ART vs. Art
What does “ART” mean, anyway? The U.S. Centers for Disease Control & Prevention defines Assisted Reproductive Technology as all fertility interventions in which both eggs and sperm are therapeutically processed (or “medically handled”). This means that for something to be classified as an ART procedure, it must involve surgically removing eggs from a woman, combining these eggs with sperm in a laboratory, and then placing the resulting embryo into the woman’s body—or donating the embryos to someone else. So, strictly speaking, ART does not include treatments where just sperm alone is processed/handled (i.e., intrauterine—or artificial—insemination), or procedures in which a woman takes medicine only to stimulate her egg production without the intention of having eggs surgically retrieved.
So now you know the difference between Art and ART…and some doctors can do both!
High school senior Scott Sills (at right) on the platform of Fallen Wings, his Alexander Calder-inspired 1½ ton iron sculpture (1983), on the Harriman High School campus.
The main issue confronting many who are considering ART as a way to start (or grow) their family is safety. Is IVF really safe? What are the health concerns—both for mom and for baby?
Dr. Sills takes these matters seriously, and writes about this topic whenever possible. Although he has personally been involved in thousands of IVF cases worldwide, Dr. Sills agrees that this treatment should only be undertaken after careful thought. In 2014, he restated this position in the British Medical Journal (along with Oxford University co-author Dr. Gary S. Collins) where the important role of adoption was also acknowledged.
Does IVF increase the risk of cancer? This question actually has two parts—cancer risk for moms, and cancer risk for babies. Let’s look at the data on mothers (the IVF patients) first.
One of the largest & best known studies on this topic was produced by the Lund Institute (Sweden). They focused mainly on ovarian cancer, and recognized that the same pathology causing any ovarian disease might also be associated with female infertility later. Thus, cancer itself(or cancer treatment) may increase the risk for infertility,which can lead to IVF. But these researchers found that after IVF, where most patients had treatment that included fertility drugs, a significantly low cancer risk was measured. Ovarian cancer showed some risk, although lower than before IVF. One possible reason for this is that the same ovarian pathology causing infertility also brings an increased ovarian cancer risk.
What about babies conceived from IVF? To address the next part of the question, University College London sponsored research based on the comprehensive national registry of all IVF clinics in the U.K. and linked that with the British cancer registries. That way, they could tell if the babies born after IVF were showing up later with serious medical problems. The study revealed no overall increased risk of cancer among children born from IVF compared with the general population.
What about other factors? Recently, researchers led by New Zealand’s Liggins Institute (UnivAukland) reported IVF children were a bit taller than expected and had better cholesterol profiles. This was reassuring considering that some authors had previously wondered if the lower birth weight sometimes observed in IVF babies might be associated with poorer health long term.
But the details were intriguing: children conceived when estrogen levels were elevated (i.e., IVF + fresh embryo transfer) were taller, while children conceived with typical amounts of estrogen (i.e., thawed embryo transfer, “FET”) were average height. Of note, children conceived with clomid/clomiphene (an anti-estrogen) were actually shorter.
So, rather than the culture milieu associated with IVF embryos resulting in some apparent change in offspring height, it now seems plausible that the prevailing hormone situation near the time of conception is really what matters. Such findings appear to show that the fertility “stimulation protocol” chosen for IVF matters a lot, and there is more to assisted reproduction than just what happens in our laboratories.
IVF in the news: Celine Dion and husband RenéAngélil in 2011, with their twins Nelson & Eddy (then age 5 months) and son René-Charles. IVF was necessary to conceive all three of the couple’s children.