Fertility Treatment and Prematurity
Many infertile couples ask about the risk of fertility treatments. Their main focus is whether there is an increase in the risk for birth defects , particularly with complicated treatments such as IVF. It is unclear whether there is an increase in the risk for birth defects.
However, many couples completely overlook the biggest risk of fertility treatment: multiple pregnancy. Essentially, every complication of pregnancy occurs more commonly when there is more than one baby in the uterus. Ironically, many infertile couples, if asked, state they prefer to have a twin pregnancy. Most are unaware that even twins carry much greater risks to the mother and the babies.
One of the biggest risks of a multiple pregnancy is prematurity.
More than one million babies die each year within a month of birth because they’re born too soon, according to the first study to evaluate the global burden of premature births. Each year, according to the March of Dimes, about 13 million babies– approximately 10 percent of all newborns — are born prematurely being born before 37 weeks of gestation. This is about the rate found in the United States. A woman’s due date is calculated as 40 weeks past the first day of her last menstrual period. If a woman has used fertility treatment and the day of conception is known with certainly, the due date is determined by “calculating” the first day of her last menstrual period as two weeks before the date of conception. The day of conception is the day that an intrauterine insemination was performed or the day that sperm was added to the eggs in an IVF cycle.
In the United States, the rate of preterm birth has increased 36 percent in the last twenty five years. The dramatic increase in the rate of preterm labor is thought to be due to older women having babies and the use of fertility medications that increase the risk of multiple pregnancy.
Some premature babies face serious complications, such as these:
Respiratory distress syndrome (RDS): A serious breathing problem that affects mainly babies born before 34 weeks of pregnancy. RDS is causes in part be the lungs being incompletely developed a the time of birth. Can ultimately lead to death of the infant.
Bleeding in the brain: Bleeding in the brain is called intraventricular hemmorhage (IVH). IVF is most common in babies born before 32 weeks of pregnancy. It can cause pressure in the brain and brain damage. Can ultimately lead to death of the infant.
Patent ductus arteriosus: A heart problem that is common in premature babies. Untreated, it can lead to heart failure. Can ultimately lead to death of the infant.
Necrotizing enterocolitis (NEC): NEC is a potentially dangerous intestinal problem. Portion of the bowel can “die off”. This may require surgery to removed dead portions of bowel. Can ultimately lead to death of the infant.
Retinopathy of prematurity (ROP): An eye problem that occurs mainly in babies born before 32 weeks of pregnancy. In severe cases, treatment is needed to help prevent vision loss.
