Children born from in vitro fertilization (IVF)

Assessment Objective

Systematic literature review of studies that followed up on children born from in vitro fertilization (IVF). The literature review was requested by The National Swedish Board of Health and Welfare and is part of a broader review in the field of in vitro fertilization.

Assessment Strategy

Systematic literature review. Search in MEDLINE, Psychinfo, Embase. In total, approximately 150 relevant studies were found. The review also includes a large Swedish registry study of IVF births. At least two members of the project group evaluated each study.

Primary Data Collection

No.

Data Criteria: Type of Studies Included

All studies that were judged to be relevant and of acceptable quality were included (57 studies). The overwhelming majority were cohort studies or case control studies.

Review of Publications

Four external reviewers, the SBU Board of Directors, and the SBU Scientific Advisory Committee reviewed the manuscript.

Findings

The findings reveal that the greatest concern associated with in vitro fertilization is the high rate of twin births. In Sweden over 40 percent of IVF children are twins. In addition, there is a greater risk for complications related to premature birth and low birth weight, both of which in the short and the long term can lead to increased morbidity among the children. Even with single births, there is an increased risk for premature delivery and low birth weight, which presumably is associated with the condition of the mother rather than with the IVF method per se. Many studies have attempted to determine if there is a higher risk for various types of malformations, but most studies are too small to confirm this. A large Swedish registry study, however, suggests there may be such an increased risk. In absolute numbers, however, the risks for malformation are small and most children born after IVF are healthy. Nevertheless, it is important to reduce the number of twin births. This can be done by implanting only a single fertilized egg at a time into the mother.