In vitro fertilization (IVF) was first created as a treatment option for women who had fallopian tube disorders and men who were severely infertile.
The team of experts who conducted the analysis, led by Dr. Esme I. Kamphuis of the Centre for Reproductive Medicine at the University of Amsterdam in the Netherlands, states that in recent years, IVF has been used for other conditions that affect fertility, and it has even been used to treat unexplained fertility problems.
They say between 2000 and 2010, the number of annual IVF cycles in the US increased from 90,000 to 150,000. The proportion of IVF cycles for tubal problems reduced from 25 % to 16 % during this period.
The experts point out that unexplained fertility accounts for around 25-30 % of couples undergoing IVF treatment. But they note that when not treated with IVF straight away, most of these couples are able to conceive naturally before treatment.
“In a cohort of 500 Dutch subfertile couples with on average almost 2 years of unexplained subfertility, 60 % conceived naturally after the initial assessment in the fertility clinic. Other observational studies have confirmed natural conceptions in couples with subfertility for 2-3 years,” the experts write, adding:
“It seems that a short delay in treatment does not affect ovarian reserve in such away that more couples will end up childless.”.
Furthermore, the authors note that the majority of research looking into the success of IVF does not state how long couples have been trying to conceive and many countries do not collect data that shows infertility duration.
Extended IVF use ‘harmful’.
The experts argue that extended IVF use increases the risk of harm to both the mother and offspring.
“Multiple pregnancies are associated with maternal and perinatal complications such as gestational diabetes, fetal growth restriction, and preeclampsia as well as premature birth. And even singletons born through IVF have been shown to have worse outcomes than those conceived naturally,” they write.
Furthermore, the authors say there are also concerns surrounding the long-term health of children born through IVF. They note that these children may have higher blood pressure, adiposity, glucose levels and more generalized vascular abnormalities, compared with children who are conceived naturally.
“These effects seem to be related to the IVF procedure itself rather than to underlying subfertility,” the experts add.
They stress that couples should be warned about these potential risks before undergoing IVF, particularly if they have a reasonable chance of conceiving naturally.
IVF has ‘evolved as a profit-generating industry’.
The experts say that the progression of IVF is being prevented by “a lack of will to question its perceived success.”.
They add that at present, bodies who fund the treatment are not interested in funding studies that investigate the long-term safety of IVF.
“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,” they write.
They say that considering the increasing uptake of IVF treatment globally, couples looking to IVF as a treatment option need to be presented with evidence that proves its long-term safety.
“As a society we face a choice. We can continue to offer early, non-evidence based access to IVF to couples with fertility problems or follow a more challenging path to prove interventions are effective and safe and to optimize the IVF procedure.
We owe it to all subfertile couples and their potential children to use IVF judiciously and to ensure that we are first doing no harm.”.