Infertility management and success has blossomed since the late 1970s. Technologic advances have spurned increased success and availability. In recent years, the concern for safety to both the child and mother during the IVF process and pregnancy has come to the forefront. In particular, the acknowledgement that adult disease may be rooted in gestational exposure where lower birth weight may be associated with poorer long term health effects (risks of diabetes, cardiovascular disease and hypertension).
Multiple studies have suggested that IVF pregnancies may demonstrate increased risks of preterm birth, low birth weight and congenital anomalies. However, there is an unclear association between low birth weight and IVF.
The specific causes of poor perinatal outcomes remain elusive. Increased risk of low birth weight babies (LBW) largely has been associated with a higher rate of multiple gestation. Higher rates of multiple gestations are associated with IVF. There is an increase slight increase in LBW babies even when they are a singleton gestation comparing IVF to natural conception in some studies, but not in others.
The discrepancies in these studies and the inability to establish a clear, causal relationship may represent the devil in the details. When compiled, these data may not account for important potential biases such as maternal age, number of children birthed, maternal health issues and socioeconomic status. These factors most likely play key factors in influencing outcomes of interest.
It remains unclear as to whether low birth weight is associated with IVF or underlying infertility. The key is to provide safe and effective treatments for infertility and to provide a nurturing environment for gestation.
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