Outcomes of IVF: complications for babies and mothers
In the first installment of this series on assisted reproductive technologies (ART), we explored the moral implications of IVF as it pertains to the death of the embryos created through the process. For those of you who missed the first installment: in vitro fertilization is a common method of ART where human oocytes (eggs) are fertilized in a dish, before being implanted in the uterus. Last time, we discussed the death of embryos that is always involved in the process, either through intentional destruction, or unintentional loss. In this second installment, we will be considering the health outcomes from ART for the genetic mother, any surrogates, and the children conceived.
But, before we begin, it’s important to make the same caveat I made last time: regardless of how s/he was conceived, all human beings are valuable and worthy of dignity and respect. In no way should the talk of whether IVF is a moral means to go about conceiving a child EVER imply that the children (and now adults!) who were conceived through these means are any less valuable than everyone else. All human beings are equal in dignity.
We have long known that the children conceived in IVF have an increase in certain negative perinatal outcomes (outcomes occurring at, or soon after birth). It is uncertain whether these differences are owing to assisted reproduction, or to other factors that tend to be concomitant with the use of IVF (i.e. the causes of the infertility that led to a couple’s decision to use IVF). That is, the fact that most couples or individuals using IVF are of an advanced age, and have previously had issues conceiving, could be the underlying cause of the negative outcomes for children conceived in this way.
Still, whatever the reason, the likelihood that a child conceived through IVF could have health issues of some kind should give us pause, before resorting to this method of “assisted reproduction.” And there are some good reasons to believe that the IVF itself may cause some of the increased negative outcomes. For instance, children conceived after IVF seem to have an increase risk for preterm birth, low birth weight, and perinatal mortality, even when the analyses control for maternal age. 1
Additionally, certain genetic disorders, such as Angelman syndrome, seem to be more common (though still rare) in children conceived through IVF. 2 This is likely due to genomic imprinting issues in the early development. The source of these issues is unclear, but is perhaps caused by the unusual extra-uterine environment, and increased gonadotrophins caused by the process of harvesting the female gametes for fertilization. There is even some reason to believe that there may be down-stream intergenerational effects of the genomic printing issues. 3
For surrogates and egg donors, there are also additional risks. These women (the egg donors, and the women who carry the embryos to term) may or may not be the intended mothers of the children produced. For gestational surrogates (women who carry embryos not genetically related to them) this includes increased risk for hypertensive disorders and post-partum hemorrhage. 4 For women whose eggs will be harvested, risks include bleeding and ovarian hyperstimulation syndrome (OHSS). Mild cases of OHSS are characterized by nausea, abdominal pain, vomiting and diarrhea. More severe cases can include retention of fluid in the abdomen, difficulty breathing, and potentially lethal complications (like ovarian rupture, or renal failure). 5
And that’s just some of the increased risks that we know about.
The reality is, we don’t know all the effects that IVF may be having. Assisted Reproduction Technologies are still relatively new from a historical perspective, so years and generations worth of research would be needed to fully understand the impact it has on individuals and families.
While the response to this from the medical community seems to be to try to mitigate the negative effects, it seems reasonable to ask whether IVF is worth the risks to the children conceived and the women involved.
1 Growth and development of children born after in vitro fertilization - ScienceDirect
2 Growth and development of children born after in vitro fertilization (sciencedirectassets.com) 1669
3 Growth and development of children born after in vitro fertilization (sciencedirectassets.com) 1671
4 Henrike E. Peters, Roel Schats, Marieke O. Verhoeven, Velja Mijatovic, Christianne J.M. de Groot, Joanna L.
Sandberg, Immelie. P. Peeters, Cornelis B. Lambalk,
Gestational surrogacy: results of 10 years of experience in the Netherlands,
Reproductive BioMedicine Online,
Volume 37, Issue 6,
2018,