Time to think of health costs to IVF babies, Bioethicist says

By Art Caplan, Ph.D.

An article just published in the highly respected journal Fertility and Sterility ought to give anyone thinking about using “test tube” baby technology pause. A review of 124,000 children born through two very common infertility treatments — in vitro fertilization, creating embryos in a dish and transferring them to a womb and ICSI, in which a single sperm is injected directly into an egg — showed large increase in the risk of having a child with a birth defect. The risk was 37 percent higher than that seen in children made the old fashioned way. That is a huge number.

There is some danger that this message will not get heard by those thinking about using infertility treatments or considering putting off having a baby until later in life figuring they can use IVF if they need to.

Celebrities continue to appear on television gab shows proclaiming that they used infertility treatment to have a child and that it was a breeze. Stories about Nadya Suleman and other super-multiple pregnancies rarely mention the grim facts about disability and premature death that accompany these morally dubious pregnancies. Too many clinics providing reproductive services for cash fail to emphasize the risks faced by kids made technologically.

I am not anti-technology when it comes to making babies. The position of the Catholic Church and some social conservatives in opposing the creation of life with a technological assist when infertility prevents a married couple from reproduction strikes me as cruel and anti-life. And those who worry about turning baby-making into manufacturing when it is done in a clinic seem to me to have a very optimistic view about the circumstances that accompany the creation of a huge number of kids when sex is used.

That said, the large risk factor now on the table needs to be a key part of how everyone thinks about making babies in medical settings. The authors of the study say they do not know why the risk is so large. And it has taken far too long for this question to get asked. We need to be sure that long-term monitoring of children born by means of infertility treatment is routine and that more research is done into the causes of health problems for kids who cannot make choices about facing risk.

Infertility treatments have brought a great deal of joy to many. But, the price is high — so high that we need to be sure it is a key element in thinking about using these treatments.