New Studies Highlight Medical Risks of In-Vitro Fertilization

By Abigail Wilkinson | July 24, 2014 | 12:32 PM EDT

(AP photo)

( While the fate of multiple embryos created in the process of in-vitro fertilization (IVF) is a frequently discussed medical ethics issue, far less attention has been paid to the risky nature of the procedure itself.

But these risks - including damaged eggs and a heightened chance of developing pregnancy-induced hypertension or Ovarian Hyperstimulation Syndrome (OHSS) - are now the subject of two medical studies released in Europe earlier this month.

The Human Fertilisation and Embryology Authority (HFEA), which is “dedicated to licensing and monitoring fertility clinics in the United Kingdom (UK) and all UK research involving human embryos,” released a report on July 8 that chronicled  “adverse incidents” reported by British fertility clinics.

Between January 2010 and December 2012, there were a total of 1,679 incidents reported out of some 60,000 cycles of fertility treatments, affecting one out of every 100 women who underwent IVF, the report stated.

Three were considered “A” incidents, which are defined as “the most serious events,” and include embryo mix-ups, storage malfunctions or the patient’s death.

Another 714 incidents were graded “B” for “serious adverse events,” such as the loss of a patient’s embryos or “breaches of confidentiality.”

However, the majority of adverse outcomes - 815- were considered less severe “C” grade incidents. They include the damage of eggs during processing and the development of OHSS due to the fertility drugs.

“Clinics can and should be eradicating these sorts of avoidable errors, which will go a long way towards reducing patient distress and improving the overall experience of IVF treatment,” said HFEA Chair Sally Cheshire.

The risks are heightened when donor eggs are used during the IVF treatment, another study from France shows.

According to the European Society of Human Reproduction and Embryology (ESHRE), egg donation now plays a role in 4 percent of all fertility treatments in the UK and 12 percent of all  treatments in the US.

“Our aim was to find out whether pregnancies from egg donation are genuinely associated with higher risk of hypertension and pre-eclampsia than those from treatments using the patient’s own eggs,” said Dr. Hélène Letur, who conducted the study.

The results indicated that IVF patients who used donated eggs had more than three times the risk of developing pregnancy-induced hypertension than did patients who used their own eggs, with the risk rising from 5.3 percent to 17.8 percent. The risk of pre-eclampsia is also magnified from 2.8 percent to 11.2 percent when using donor eggs.

“We would have to conclude from the results that egg donation itself is a risk factor for pregnancy-induced hypertension and pre-eclampsia,” said Dr. Letur.

An article published in BMJ (formerly the British Medical Journal) in January by several IVF clinicians, stated that “outcomes in children conceived through IVF seem to be poorer than in those conceived naturally...These effects seem to be related to the IVF procedure itself.”

“IVF has evolved in many parts of the world as a profit generating industry that values the money brought in by immediate gains of pregnancy and live birth over long term considerations about the health of the mothers and children,” the authors point out.

The National Institutes of Health (NIH) says that OHSS affects up to one in 10 American women who undergo IVF. It also points at the financial toll taken by IVF treatments.

“Fees for a single IVF cycle include costs for medicines, surgery, anesthesia, ultrasounds, blood tests, processing the eggs and sperm, embryo storage, and embryo transfer. The exact total of a single IVF cycle varies, but may cost more than $12,000-$17,000.”

The success rates of IVF in the US - the percentages of treatments which result in a live birth - are highest for women under the age of 35, ranging from 30 to 35 percent.

However, they decrease with age, falling to 25 percent for women ages 35 to 37, 15 to 20 percent for women ages 38 to 40, and just 6 to 10 percent for women older than 40.