Assisted reproduction techniques may be over-used, it is claimed today.
In the light of recent links between in vitro fertilisation and a range of health risks, Professor Siladitya Bhattacharya of Aberdeen University, UK, and colleagues question its widespread use.
In the British Medical Journal today, they state that the technique was originally developed for women with fallopian tube diseases, but "the scope of IVF has expanded in the last two decades to embrace a wider range of indications." These include male subfertility, endometriosis, and unexplained subfertility.
However, "the evidence underpinning the use of IVF for some of these newer indications is weak", say the authors, especially as "outcomes in children conceived through IVF seem to be poorer than in those conceived naturally".
IVF also increases the rate of multiple pregnancies, which are associated with complications such as gestational diabetes, foetal growth restriction, pre-eclampsia, and premature birth. Even singleton babies born through IVF may have a raised risk of preterm birth and congenital malformations, as well as longer term health problems such as higher blood pressure and glucose levels.
"Until these concerns are resolved, there should be caution about using IVF in couples when the benefit is uncertain or the chances of natural conception are still reasonable," the authors write.
They add that: "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.
"We need to evaluate which couples have a reasonable chance of natural conception, and for those needing help, the effectiveness and safety of IVF should be investigated afresh," they conclude.
Kamphuis, E. I. et al. Are we overusing IVF? BMJ 29 January 2014; doi: 10.1136/bmj.g252 [abstract]
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