Interview With Neonatologist Carlo Bellieni

ROME, JUNE 7, 2004 (Zenit) - In vitro fertilization, a practice that entails high risks for the health of a child, reflects a trivialization of conception, warns a neonatologist.

In this interview, Dr. Carlo Bellieni, professor of neonatal therapy at the School of Pediatrics of the University of Siena, talks about the dangers of artificial procreation for the child conceived, as revealed in recent scientific studies. Accompanying his statements are key references to medical research.

Q: What are some factors in the in vitro fertilization debate?

Bellieni: Reflections on in vitro fertilization relate to two opposing factors: the safeguarding of the conceived embryo on one hand and the pressing request of some couples to have a child on the other.

Leaving to one side for the moment the fact that one can also have a child by adoption, it is strange that no thought is given to the fate of the children conceived in this manner [IVF], as though once the horror of spare embryos has been overcome, a child conceived in a test tube is comparable to one conceived normally.

Obviously, I am not referring to emotional differences: a child is always a child, regardless of the way he was conceived. However, we wish to consider if the risks of IVF are such as to impose at least some caution.

Q: What are the risks for children conceived in vitro?

Bellieni: Three studies on large numbers of children conceived in vitro were published in 2002 in prestigious international scientific journals and the conclusions are not at all comforting.

The conclusions verify that "Children who are underweight at birth run the risk of incapacity and death. The use of IVF implies an increase of children who are underweight at birth in the U.S. because it is associated with a high rate of twin births. Until 1997, IVF was the cause of 40% of triple births. Likewise, studies show that there are more underweight children at birth by IVF than in normal pregnancies" [Citation from Schieve, L.A. et al: "Low and Very Low Birth Weight in Infants Conceived with Use of Assisted Reproductive Technology," The New England Journal of Medicine, 2002; 346:731-737].

"Our study suggests that children born by IVF have an increased risk of developing cerebral problems, in particular cerebral paralysis" [Stromberg B. et al: "Neurological Sequelae in Children Born after In-Vitro Fertilization: A Population-Based Study," The Lancet, 2002; 359: 461-5].

"Children conceived with the use of 'Intracytoplasmic Sperm Injection' (ICSI) or IVF run a double risk of presenting a greater defect at birth in relation to the general population" [Hansen, M. et al: "The Risk of Major Birth Defects After Intracytoplasmic Sperm Injection and In Vitro Fertilization," The New England Journal of Medicine, 2002; 346 (10): 725-30)].

These studies were used in other pediatric journals that emphasized: "In February of 2002, a team of Uppsala, Sweden, referred to a retrospective work on 5,680 children born by IVF: it showed that in general, children born by IVF have greater need for rehabilitation centers in relation to the normal population and the risk (OR) of cerebral paralysis is 3.7. The greatest difference is observed among children of single birth, while the risk of those born as twins is similar to that of the normal population. In an Australian study, 8.6% of children born by IVF had greater defects at birth, double that of the control group" [Koren, G.: "Adverse Effects of Assisted Reproductive Technology and Pregnancy Outcome," Pediatric Research, 2002].

The risk of having a handicapped child by opting for IVF is 11% compared to 5% by normal conception [NN: "Neurological Sequelae and Major Birth Defects in Children Born after In Vitro Fertilization or Intracytoplasmic Sperm Injection," European Journal of Pediatrics, 2003; 162:64].

Multiple-births are one of the great risks of IVF and can cause premature birth [Greisen, G.: "Multifoetal Pregnancy and Prematurity: The Costs of Assisted Reproduction," Acta Paediatrica, 2002; 91:1449-50].

Now, these observations seems obvious to the neonatologist: Multifetal pregnancy and prematurity, though trivialized by the press, represent a great risk for the health of the child -- and of the mother.

But the new fact is this: including in the case of the conception of a single child, the rate of risk for his health, if born by in vitro fertilization, is greater than for the normal population. A recent analysis of 25 scientific studies published in the British Medical Journal concludes that single pregnancies from assisted reproduction have a significantly worse perinatal result in relation to the normal population, although it adds that in twin pregnancies, perinatal ...