Showing posts with label Birth. Show all posts
Showing posts with label Birth. Show all posts

Tuesday, October 23, 2012

Infertility Treatment May Raise Birth Defect Risk

By Salynn Boyles
WebMD Health News

Reviewed by Brunilda Nazario, MD

Oct. 20, 2012 -- Babies conceived with the help of high-tech fertility treatments such as in vitro fertilization (IVF) have an increased risk for birth defects, a new study shows.

Compared to infants born to mothers who conceived without assisted reproduction, those born following treatments like IVF were 25% more likely to have birth defects.

Researchers say the actual or "absolute" risk remains low overall.

The study, which was presented today in New Orleans at a national conference of the American Academy of Pediatrics, is not the first to show a small increase in birth defects among babies conceived through assisted reproduction.

"We don't really understand why IVF raises the risk for birth defects," says researcher Lorraine Kelley-Quon, MD, of UCLA Medical Center. "But we have now seen many studies from all over the world that show this association."

In the new study, Kelley-Quon and colleagues from UCLA's Mattel Children's Hospital used a statewide birth database to compare the incidence of birth defects among babies conceived through high-tech reproduction such as IVF and those born to mothers who conceived naturally.

The two groups of women were matched for characteristics including age, race, and previous births.

The birth defect rate for babies born through IVF or other high-tech fertility treatments was 9% compared to 6.6% for those conceived naturally.

Malformations of the eye, heart defects, and defects of reproductive organs and the urinary system were all more common among babies conceived through high-tech treatments.

Fertility treatments such as artificial insemination, intrauterine insemination, and use of fertility-enhancing drugs were not associated with an increased birth defect risk.

The researchers did not have information on which assisted reproduction treatments the couples in the study had.

In vitro fertilization typically involves attempts to fertilize in a laboratory and a transfer of the embryo back into the womb.

Reproductive endocrinologist Nancy Klein, MD, of Seattle Reproductive Medicine, says more study is needed to confirm this finding.

She adds that while it does appear that babies born following assisted reproduction have a small increased risk for birth defects, it is still not clear if the procedures are to blame.

It may be that infertility itself is a risk factor for birth defects, she says.

Avner Hershlag, MD, who is chief of the Center for Human Reproduction at North Shore-LIJ Health Center in New York, says if IVF and other forms of assisted reproduction do raise the risk for birth defects, the risk is small.

"It is important to do the research to answer this question," he says. An estimated 5 million people were born using these techniques and the vast majority have no birth defects, he adds.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

SOURCES: American Academy of Pediatrics National Conference and Exhibit, Oct. 20-23, 2012, New Orleans. Loraine I. Kelley Quon, MD, MSHS, Pediatric Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles. Nancy Klein, MD, reproductive endocrinologist, Seattle Reproductive Medicine. Avner Hershlag, MD, chief of the Center for Human Reproduction, North Shore-LIJ Health Center, New York. News release, American Academy of Pediatrics. Davies, M.J. New England Journal of Medicine, May 14, 2012.

©2012 WebMD, LLC. All Rights Reserved.



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Sunday, October 21, 2012

IUDs Increasingly Popular Form of Birth Control

By Rita Rubin
WebMD Health News

Reviewed by Louise Chang, MD

Oct. 18, 2012 -- While the use of long-acting intrauterine devices (IUDs) is increasing, 1 in 9 women at risk for unintended pregnancies is not using any birth control, according to a new government report.

Researchers from the National Center for Health Statistics, part of the CDC, analyzed data from more than 12,000 women aged 15 to 44. They compared that information with data collected from nearly 11,000 women in 1995.

Nearly two-thirds, or 62%, of women of reproductive age use contraception, with the pill preferred by 28% of women and female sterilization the choice of 27%, almost exactly the same proportions as in 1995.

Use of IUDs rose to 5.6%, seven times the .8% in 1995, an increase that James Trussell, PhD, calls "striking." Trussell is a faculty associate at Princeton University's Office of Population Research. He was not involved in the study.

Depending on the type of IUD, the devices work for five years or 10 years and are more than 99% effective in preventing pregnancy.

Earlier this month, the American Congress of Obstetricians and Gynecologists' Committee on Adolescent Health Care took a step toward clearing up the misconception that only women who've delivered children can use an IUD. The committee published an opinion paper concluding that teens, who are at high risk of unintended pregnancy, might benefit from greater access to long-acting reversible contraceptives, namely IUDs and contraceptive implants. The implants, tiny hormone-releasing rods inserted under the skin of the arm, are more than 99% effective and can be left in place for three years.

Teens increasingly have turned to hormonal contraceptives such as the pill and away from condoms, the new report shows. Since 1995, there was a 45% decline in the use of condoms as the main form of birth control by young women 15 to 19 years old, researchers found. That change, along with the increased use of contraceptives the first time they have intercourse, and using more than one method at a time, such as the pill and condoms, have been credited with the recent decline in teen birth rates, the researchers write.

"One of the things that I was struck with was the adoption of the newer methods of birth control by the younger women and women of color," says researcher Jo Jones, PhD, a statistician and demographer at the National Center for Health Statistics. Since 1990, a number of new hormonal methods have become available. These include NuvaRing, a vaginal ring left in place for three weeks and then removed for a week, and Ortho Evra, a patch that is placed on the skin and changed weekly.

Use of IUDs and implants might continue to supplant condoms and other less-effective birth control methods, says Lawrence Finer, PhD, director of domestic research at the Guttmacher Institute, which performs research, policy analysis, and public education focused on sexual and reproductive health. "It's possible we're seeing the start of a transition here toward these more effective long-acting methods," Finer says.

In the current issue of Fertility & Sterility, Finer and his colleagues published a separate analysis of data collected in 2007-2009. Their study found that among women using birth control, the proportion who opted for an IUD or implant increased from 2.4% in 2002 to 8.5% in 2009.

SOURCES: James Trussell, PhD, faculty associate at Princeton University's Office of Population Research. Jo Jones, PhD, a statistician and demographer at the National Center for Health Statistics. Lawrence Finer, PhD, director of domestic research at the Guttmacher Institute.

©2012 WebMD, LLC. All Rights Reserved.



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