July 2, 2013

expert reaction to IVF and autism

In a JAMA study of more than 2.5 million children born in Sweden in vitro fertilization (IVF) treatment was associated with a small but statistically significantly increased risk of mental retardation, though not associated with autistic disorder. This roundup and a before the headlines analysis accompanied an SMC briefing.

Dr Allan Pacey, Fertility Expert at the University of Sheffield and Chairman of the British Fertility Society, said:

“This is a very important study which defines the risks of IVF children being born with two neurodevelopmental disorders. It is a large study and is exactly the kind we need if we are to give patients accurate information before they embark on treatment.

“The main message of the paper is a positive one, suggesting that any risk of these disorders is very low, or absent, in comparison to children conceived naturally. However it does highlight the importance of preferentially using standard IVF rather than ICSI, and also using ejaculated sperm rather than those recovered surgically from the testicle, in situations where it is possible to do so.

“Patients about to embark on treatment should not worry and should discuss any concerns about their treatment plan with the team responsible for their care.”

Dr Dagan Wells, Institute of Reproductive Sciences, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, said:

“In general the results of the study should be reassuring for patients undergoing IVF treatment. They show that risks of problems such as autism and mental retardation remain low following infertility treatments.

“However, the research does suggest that patients having certain types of procedure, specifically those receiving treatment for severe male infertility, may see a small increase in the occurrence of autism. It is not clear whether the slightly elevated risk is somehow related to the father’s infertility or whether it is caused by the treatment process itself.

“Assessing the long-term effects of treatments such as IVF is difficult. Technologies are constantly evolving and changing, presenting a moving target for doctors and scientists. A limitation of this study is that some of the data comes from treatments carried out 30 years ago, when IVF was in its infancy. The methods used today differ significantly from techniques used decades ago. Whether they are more or less safe remains to be seen.

“The use of IVF is growing and now accounts for between 1% and 5% of all births in most industrialised countries. Consequently, an improved understanding of any associated problems is of great importance. So far, multiple studies evaluating children born after IVF have indicated that it is a safe procedure- any increases in the risk of medical problems appear to be small. However, there is still very little information about the long-term health of the children born. More studies of this type are needed.”

‘Autism and Mental Retardation Among Offspring Born After In Vitro Fertilization’ by Sandin et al., published in JAMA on Tuesday 2^nd July.