common questions is if an IVF baby is any different from a baby conceived naturally or if either baby is healthier. The truth lies in scientific studies and research. IVF babies seem to be just as healthy as naturally conceived babies though there is evidence of certain disparities that require further research. So let’s begin!

Things to Know About IVF Babies

Couples experiencing infertility often view IVF as a viable option. However, if there are any congenital abnormalities in the child, it may not be a direct result of the IVF treatment. It could possibly be the effect of abnormalities in the sperm or eggs of the partners involved as a result of the infertility itself. Specifically, men with a low sperm count possess the highest risk of having a child with an abnormality. Because men with low sperm counts often decide to try ICSI (intracytoplasmic sperm injection), ICSI might have higher risks of leading to abnormalities than IVF. This difference does not exist if the man involved in ICSI does not have a low sperm count. The probability of the fertile population having a child with a genetic defect is approximately 3%–5%. The birth defect rate increases by approximately 1 percent for those who undergo IVF. However, studies show that couples struggling with infertility have that same disparity even if they choose not to opt for IVF.    Additionally, many individuals who opt for IVF are of older age. Older age does influence fertility and in turn the probability of the fetus developing a genetic abnormality. That is an important concept to keep in mind when analyzing the congenital abnormalities of any child conceived via IVF or any assisted reproductive technologies (ART). 

Are IVF Babies Healthy? – The Research

A study in Australia used questionnaires and a three-hour medical screening of each individual in the study who were conceived by IVF. They found no evidence of heart, growth, metabolic or respiratory problems. ART conceived men also seemed to have lower blood pressures. However, IVF conceived adults reported suffering from asthma as a child. This disparity was not noticed during adulthood. 

IVF Babies and imprinting disorders?

Imprinting disorders are when paternal or maternal genes are mistakenly expressed in the embryo. This risk in the IVF population is 2-5 individuals out of 15,000 while for the general population it is 1 out of 15,000.

What are preimplantation genetic tests?

Pre-implantation genetic tests (PGT) provide IVF patients with the opportunity to confirm if their embryo might test positive for a specific genetic disease. The search for the specific disease may be because one of the parents has the disease or is a carrier. This test is carried out before the embryos are transferred for implantation. That way, embryos with abnormalities or chances of a failed pregnancy can be avoided. Recently, invasive and damaging trophectoderm biopsy that can only be performed by the most skilled embryologists has fallen out of favor for safer, more accurate Artificial Intelligence. AiVF is a world leader in developing new technologies that advance infertility and IVF healthcare, and reduce the risk of transferring unhealthy embryos.

EMA by AiVF is a multi-module integrated platform that combines AI, computer vision, and big data to improve the success rates in patients undergoing IVF treatment. Its genetic evaluation tool can determine if the given embryo is genetically suitable for transfer by avoiding an invasive biopsy. AiVF has the largest embryo database in the world and the platform offers objective and automatic tools. One groundbreaking study from AiVF, tested the effectiveness of EMATM, AiVF’s multi-module integrated platform, which combines AI, computer vision, and big data. According to the study, EMATM detected significant differences between aneuploid and euploid embryos during the first five days of embryonic development. This was based on a retrospective study involving 2,500 embryos with PGT-A results – 1,000 euploid (genetically normal) embryos and 1,500 aneuploid (genetically abnormal) embryos. Aneuploid embryos were significantly more likely to reach each specific embryo developmental event later than euploid embryos and the time gaps between developmental milestones were also statistically longer in aneuploid embryos.

What is amniocentesis?

Amniocentesis is when a needle is inserted into the uterus to extract amniotic fluid from the amniotic sac, a bag-like structure that encompasses the fetus. The amniotic fluid is what the fetus floats in. By obtaining a sample of the fluid, paternity testing, genetic testing, testing for infections and a test for the fetus’s lungs can be conducted. This offers a way to ensure that the fetus is safe inside the womb!

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Should this affect my decision to opt for ART?

Decisions that you and your partner make regarding your fertility journey and completely intimate! A lot of the journey depends on intuition and following what you think is the best path with a little advice or help from your physician. However, as we have seen, the disparity between IVF babies and the general population is not very significant. Also, while I have been able to list some disparities between individuals conceived via IVF and those conceived naturally, there is still a lot that remains unknown. IVF technologies are only 42 years old. This means the oldest possible individual conceived using IVF is 42 years old. Hence, the possible side effects in the elderly are not yet known. There is still more to learn about IVF. But as we have seen, the medical community has devised tests and tools to help identify abnormalities in the embryos early on. With continued efforts by scientists and healthcare professionals, there will always be new and improved ways to know how your embryos are doing! If you ever have further questions, always contact your physician! They’ll help guide you through your TTC journey! 

Responding to concerns about IVF babies

IVF is unarguably one of the greatest achievements by the medical community. Infertility is a rough, exhausting and draining journey. IVF provides those struggling with infertility with the opportunity to begin or expand their family. It gives them their long awaited bundle of joy. Unfortunately, many parents experience social stigma because of their decision to opt for IVF. Perhaps you have been asked insensitive or personal questions by friends and family. Or maybe people have found it okay to look down upon someone’s decisions and for their infertility issues they do not have control of. The worst of all, someone might have looked at your child differently once you revealed you’ve undergone IVF. Suddenly they question the child’s health and wellbeing when they have no idea what they’re talking about. If you have a child born via IVF, know that he or she is beautiful. Any concerns you have about their health should be between you, your child and a physician. Here at ART Compass, we are a TTC tribe and support one of another. There is no room for shame or hate.

References:

O’Connell B, Sun H, “Study finds IVF children as healthy as naturally conceived peers, “Monash IVF, April 2016.