Larger studies are needed to confirm results

Children conceived through assisted reproductive technologies may be at an increased risk of developing arterial hypertension early in life, among other cardiovascular complications, according to a Swiss study in the Journal of the American College of Cardiology.

The most common ART methods are in vitro fertilization and intracytoplasmic sperm injection, which can expose the gamete and embryo to a variety of environmental factors before implantation. Children conceived using ART make up 1.7 percent of all infants born in the United States every year and currently over six million persons worldwide.

The study assessed the circulatory system of 54 young, healthy ART adolescents (mean age 16) by measuring ambulatory blood pressure, as well as plaque build-up, blood vessel function and artery stiffness. It found that they had significantly higher arterial hypertension. “This places ART children at a six times higher rate of hypertension than children conceived naturally,” said the lead author of the study, Emrush Rexhaj, of University Hospital in Bern.

In an accompanying editorial, Larry A. Weinrauch, a cardiologist at Mount Auburn Hospital, said that the study’s small cohort may understate the importance of this problem for ART adolescents, especially since multiple birth pregnancies and maternal risk factors (such as eclampsia, chronic hypertension and diabetes) were excluded from the study.

“Early study, detection and treatment of ART conceived individuals may be the appropriate course of preventative action,” Weinrauch said. “We need to be vigilant in the development of elevated blood pressure among children conceived through ART to implement early lifestyle-based modifications and, if necessary, pharmacotherapy.”

IVF specialists acknowledged the warning, but observed that the study was a small one and that larger population studies should be carried out to see if these sombre results could be confirmed.

Yutang Wang, of Federation University Australia, commented that “ARTs involve the manipulation of early embryos at a time when they may be particularly vulnerable to external disturbances. Therefore, it is not surprising that ARTs could increase individual’s susceptibility to some diseases. Mice generated by IVF have a shortened lifespan compared with control mice. Whether this is the case in humans remains unknown. Future research will tell us whether ARTs increase long-term cardiovascular diseases such as stroke and heart attack in humans, and research into methods to minimise such risks are urgently needed.”

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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