From the Guidelines
In vitro fertilization (IVF) itself does not directly cause cerebral palsy, but there is a slightly increased risk compared to naturally conceived pregnancies, primarily due to associated factors such as multiple pregnancies and premature birth. This increased risk is not directly attributed to the IVF procedure but to the higher incidence of complications that can occur in IVF pregnancies, such as twin-twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) pregnancies, as noted in a study published in the American Journal of Obstetrics and Gynecology 1.
Key Points to Consider
- The risk of cerebral palsy in children conceived through IVF is slightly higher than in those conceived naturally, largely due to the increased risk of premature birth and low birth weight associated with multiple pregnancies.
- IVF pregnancies have a higher rate of complications, including TTTS, which can affect neurologic outcomes in survivors, with a reported 10-30% of cotwin survivors experiencing neurologic handicaps 1.
- Underlying fertility issues that lead to the use of IVF might also contribute to the risk of developmental complications, including cerebral palsy.
- The absolute risk of cerebral palsy in IVF-conceived children remains low, with the majority of children conceived through IVF not developing cerebral palsy.
Recommendations for Parents Considering IVF
- Discuss the potential risks, including the increased risk of cerebral palsy, with a fertility specialist.
- Consider single embryo transfer to reduce the risk of multiple pregnancies when appropriate.
- Ensure regular prenatal care to monitor pregnancy health and address any complications promptly.
From the Research
Association between In Vitro Fertilization and Cerebral Palsy
- Studies have investigated the potential link between in vitro fertilization (IVF) and the risk of cerebral palsy in children 2, 3, 4, 5.
- A population-based cohort study found that children born after IVF had an increased risk of cerebral palsy, but this risk was largely attributed to preterm delivery and multiplicity 2.
- Another study suggested that the underlying infertility, rather than IVF itself, may be associated with an increased risk of cerebral palsy 3.
- However, a study using the Danish National Birth Cohort found that children born after IVF/ICSI had an increased risk of cerebral palsy, even after adjustment for preterm birth and multiplicity 3.
Risk Factors for Cerebral Palsy in IVF-Conceived Children
- Preterm delivery and multiplicity are significant risk factors for cerebral palsy in children conceived through IVF 2, 4, 5.
- A study found that the risk of cerebral palsy after IVF was lower and not statistically significant when singletons or unlike-sexed twins were analyzed 4.
- Stratification for various neonatal characteristics also reduced the odds ratios for cerebral palsy to non-significant levels 4.
Genetic Counseling Considerations
- Genetic counseling is essential for families considering genome-wide sequencing for cerebral palsy, as it can help identify underlying genetic causes and provide personalized treatment and management plans 6.
- Genetic counselors play a crucial role in educating and supporting families, helping them make informed testing decisions, and adapting to the implications of a genomic diagnosis 6.