IVF babies are 45 per cent more likely to die before their first birthday, a study of almost three million children has found.
Researchers in Sweden compared the outcomes of babies conceived naturally and through assisted reproductive techniques.
Babies from a frozen embryo had a more than two-fold higher risk of death than babies conceived naturally in the first few weeks of life.
It may be because so-called ‘test tube babies’ are often born premature, the team said. This can make their immune system weaker.
They emphasised the risk of death was still very small for babies across all groups.
IVF babies are 45 per cent more likely to die before their first birthday, a study of almost three million children has found. Stock photo of an IVF embryo
One in seven couples struggle with infertility, and assisted reproductive techniques (ART) have helped millions of people have healthy babies in recent years.
More than 75,000 IVF treatment cycles were carried out across the UK in 2017, according to the fertility watchdog, the Human Fertilisation and Embryology Authority (HFAE).
Prior studies show, however, that IVF-pregnancies come with an increased risk of low birth weight, prematurity and birth defects. These risks have partly been linked to the increased probability of twin-births after IVF-treatment.
In the current study, the researchers at Karolinska Institutet in Sweden analysed data on 2.8million children born in Sweden over a period of 30 years. Some 43,500 of these were the result of assisted reproduction.
In total, 7,236 children died before one year of age, of whom only 114 were conceived with assisted reproductive techniques.
After adjusting for confounding factors such as the mother’s age and earlier infertility, the researchers found that the children conceived through IVF had a 45 percent higher risk of death before their first birthday than children conceived naturally.
The level of risk varied depending on which type of assisted reproductive technique was used, and how many days had passed since birth.
During the first week of life, the children conceived after transfer of a frozen embryo had a more than two-fold higher risk of death.
This was, however, based on only a small sample of children conceived with frozen embryos.
After one week, the risk dropped to about the same level as the naturally conceived children.
Infants conceived from transfer of a fresh embryo or with the help of an intracytoplasmic sperm injection (ICSI) did not have a higher risk of death.
The risk gradually declined after the first weeks of life. Beyond one year of age, the risk of mortality was similar for all children regardless of conception method.
‘Our results indicate that the kind of assisted reproductive technique used may make a difference, and therefore it is important to further investigate what causes or underlying mechanisms are behind the risks,’ says senior lead author Professor Anastasia Nyman Iliadou.
‘They also show the need for extra attention and care of children conceived with IVF, especially during the first week of life.’
According to the researchers, one explanation may be that more IVF-children are born prematurely than those conceived naturally, which in itself could have negative consequences.
One of the major risks of babies born premature – before 37 weeks – is breathing difficulties. They also have an underdeveloped immune system, making it harder for them to fight infection.
The leading causes of infant mortality among children conceived with ART included respiratory distress, incomplete lung development, infections and neonatal haemorrhage, which are conditions often linked to prematurity.
Prior studies show that IVF-pregnancies come with an increased risk of low birth weight and birth defects, as well as prematurity.
These risks have partly been linked to the increased probability of twin-births after IVF-treatment. However, the current study selected only singleton children.
It is also possible that the underlying cause of infertility in either the mother or father leads to a higher risk of complications, the team said.
A major study published in PLOS ONE in 2014 found mothers who had been given a diagnosis of ‘infertile’ before conceiving naturally were seven times more likely to have a stillbirth.
Professor Kenny Rodriguez-Wallberg, corresponding author of the latest study said: ‘It is important to note that even if we on a group level can see a somewhat increased risk of infant mortality after IVF, the absolute risk for each individual is still very small.
‘It is also reassuring to know that there is no increased risk of mortality in this group of children beyond the first year of life.’
WHAT ARE THE RISKS OF IVF?
Researchers from the National University of Singapore found the odds of developing gestational diabetes doulbed for women who conceived through IVF compared with women who conceive naturally.
The risk appeared to be more pronounced in women who were overweight or obesity.
The NHS states if a woman who undergoes IVF gets pregnant with multiple babies – due to more than one embryo being replaced in the womb – there is a significantly higher risk of complications for mother and babies.
These include miscarriage, pregnancy-related high blood pressure and pre-eclampsia, gestational diabetes, anaemia and heavy bleeding and needing a caesarean section.
The babies are also more likely to be born prematurely or with a low birth weight, and are at an increased risk of developing life-threatening complications such as neonatal respiratory distress syndrome or long-term disabilities, such as cerebral palsy.
Some of the reasons why problems occur are not clear, but it may be due to underlying causes of infertility or age.
The risk of miscarriage and birth defects increases with the age of the woman having IVF treatment.
Many women also have side effects from the medication used.