To think we don’t know the long term impacts of ivf

[Redteapot67]

I read shocking research (albeit in the daily fail) today that ivf children are x6 more likely to have hypertension, which of course puts them at risk of cardiovascular disease.
It’s a stark reminder the first ivf baby is only 40 years old - we have no idea about the long term impacts on a baby of being born this way which I find frightening.
Please - I just want to discuss this if you are going to be upset by the debate look at another thread.
My personal take is that despite the possible unknown health risks if ivf were my only route to having a baby I would have it.

LRD
Can you explain more about the egg “choosing” the sperm? I have never heard this before.

I am a mum of ICSI twins aged 8. All healthy so far. They were born at full term by CS and both gold weights.
Our issue was severe male factor due to DH having an undescended testicle as a child that wasn’t corrected until he was about 8. Our DS has been checked and he doesn’t have this issue.
I had no problems myself so I have no reason to believe my DC will have any fertility problems themselves but I often worry if they are susceptible to other things that we don’t know yet. However I haven’t seen any evidence yet.

*good not good

*good not gold!

Right guys, sorry, I’m only just joining this thread now - regular infertility posters may recognise me and my AIBU-IVF diatribes - strap in, there’s a good few posts coming

(working backwards through the thread so I don’t reply to anything that’s already been addressed)

Itsear there are more issues with ICSI because it’s used when the sperm quality isn’t good.

There MAY be more issues with children born via ICSI having infertility issues themselves, because the very reason their father is having treatment is because they themselves have an infertility issue which may potentially be inheritable (or indeed it may not). Most of us infertiles had fertile parents, or else there’s a good chance we wouldn’t otherwise be here - but equally infertile men who needed ICSI may not have conceived in the past, so any inherited sperm issues may not have been passed on

ICSI is used as standard in many clinics, and in many other circumstances beyond male factor - incl eggs from older women (harder zona pellucida), previous poor fertilisation, fertilisation of thawed frozen eggs, and in some clinics for embryos undergoing PGS (we had IVF rather than ICSI for our PGS but it varies from clinic to clinic)

I would be far more concerned about environmental factors that are likely to impact on a far higher % of the population

I have epilepsy - which can be inherited, should I not have been allowed to try and procreate in case it was passed on? Epileptic women the world over have babies - would you deny them the right to try for children just in case of passing on the condition

How about autism, if we’re concerned about any neurodevelopment issues? Would you suggest that autistic couples shouldn’t procreate in case of having autistic children. I would hope not.

Yes, we need lots of research over population levels for IVF and ICSI, as we do ANY medical technology, as we do ANY environmental impact that’s likely to impact a large group of people.

Does that mean we should restrict IVF? Should we restrict mobile phone usage in case of EMF causing brain damage?

To which I come to
Well, I think that there is a lot we don’t know about fertility, and its possible that IVF children might grow up to have more fertility issues (that by that time have emerged as genetic factors, inherited from parents)

OK, so if infertility is inherited (which, as per the above, we have no idea whether that’s true or not), we have two scenarios

1. Couples with infertility don’t have access to medical advances in assisted conception to try to have much wanted, much longed-for, children. They don’t conceive naturally and don’t pass on their infertile genes to offspring they weren’t able to conceive in the first place. Do you think that’s going to eliminate fertility issues? Given we’ve had infertile couples since the beginning of human existence, and assisted conception for a matter of decades. Doesn’t appear that we’ve managed to eliminate infertility from the gene pool, so natural selection there doesn’t appear to have panned out quite that way…
2. Infertile couples access assisted conception to give them the chance of having a child. It is possible that a child MAY have their own fertility issues - it’s also possible that they don’t. They might be perfectly fertile (Louise Brown and her sister both have children naturally, her younger sister has 5!), and the children of fertile couples may have their own infertility issues. And hopefully by the time they’re ready to try and start families of their own, they will have access to even more improved assisted conception technology

I'd be more concerned with the emotional fallout of repeated IVF cycling. I was lucky myself but often wonder where my head would be at if it hadn't worked. Def more of a consequence for the woman than the child in my experience.

IVE is like a very expensive form of self harm. We only had 4 cycles, 7 cancelled cycles, 2 pg and 2 mc (and been told I will never carry a child) - but I know women who’ve had 15, 17, even 21 cycles (spoiler alert, no baby). I’ve considered whether or not there’s any point being on this planet if I can’t have a child. I’ve had a lot of therapy. I’m on anti depressants. Infertility related PTSD isn’t uncommon. People have breakdowns. It’s pure hell on earth. I wouldn’t wish infertility on my worst enemy

Spring machine wasn't the first ivf baby a girl? Louise?

It was Louise Brown's 40th birthday in July and there is an exhibition at the Science Museum in her honour

www.sciencemuseum.org.uk/ivf

She has children naturally
Her IVF born sister has 5

The thing with Louise Brown was her mother had blocked tubes. A mechanical problem. Nothing to do with egg or sperm quality, just that there was no way for them to meet. Blocked tubes sren’t hereditary, so no reason why Louise and her sister could not have healthy children.

Children, in some situations, are the result of 'weak' sperm or eggs- the process is forced with substandard eggs and sperm that naturally aren't strong enough to get together naturally. This surely has to in some cases lead to increased issues for the child

On what basis?

If someone has blocked tubes, or endometriosis, or uterine factor, that has absolutely no bearing on the sperm and egg

Humans are STAGGERINGLY inefficient at reproducing

And with pre implantation genetic testing we can get an idea of chromosomal abnormalities

In the space of 3 IVF cycles over 9 months I had a total of:
55 eggs retrieved
45 of which were mature
35 of which fertilised (via IVF, ie self insemination, strongest sperm picked itself)
Of these 35 embryos, only 14 made it to blastocyst stage (a day 5 embryos) - most embryos drop off between day 1 and 5, because they’re not chromosomally competent
We had genetic testing and of those 14 blastocyst embryos, 7 were euploid (ie chromosomally normal)

This is completely average for someone of my then-age (34)

My issues weren’t because my eggs and sperm couldn’t meet naturally

It was because I had uterine issues

There were no issues with my eggs and my DH sperm

They could meet fine

But they couldn’t implant and propagate a pregnancy because of problems with my endometrial lining

LOTS of people have IVF for reasons where the competency of the egg and sperm is irrelevant

There are some cases where male factor is an issue, but there are lots and lots of other issues where there’s no reason that fertilisation is the issue

I don't know about health risks to children born from IVF but I do know there is reason to be concerned about the potential increased risks to women who go through fertility treatments. I have gone through a round of IVF and several rounds of IUI myself and I won't lie, one of the reasons I stopped was my concern about the long term implications of high doses of hormones. The truth is that the fertility industry right now can say in all honesty that there are no known increased risks due to fertility treatment and the reason they can say this is because no one is tracking or studying the health impacts on women.

Agreed that more tracking needs to be done

The issue also is that in ANY medical field, lots and lots of medications are used off-licence

These are just a handful of the medications I took during my fertility treatment (spoiler alert: unsuccessful)
Clomid tablets
Tamoxifen tablets (used for breast cancer tx, off label for ovulation induction)
FSH injections
GNRH antagonist injections (cetrotide)
GNRH agonist injections (buserelin)
hCG injections
HRT pills (orally and vaginally)
HRT patches
Oral viagra tablets
Vaginal viagra pessaries
Progesterone pessaries
Progesterone injections
Aspirin tablets
Clexane injections (heparin-blood thinner)
Prednisolone tablets (steroids)
GSCF Neupogen uterine wash (used to harvest bone marrow and treat neutropenia, used off label as a uterine wash to improve uterine lining)
Blood pressure tablets (Pentoxifyilline)
IV Intralipid infusions

Stuff I didn't take but which are cytotoxic drugs used as part of controversial immunotherapy at some clinics
Humira injections (immunosuppressive drug used for Crohns)
IVIG - intravenous immunoglobulin used for a number of immune-related conditions

The fact is that lots of fertility meds are used empirically, just as many meds in pregnancy are used empirically. The latter because it's not ethical to run clinical trials, the former because it's challenging to run clinical trials because it's harder to persuade couples to take part in double blind RCT, where they risk getting a placebo - they'd rather take the drug if it gives them a glimmer of hope of an increased chance of success

The HFEA traffic light system for add-on treatments is a good start for the evidence base

That said I didn't care about the evidence base - only a very small number of studies on Neupogen wash had been done, because intractable thin endometrium was such an unusual fertility issue that only a small minority of patients will ever be affected

I did take part in a clinical research study at the Coventry Implantation & Miscarriage clinic about the role of uterine NK cells in infertility & miscarriage, they have funding from Tommys to support their clinical research - a lot of the issue is one of funding

There is LOTS of misunderstanding here about what sperm quality issues actually are. There are four different ways that sperm quality can be affected: Motility (the sperm don't swim properly), morphology (the sperm aren't the right shape), mortality (the sperm are dead) and count (there aren't enough of them).

Even in a perfectly healthy fertile man, there will be plenty of sperm that don't swim, are a weird shape or are already dead. It's just that there are enough good ones that it doesn't matter.

When you have male factor infertility, all four of these issues are checked in any semen analysis. Plenty of sub fertile men have excellent quality sperm, just not enough of them - and for context, anything under 15 million (yes, million!) per millilitre of semen would be considered low. Even if that isn't the case, in many, many sub-fertile men, as long as at least some live sperm are being produced, there are usually some completely healthy ones in the mix.

The whole point of ICSI is that the clinic can pick the best ones to fertilise the egg. They can do this visually using a microscope, and protein attraction tests can be used to further spot the best. So to suggest that male factor infertility invariably means that substandard sperm are used in ICSI is just not true.

mam - well, I'm not a biologist, but my DP, who is a biologist (she mostly works with stem cells) could probably tell me more when she gets home. But, basically, people used to assume sperm compete to penetrate the egg and the egg just sits there. As I understand it, it's really simply a matter of looking what happens super close-up, and you can see that several sperm will sort of clunk into the egg, but it's the egg that chooses which one to suck in and surround.

Obviously saying 'choose' is daft really, but I just think it's interesting that we (or the writers of old biology text books!) thought it must be the sperm that does the active bit.

Proper biologists could explain loads better though! quantum? (And btw, I didn't know that about male infertility and it's very useful, thanks!)

"Itsear there are more issues with ICSI because it’s used when the sperm quality isn’t good."

ICSI is often used when donor sperm ( so very good sperm quality) is used because it gives a higher pregnancy rate.

In addition, even with ICSI, the fact is that the sperm with the best morphology is likely to have less DNA fragmentation than a wonky looking swimmer

So picking the best looking swimmer can indeed help to select a strong sperm

BTW - to any IVF-ers on this thread

I'm writing a book inspired by my experiences on the infertility boards

It's about the real experiences of real women, telling the real, unvarnished truth about the emotional experience of infertility and pregnancy loss. Because it's when we share our stories with each other, that we realise that we aren't alone. And that whilst it's a club you don't want anyone else to have to be a member of, it means the world to know there are other members in the same boat.

I've created an questionnaire to enable people to share their experiences anonymously - I've been overwhelmed by the contributions from MN-ers already (well, I assume they're MN-ers, they're anonymous, but there's a question about online support, and MN has been mentioned by a lot of respondents!), and would love to hear from ANYONE who has experienced infertility and / or pregnancy loss, whether current or past, successful or not

The working title is: Über Barrens Club: Sisterhood, Solidarity & Support - Stories from the Club No One Wants to Join

Here's the website for the book project:
uberbarrens.club/

More about the book:
uberbarrens.club/book/

And the questionnaires (for both women and men):
uberbarrens.club/share/

Please do share with anyone else who may be interested, I'm really keen to represent as many voices and experiences as possible.

With love and solidarity, and thank you to all your MN-ers who've already contributed. I hope I can do all your stories justice

xxx

Ooh! banana, I'm going to PM you. Fascinating!

Thanks LRD please please do!!

The questionnaire includes sections for primary infertility, secondary infertility, pregnancy loss, donor conception, surrogacy, parenting after infertility, adoption after infertility, as well as reaching the end of the road and living a meaningful life without children. And by ‘pregnancy loss’, that includes the full spectrum of experiences - everything from miscarriage, ectopic or molar pregnancies, terminations for medical reasons or stillbirth.

All and any experiences ‘count’ - your contributions would be enormously gratefully received.

I also have a link to a public FB post which I'd be hugely grateful if anyone would consider sharing

Don't want to publish my real FB profile on AIBU, although as I've got various articles coming out under my real name, my identity isn't exactly going to be a secret any more!

If anyone would be willing to share on FB, please do PM me and I can happily share the link

Hugs xx

Something similar to this came up in a discussion I overheard at my kids sport last week. Something along the lines of the hormone treatments required to undergo IVF has be suggested to contribute to the increase in children being born gender confused.

Not saying I believe this, just contributing another theory that seems to be going around...

I'll share on FB! I've just sent you a PM so do PM me with the link.

‘Infertility treatment is like an expensive form of self harm’

Can see what you mean banana!

Of course no one knows the long term risks to both mother and any children. There has not been enough research into it. It would not be surprising if all the drugs women take during IVF increase the chance of long term health problems. But how much is that risk?
Of course life brings other risks, but it is difficult to make decisions when we don't actually know what the risks are.
And research can lead to improvements. For example, one study said that frozen embryos that are implanted are less likely to lead to birth defects than fresh ones and that ICSI increases the risk of birth defects. If this is true, we can choose to use frozen embryos to minimise the risk.

And yes, IVF babies tend to be smaller than average. Quoting that your IVF baby was a normal weight is fairly meaningless.
Smoking tends to produce smaller babies. My mum who smoked all through her pregnancy with me rubbishes this because I was a normal weight. She is wrong. It does not mean all babies are smaller, but in general they are smaller. And that brings increased health risks when you are older.

Something similar to this came up in a discussion I overheard at my kids sport last week. Something along the lines of the hormone treatments required to undergo IVF has be suggested to contribute to the increase in children being born gender confused

That’s fucking outrageous.

Any differences in children's health is I suspect due to mothers and fathers being older than average, IVF babies tending to be lower in birth weight which leads to increased health problems in later life, and perhaps some epigenetics around hormones taken by the mother.

@Standbyyourmammaryglands

Trust me, I agree. I almost spoke up about the inappropriateness of the conversation seeing as they were sitting amongst a large group of women and statistically there were bound to be some who have had some sort hormone assistance. But of course non confrontational me said nothing.

Something along the lines of the hormone treatments required to undergo IVF has be suggested to contribute to the increase in children being born gender confuse

If you really wanted to look for the potential impact of hormonal factors, looking to the effect of the contraceptive pill in water supplies (one possible factor contributing to declining sperm counts at a population level), and oestrogenic effects of BPA plastics would be a MUCH more relevant target for research

Unless there's decent data about the astronomical increase in gender dysphoria amongst IVF-born children vs children born via natural conception, that sounds like the highest grade bollocks to me

"And yes, IVF babies tend to be smaller than average."

Is gestation taken into account with that? I think ivf babies tend to be born earlier on average because of not wanting them to go overdue. I know there are slightly higher risks of placental failure with ivf particularly past term.