Category: Reports

Article: Do IVF and Other Infertility Tech Lead to Health Risks for the Baby? Maybe.

Do IVF and Other Infertility Tech Lead to Health Risks for the Baby? Maybe.
By Mara Gordon | National Public Radio | Sept. 19, 2018

This article explores new research, published in the Journal of the American College of Cardiology, on children conceived through certain infertility treatments and their risk for cardiovascular disease. While the study’s authors indicate that the findings are preliminary, they encourage families using infertility treatments to be vigilant about screening their children and mitigating other risk factors, such as smoking, obesity, and a sedentary lifestyle.

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In 2012, the same team of scientists published a paper showing that 65 healthy children  born with the help of ART were more likely than their peers to have early signs of problematic blood vessels.

Read the full paper >

Report: Assisted Reproductive Technology Surveillance — United States, 2015

Assisted Reproductive Technology Surveillance — United States, 2015
By Centers for Disease Control and Prevention | Morbidity and Mortality Weekly Report | Feb. 16, 2018

From the introduction:

Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery (<37 weeks), and low birthweight (<2,500 g) infants. This report provides state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2015 and compares birth outcomes that occurred in 2015 (resulting from ART procedures performed in 2014 and 2015) with outcomes for all infants born in the United States in 2015.

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Report: Multiple Pregnancies Following Assisted Conception

Multiple Pregnancies Following Assisted Conception
By T. El-Toukhy, S. Bhattacharya and V. A. Akande | Royal College of Obstetricians and Gynaecologists | February 2018

First published in 2011, under the same title, this report raises an alarm about the risks of multiple pregnancies in assisted reproduction, resulting from the common practice of transferring multiple embryos. Maternal complications, according to the report, include increased risk of pregnancy-induced hypertension, gestational diabetes, peripartum haemorrhage, operative delivery, postpartum depression, and heightened symptoms of anxiety and parenting stress. Multiple pregnancy is also associated with a six-fold increase in the risk of preterm birth, which is a leading cause of infant mortality and long-term mental and physical disabilities, including cerebral palsy, learning difficulties and chronic lung disease.

Read the full report >

Read a summary, along with RCOG’s recommendation that IVF be fully funded by the National Health Service, as a step towards reducing multiple pregnancies and related risks.

 

Video: Deseos (“Longing”)

Deseos
By GIRE Mexico | 2017

GIRE, a Mexico-based organization that has studied, documented, published, and advocated on international recently released a documentary on the practice in 2017. “Deseos” or “Longing” follows Mirna, a divorced gestational mother with three of her own and shines a critical light on the lack of regulation around surrogacy in Mexico.

Visit GIRE’s website and read the organization’s latest report on surrogacy in Mexico. In it, GIRE offers a comprehensive overview of the current status of surrogacy, the scope of the debate around the practice, legal frameworks, cases, and recommendations. The last includes, for example:

  • Legislation that defines surrogacy as a contract between gestational mothers and intended parents.
  • Decriminalization of all the parties involved, including any criminalization based on nationality, sexual orientation, marital status, and age.
  • Quality and confidential health and legal care for gestational mothers.
  • Guarantees that costs related to pregnancy, birth, and postpartum be covered by intended parents (regardless of birth outcomes).
  • Contract revisions be contingent on the involvement of a competent notary/judge and consent of all parties.
  • Notifications of relevant state and federal authorities to avoid problems related to registration, legal parentage, and citizenship while contracts are valid or after birth.

Read the full report > 

Report: Toward a Strengthened Assisted Human Reproduction Act

Toward a Strengthened Assisted Human Reproduction Act
By Health Canada | July 11, 2017

This report tracks steps taken by the Government of Canada towards strengthening the country’s Assisted Human Reproduction Act and supporting regulation. It focuses on three specific areas: the safety of donor sperm and eggs; the process, scope, and documentation related to reimbursement; administration and enforcement.

The purpose of the document, according to its introduction, is to provide Canadians with an overview of key policy proposals that will help inform the development of regulations and engage citizens prior to finalizing policy. Several members of Impact Ethics participated in a public consultation (read the summary), including Françoise Baylis, co-editor of “Family Making: Contemporary Ethical Challenges.”

Read the full report >

Read a commentary on Health Canada’s efforts to reboot the Assisted Human Reproduction Act, contributed to the International Journal of Feminist Approaches to Bioethics by Francine Coeytaux (Co-Director of Pro-Choice Alliance for Responsible Research), Marcy Darnovsky (Executive Director of Center for Genetics and Society), Susan Berke Fogel (Co-Director of Pro-Choice Alliance for Responsible Research), and Emily Galpern (Consultant at Center for Genetics and Society).

Report: The Surrogacy (Regulation) Bill, 2016

The Surrogacy (Regulation) Bill, 2016
By PRS Legislative Research | 2016

In case there were any doubts, this short overview of the regulation in India is a helpful crib sheet on the legal status of commercial surrogacy in the country. Three main conditions included in the bill include:

  • The intending couple must be Indian citizens and married for at least five years with at least one of them being infertile.  The surrogate mother has to be a close relative who has been married and has had a child of her own.
  • No payment other than reasonable medical expenses can be made to the surrogate mother.  The surrogate child will be deemed to be the biological child of the intending couple.
  • Central and state governments will appoint appropriate authorities to grant eligibility certificates to the intending couple and the surrogate mother.  These authorities will also regulate surrogacy clinics.

Read the full overview and analysis >

For background and information on preceding legislation (2012), read BioNews on visa restrictions imposed by the Indian government on foreign intended parents.

Report: Assisted Reproductive Technology National Summary Report

Assisted Reproductive Technology National Summary Report
Centers for Disease Control and Prevention | October 2016

cdc-2016-art-reportThe data for this report come from the 458 U.S. fertility clinics in operation in 2014. It is organized into the following sections.

  • Section 1: Information on the different types of ART cycles performed in 2014.
  • Section 2: Information on ART cycles that used only fresh non-donor eggs or embryos.
  • Section 3: Information on the ART cycles that used only frozen non-donor embryos.
  • Section 4: Information on the ART cycles that used only donated eggs or embryos.
  • Section 5: Information on trends in the number of ART procedures and measures of success over the past 10 years, from 2005 through 2014.

Read the full report >

Report: Ethical Use of Assisted Reproductive Technologies

Ethical Use of Assisted Reproductive Technologies
National Perinatal Association | December 2015

screen-shot-2016-12-06-at-3-06-14-pmProfessor Michele Goodwin at the University of Minnesota and Judy Norsigian have described the “raw and debilitating physical, emotional and spiritual challenges created by deeply personal and life-altering procedures” experienced by some women seeking ART and support the need for additional regulation. In addition to the invasive processes involved in conception, the ethical quandary created by a recommendation for fetal reduction and the emotional toll on women and couples may be profound and is incompletely studied. Professor Goodwin asserts there is a “much needed public discourse that could also become the clarion call for regulation of a field of medicine that has thus far unsuccessfully regulated itself.”

This position paper by the National Perinatal Association addresses the ethical use of assisted reproductive technologies. It emphasizes reducing disparities in care provided to mothers and children and makes helpful recommendations, including: single embryo transfers, counseling from a multi-disciplinary team, informed consent prior to treatment, and access to comprehensive obstetric care during and after treatment.

Read the full document >

Report: Perinatal Risks Associated with Assisted Reproductive Technology

Perinatal Risks Associated with Assisted Reproductive Technology
The American College of Obstetricians and Gynecologists | Committee Opinion Number 671 | September 2016

screen-shot-2016-12-12-at-3-58-25-pmPerinatal risks that may be associated with assisted reproductive technology (ART) and ovulation induction include multifetal gestations, prematurity, low birth weight, small for gestational age, perinatal mortality, cesarean delivery, placenta previa, abruptio placentae, preeclampsia, and birth defects. Although these risks are much higher in multifetal gestations, even singletons achieved with ART and ovulation induction may be at higher risk than singletons from naturally occurring pregnancies.

ACOG’s report recognizes the importance of ARTs for infertile couples but, in the spirit of informed consent, it provides a comprehensive outline of related perinatal risks.

To promote optimal outcomes, ACOG suggests that patients receive counseling and a thorough medical evaluation; and that obstetrician–gynecologists and other health care providers address maternal health problems or health conditions before initiating treatment and, when proceeding, make every appropriate effort to achieve a singleton gestation.

Read the full report >

Report: More ART than Science

More ART than Science
Reproductive Health Technologies Project | 2016

screen-shot-2016-11-11-at-4-45-31-pmThis report provides an overview of recent scientific literature on the long-term health effects of ovarian stimulation and egg retrieval, a specific component of ART used during in vitro fertilization (IVF), egg donation, and egg freezing. It is not a complete literature review but, as described, “an overall assessment of what is and what is not currently known, followed by recommendations for how to improve the information available about this aspect of reproductive health care.”

This paper builds on work the Reproductive Health Technologies Project began in 2003, when the organization convened leaders from reproductive health, rights, and justice organizations and women’s health advocacy organizations to consider issues related to ARTs and emerging technologies.

Shortly after that convening, RHTP produced a white paper about ovarian stimulation and egg retrieval. This report provides an update to reflect the additional knowledge gained from the research that has taken place since RHTP’s earlier exploration of the field.

Read the full report >