Do IVF Babies have higher risk of abnormalities?


Question: We are thinking of going through an IVF, but we are concerned whether IVF babies have higher risk of abnormalities. We are also concerned that IVF babies are less healthy than their counter-parts and have shorter life-span, is it true?


Dr Helena’s answer:

Since the advent of IVF and Assisted Reproductive Technology, there had been constant debates on its safety and implication towards the health of the next generation. One of the biggest concerns is whether these fertility treatment will give rise to increase risk of congenital abnormalities in babies born as a result of IVF.

These debates and concerns are certainly valid. After all, the process of IVF in creating life outside human body in a Petri dish and then putting them back into the human body to let it grow into a baby is certainly mind blowing. How would we ensure that the doctors and scientists know what they are doing? And mind you, the IVF process were the results of many trials and errors. What makes you think the product (which is the baby), is not plagued with defects and errors?

Intensive research in the early years, and a thriving population that has now grown to more than 5 million IVF children worldwide, have reassured scientists, but they have not stopped studying and trying to improve the process.

Recent discoveries in epigenetics – the study of how environmental factors can affect gene activity, and how a person’s risk of getting chronic diseases is “programmed” into them before they are even born – have opened up new possibilities.

Much of today’s research stems from the Barker hypothesis, which proposes that birth weight may be linked to the likelihood of getting certain diseases. IVF babies are known to have lower average birth weights – even if the difference, at about 20-30 grams, is small. Scientists are now investigating whether IVF conception equates with more hospital admissions, and an increased risk of cardiovascular disease, high blood pressure and diabetes in later life. However, there is no good evidence as yet to suggest likewise

A recent study by the Human Fertilization and Embryology Authority, which linked 106, 381 HFEA register records from 1992-2008 to the UK’s National Registry of Childhood Tumours (NRCT) is one of the largest population-based linkage studies ever carried out. This study has found no association between ART and childhood cancer. This finding offers comfort to those patients facing the difficult decision about whether to undergo fertility treatment or not.

In 2012, scientists at the University of California, Los Angeles (UCLA) looked at birth defects among infants born both via IVF and conceived through natural means in California, which has the country’s highest rate of IVF use. They included babies born after IVF and other assisted reproductive treatments such as couples’ use of fertility-enhancing drugs and artificial insemination.

Among 4795 babies born after IVF and 46,025 infants who were conceived naturally, 3,463 babies had congenital birth defects. Even after controlling for factors that can affect such birth defects, such as mother’s age, and race, which can influence rates of genetic and environmentally driven developmental disorders, 9% of infants born after IVF had birth defects compared to 6.6% of babies who were conceived naturally. Overall, the babies born after IVF were 1.25 times more likely to be born with abnormalities. The researchers did not find a link between birth defects and other fertility treatments like artificial insemination or ovulation induction.

It’s possible that the higher rate of abnormalities with IVF is due in part to whatever was contributing to infertility in the first place, say the researchers. But some of the researchers’ view was the fact that an increase was not seen among babies conceived using artificial insemination or ovulation induction suggests that process of IVF itself, in which eggs are removed from a woman, fertilized in a dish with sperm and then allowed to develop into embryos, which are transplanted back into the womb, is the primary culprit.

However, another more recent study in 2016 by researchers from the University of Adelaide and the University of Melbourne. The study reviewed all assisted reproduction technologies carried out in South Australia over a 16-year period from 1986 to 2002.

This was linked to data on birth outcomes from the South Australian Birth Defects Register (SABDR). The register includes a record of all live births, stillbirths, terminations, birth weight and congenital defects. Birth defects were also followed up for five years. The researchers looked at the statistical link between maternal factors and birth defects, and compared this between babies either conceived naturally or by IVF and ICSI. The study found no statistically significant increase in birth defect. There was some suggestion by the press that this study suggest that IVF reduces the incidence of birth defect in women after the age of 40, but was refuted by the research group due to its misleading nature.

With the advent of Pre-implantation genetic screening (PGS) & Pre-implantation genetic diagnosis (PGD), which is fast gaining popularity, scientist can now screen embryos to exclude chromosomal and genetic abnormalities. The use of these technologies may further decrease the incidence of birth defect and congenital abnormalities associated with chromosomal defects or genetic issues. However, more long term data is required to support this hypotheses.


In conclusion, although there had been great hypothetical concerns about the risk of cancers & birth defects amongst babies born following Assisted Reproductive Technologies (ART), the actual link is difficult to establish due to many confounding factors such as parental age, the cause of infertility and etc. the actual incidence of childhood cancers and birth defects are small and should not be a great stumbling stone to those who are considering going through fertility treatment to have their babies





What you should know about PGD & PGS


What you should know about PGD & PGS

If you and your partner have been struggling with fertility issues and are seriously considering In-Vitro Fertilisation or IVF, the consideration of whether you should be undergoing PGD and PGS on top of an IVF can be quite daunting. This is because, in normal IVF procedures, the best embryos are selected based on their appearance and morphology only. Therefore, the genetic content of those embryos or any chromosomal abnormality cannot be detected. However, by undergoing PGD and PGS, you will be able to screen your embryos for any potential genetic and chromosomal issues.  However, before we jump into the band wagon of having PGS or PGD, there are a few things we need to consider.



What is PGS?
PGS stands for Pre-implantation Genetic Screening. In PGS, a cell is taken from an embryo  which was created following an IVF procedure, so that it can be tested for chromosomal abnormalities before the embryo is transferred to the womb. This test will be able to tell us whether the embryo has normal sets of chromosomes. However, it will not be able to tell us whether this embryo has a genetic problem or not.

It is important to note that not all the patients going through an IVF required a PGS. You may want to consider it if:

  • You are of advanced maternal age, whereby embryos may show greater levels of chromosomal abnormalities.
  • You have had recurrent miscarriages.
  • You have had repeated IVF failure.
  • Either of you has a chromosome rearrangement.

The PGS procedure involves:
1. You will undergo a normal IVF treatment and your eggs will be collected and fertilised.
2. An embryo is grown in the laboratory for a few days.
3. An embryologist will perform a biopsy and remove a few cells, usually on day 3 or 5.
4. All 24 chromosomes are analysed (22 non-sex chromosomes and two sex chromosomes X & Y).
5. If the embryo is normal, it will be transferred into your womb.
6. Any remaining unaffected embryos can be frozen for later use.
7. Affected embryos will be allowed to perish.



What is PGD?
PGD is an abbreviation for Preimplantation Genetic Diagnosis. In PGD, a cell is taken from an IVF embryo so that it can be tested for a specific genetic condition before the embryo is transferred to the womb. It can be used to test for any genetic condition that is known to be caused by a specific gene.

At present, PGD is used to screen for more than 250 genetic conditions, such as Huntington’s disease, Cystic fibrosis, Thalassaemia, Duchenne muscular dystrophy and Fragile-XPDG to name but a few. Therefore, PGD enables individuals with an inheritable genetic condition to avoid passing it on to their children. The PGD process is more tidious and challenging compared to PGS. It is used to test for a specific genetic disease which is known to your family, i.e. you or your partner is confirmed a carrier of a specific gene at a certain point of the chromosome. You need to bear in mind that by performing a PGD, it does not mean that screening of ALL genetic diseases are performed at the same time. This is because human beings have millions of gene and it is impossible to screen ALL of the genes in one go.

However, not all IVF patients need to undergo PGD. You may want to consider it, or your specialist may recommend it to you if:

• You or your partner (or both) are carriers of single gene mutations.
• You ended a previous pregnancy due to a serious genetic condition.
• You have a child with a serious genetic condition.
• Either of you has a family history of a serious genetic condition or chromosome problems.

The PGD procedure involves

1. You will undergo a normal IVF treatment and your eggs will be collected and fertilised.
2. An embryo is grown in the laboratory for a few days, until it has divided into around 8 cells.
3. An embryologist will remove one or two of the cells from the embryo.
4. The cells are tested to see if the embryo has a gene that causes a genetic condition.
5. If the embryo is free of any genetic condition, it is transferred to the womb.
6. Any remaining unaffected embryos can be frozen for later use.
7. Affected embryos will be allowed to perish.

Since PGD and PGS help detect genetic conditions and chromosomal abnormalities, they help IVF patients to decide if they wish to continue with pregnancy.

The Pros and Cons of PGD and PGS
Before you decide on undergoing PGD or PGS, your fertility consultant will explain their pros and cons to you, which include:


  • They can detect an inherited chromosomal or genetic issues and help prevent passing chromosomal or genetic diseases to the next generations
  • They are a form of early detection of chromosomal or genetic problems before the embryo is transferred back into the uterus.
  • They help increase a couple’s chances of conceiving a healthy child.
  • It allows older women to still have viable children.


  • There is a risk that embryos may be traumatized or destroyed due to damage during the biopsy process.
  • There is always a possibility of an undetected disease, as no form of testing can guarantee 100% accuracy
  • The test is expensive
  • You may not have any embryos to transfer after the IVF & PGD/PGS , which is frustrating for patients because after investing time, money & effort, the result can be disappointing
  • There is no guarantee that an embryo which had been screened will definitely get implanted after being transferred into the uterus. Therefore, there is no guarantee that a PGS/PGD embryo will give you a life birth.

If you and your partner are interested in or have any concerns about PGD and PGS, be sure to speak to your fertility specialist to address concerns, inquiries and options.