September 18, 2019

expert reaction to conference abstract/poster looking at IVF and gestational diabetes risk

A conference poster/abstract, being presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), reports a link between IVF and a higher risk of gestational diabetes. 

Prof Alastair Sutcliffe, Professor of General Paediatrics, UCL, said:

“Issues surrounding health outcomes and IVF are emotionally charged.  This is a ‘study of studies’, not based on primary research, and the data are from Greece.  There is not really enough information available to be able to tell whether this is good quality research, because it is not a full scientific paper.

“What is claimed is that women who conceived after assisted reproductive therapies are at higher risk of gestational diabetes.  But is this important and is it valid?

“The report is not peer reviewed or published, and appears not to have taken into account a key confounder.  PCOS (poly cyctic ovarian syndrome) occurs in 8% of women but is more common in the subfertile and is associated with higher risks of diabetes, both gestational and beyond.  We are not told what proportion of the women who had IVF also had PCOS as this would be a much higher number than in the control cohorts (people not having IVF).

“So this could be a classic example of confounding by indication i.e. that the treatment for infertility is not a cause (of gestational diabetes) but more a matter of the nature of the sub fertile couple and what their underlying causes are.  So it could be the reason for needing IVF, rather than the IVF itself, which causes gestational diabetes.

“Is there grounds for panic or concern, on the available report?  Probably not.  But these kinds of analyses are needed to monitor what are largely theoretical risks – but we also need data to be peer-reviewed and published.”

Prof Charles Kingsland, Clinical Director, CARE Fertility, said:

“From the information available, although this is not a peer-reviewed paper this looks like a good study with sound methodology and huge numbers.  It clearly demonstrates what we have known for many years, that women who conceive following treatment for infertility are at a small but increased risk of pregnancy related disorders which may have a significant effect on outcome.

“What it does not demonstrate is that treatment per se causes the risk – the problem could be related to the medical disorder that has caused the difficulty in conceiving initially, rather than the fertility treatment itself.  The authors have not controlled for various medical disorders that can give an increased likelihood of gestational diabetes, but they have controlled for weight and age.  We cannot say from this that IVF causes gestational diabetes.

“Nevertheless, this is an important finding with respect to the development of gestational diabetes and infertility.”

Abstract/poster title: ‘Ηigher risk of gestational diabetes in singleton pregnancies achieved by assisted reproduction techniques compared with spontaneous conceptions: a meta-analysis’ by P. Anagnostis et al.

This is a conference abstract from the Annual Meeting of the European Association for the Study of Diabetes (EASD), and was under embargo until 23:01 UK time on Wednesday 18 September 2019.

There is no paper as this is not published work.

Declared interests

Prof Alastair Sutcliffe: “I have no conflict of interest.”

Prof Charles Kingsland: “I have no conflict of interests of which I am aware.”