Fertility treatment as safe as natural conception as stillbirth rates fall

Fertility treatment as safe as natural conception as stillbirth rates fall

Fertility treatment is becoming as safe as natural conception following a fall in the rates of stillbirths and premature deliveries, a major new study has shown. ‘Test-tube’ babies now have almost the same chance of surviving as those conceived naturally thanks to improved techniques and regulations.

The largest ever study into the health of babies born through fertility treatment showed that the rates of stillbirth, premature delivery, low birth weight and death in the first year of life, have fallen dramatically since the late 1980s.

Researchers at the University of Copenhagen studied the health of 92,000 babies born through fertility treatment between 1988 and 2007 and compared them with nearly 500,000 children conceived naturally over the same period. They found there is now no greater risk of having a stillborn baby through IVF than through a natural conception. The improvement is primarily due to new regulations which limit the number of embryos which can be transferred into the woman to avoid risky multiple births.

“We have this idealised perception of happy, healthy twins being pushed around Asda, but what you don’t see is the desperate complications that many twin births bring,” said Professor Charles Kingsland, consultant gynaecologist at Liverpool Women's hospital and clinical director of Britain's largest NHS fertility unit.

“With embroy transfer we used to have an approach rather like throwing mud at a wall. The more mud you throw the more we thought would stick. But we are now much more selective in the number of embryos we implant. 75 per cent of women at our clinic now just have one embryo. And it makes birth far safer.”

The world’s first ‘test-tube’ baby, Louise Brown, was born in 1978 at Oldham Hospital. But the success of the breakthrough was marred by the number of women who lost their babies. In the late 1980s and 1990s nearly one in eight single IVF babies was born prematurely compared with just one in 20 of those conceived naturally. For twins it was even higher, with 50 per cent likely to be premature, compared with 42 per cent for natural conceptions.

However the latest figures show just eight per cent of IVF single births are now preterm compared with five per cent for spontaneously conceived babies. The number of preterm twins has also reduced to 47 per cent even though premature twins has risen for spontaneous births to 44 per cent. And the rate of stillborn babies is now the same for test-tube babies as naturally conceived children, just 0.3 per cent. The number of deaths in the first year is now 0.3 per cent for IVF babies and 0.2 per cent for those conceived naturally.

Although the study looked at babies in Scandinavia, experts said the findings were relevant to the UK. Since 2012 the Human Fertilisation and Embryology Authority (HFEA) has advised that no more than one embryo should be transferred in the majority of cases.

"During the 20-year period of our study, we observed a remarkable decline in the risk of being born preterm or very preterm," said lead athor Dr Anna-Karina Aaris Henningsen.

"These data show that if there is a national policy to transfer only one embryo per cycle during assisted reproduction, this not only lowers the rates of multiple pregnancies, but also has an important effect on the health of the single baby.

“By transferring only a single embryo, you not only avoid multiple births and all the health problems for the babies and mothers associated with these, but also procedures to reduce the number of foetuses developing after successful implantation of several in the mother's womb.”

Sheena Lewis, professor of reproductive medicine at Queen's University, said the findings should make women more confident about fertility treatment.

“This is excellent news,” she said. “The main reason is that fertility authorities across Europe have insisted on reducing the number of embryos put back.

“Single embryo transfers are now considered best practice, unlike a decade ago when up to three embryos were put back. This means that a single baby is born rather than twins, or more, and of course that means fewer pre-term deliveries and healthier babies.

“Other improvements in milder hormone regimes for the woman and better care of the embryo in the lab have probably added to the safety as well.”

Other improvements in IVF techniques in recent years include videoing the developing embryos to check their progress so the best can be selected, and improvements in the culture medium in which the embryos are grown.

Professor Kingsland added: “This is a very important study as it underpins the importance of reducing the number of embryos but also shows that we are getting better at IVF.”

The research was published in the journal Human Reproduction.

By Sarah Knapton,

The Telegraph, Wednesday 21st Jannuary 2015

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