Ever since Louise Brown, the first ever test-tube baby, came into the world in 1978, in-vitro fertilisation (IVF) has become the first port of call for people having trouble conceiving. Since Louise’s birth, approximately one million IVF children have been born - accounting for 1 per cent of all births in the developed countries.
According to the World Health Organization, some 10 per cent of couples in the West experience difficulty conceiving and, among those who undergo infertility treatment, some 1.6 per cent now participate in IVF.
Judging by some of the media headlines, you’d think the early low success rates have finally been sorted, and that women using IVF can have babies virtually at will. However, the reality is a far different scenario. The rates of success remain low - only 22 per cent of couples undergoing IVF end up with a live baby - while issues concerning its safety continue to multiply.
These questions surfaced again recently, with publicity about TV personality Paul Merton’s wife, Sarah Parkinson, who this year died of breast cancer, and Liz Tilberis, former editor-in-chief of Harper’s Bazaar, who died of ovarian cancer in 1999. Both women were convinced their disease was caused by their efforts to conceive by IVF. Both had gone through several treatment cycles, involving high levels of female hormones.
Although the media brushed such concerns aside, the fact remains that IVF is still one vast clinical experiment. All the various varieties of IVF have been unleashed upon millions of men and women with virtually no proper studies conducted and little understanding of the risks it places on either mother or child. Indeed, every fresh discovery - and now genetically modified hormones are the latest wrinkle (see box, p 3) - is rushed into the clinic without sufficient experimental studies to back it up.
No less a figure than Lord Robert Winston himself, one of the pioneers of IVF and a member of the team that produced the test-tube ‘miracle’ in 1978, has recently spoken out publicly on the potential risks of the procedure, calling for better child follow-up and a fresh approach to IVF regulation.
So, 25 years on, we still have to ask: how safe is IVF to either mother or child?
How it works
In the most basic type of IVF procedure - where eggs from the mother and sperm from her partner are used - doctors give the woman drugs to stimulate her ovaries to produce multiple eggs. These eggs are then removed through some guided technique such as ultrasound. A sample of semen is gathered from the partner, and used to fertilise the eggs in a laboratory dish. Up to three of the resultant healthy embryos are then placed in the woman’s womb, on the (unproven) grounds that the more that are allowed to develop, the greater the likelihood that one will make it to term.
Pharmaceutical stimulation of the ovary is now the central plank of assisted reproduction. The technique essentially depends on giving multiple, powerful drugs that cause the ovaries to pump out as many mature eggs as possible.
The most dangerous potential complication is something known as ‘ovarian hyperstimulation syndrome’ (OHSS), which affects nearly 1500 women a year in the UK, or 6 per cent, of the nearly 24,000 a year who undergo IVF. Even MIMS, the UK doctors’ drugs ‘Bible’, warns that OHSS is a potentially fatal side-effect of fertility drugs, and that all patients undergoing ovulation induction are at risk. The syndrome can lead to life-threatening dehydration, massive fluid accumulation in the chest and abdomen, blood-clotting disorders and damage to the kidneys.