Health Risks of In Vitro Fertilization: A Critical Review
This paper examines the health risks associated with in vitro fertilization (IVF), one of the most widely used forms of assisted reproductive technology (ART). Beginning with an overview of the IVF procedure and its five basic steps, the paper surveys research findings on several serious medical concerns: imprinting disorders such as Beckwith-Wiedemann and Angelman syndromes, ovarian cancer risk, ovarian hyperstimulation syndrome (OHSS), cerebral palsy in IVF-conceived children, and elevated post-neonatal hospitalization costs linked to multiple births. The paper concludes by examining the ethical debate surrounding multiple embryo transfer and the professional responsibilities of reproductive medicine specialists.
- Introduction to In Vitro Fertilization: Definition, history, and purpose of IVF
- Basic Steps in IVF: Five procedural stages of the IVF process
- Rationale and Risks of IVF: Indications, physical risks, and financial costs
- Imprinting Disorders Associated with ART: ART links to Beckwith-Wiedemann and Angelman syndromes
- Ovarian Cancer and Ovarian Hyperstimulation Syndrome: Cancer risk and OHSS as serious IVF complications
- Cerebral Palsy and Post-Neonatal Hospitalization: IVF associations with CP and higher healthcare costs
- Ethics of Multiple Embryo Transfer: Professional ethics of limiting embryo transfers
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- Draws on multiple peer-reviewed sources from specialized reproductive medicine journals, giving the survey credibility across several distinct risk categories.
- Balances clinical description of the IVF procedure with evidence-based discussion of associated health risks, providing readers with both procedural context and medical consequence.
- Moves logically from mechanical process (steps of IVF) to biological risk (OHSS, imprinting disorders) to societal concern (costs, ethics), creating a coherent argumentative arc.
Key academic technique demonstrated
The paper employs a literature-survey approach, synthesizing findings from multiple independent studies to build a cumulative case that IVF carries serious but underreported health risks. Rather than relying on a single source, it cites converging evidence from Danish, Finnish, Dutch, and Irish cohorts, strengthening claims through triangulation across national datasets.
Structure breakdown
The paper opens with a definition and brief history of IVF, then walks through the five procedural steps in detail. Subsequent sections address distinct risk categories—imprinting disorders, ovarian cancer, OHSS (including its risk factors), cerebral palsy, and post-neonatal costs—each anchored to one or more specific studies. The final section shifts to ethics, addressing the professional obligations of reproductive specialists regarding multiple embryo transfer. An annotated bibliography closes the paper.
Introduction to In Vitro Fertilization
In vitro fertilization is fertilization that takes place in a laboratory dish (Storck, 2010). Fertilization is the joining of a woman's ovum, or egg, and a man's sperm. This normally occurs inside a woman's body, where the fertilized egg attaches itself to the womb and grows until it is delivered after approximately nine months. This is natural, or unassisted, conception. In contrast, in vitro fertilization (IVF) is a form of assisted reproductive technology (ART), which uses special medical techniques to help a woman become pregnant. IVF has proved successful since 1978 and has become the most widely used form of ART when less expensive techniques fail (Storck, 2010). While it appears to be the best solution for infertility, IVF carries significant impacts on health.
Basic Steps in IVF
The first step is stimulation, or super-ovulation (Storck, 2010). The woman is given fertility drugs to stimulate the ovaries to produce more eggs. Regular transvaginal ultrasounds are performed to monitor the ovaries and hormone levels.
The second step is follicular aspiration, a minor outpatient surgery that removes eggs from the woman's body. She is given painkillers, and the procedure is guided by ultrasound. A thin needle is inserted through the vagina into the ovary and follicular sacs; a suction device then removes the eggs and fluid from each follicle, one at a time. This is repeated for each ovary. The woman may experience temporary cramping. Pelvic laparoscopy is seldom used to remove eggs. If the woman cannot produce eggs, donated eggs may be used.
The third step consists of insemination and fertilization. The sperm is joined with the best-quality eggs and kept in a carefully controlled chamber. The combining of sperm and eggs is called insemination. The sperm typically enters and fertilizes the egg within a few hours. If the doctor judges the chances of fertilization to be low, sperm may be injected directly into the egg in a procedure called intracytoplasmic sperm injection (ICSI), which is routinely performed in many fertility programs.
The fourth step is embryo culture. Laboratory staff monitor the embryo's growth carefully. At this stage, couples at high risk of passing on a hereditary disorder may opt for pre-implantation genetic diagnosis (PGD), which can be performed three to four days after fertilization. Scientists remove a single cell from each embryo and screen it for specific genetic disorders. The American Society for Reproductive Medicine states that parents may decide which embryo to implant based on these results. PGD can reduce the chance of passing a hereditary defect to offspring, though the technique remains controversial and is available at only a limited number of centers.
The fifth step is embryo transfer. The selected embryo is returned to the woman's womb three to five days after retrieval and fertilization. The procedure is performed while the woman is awake: a catheter containing the embryos is inserted through the vagina and cervix into the womb. If the embryo attaches to the uterine lining, pregnancy begins. Implanting more than one embryo simultaneously can result in multiple offspring. The number of embryos permitted for transfer is a controversial issue that depends on several factors, especially the woman's age. Unused embryos may be frozen for donation at a later date (Storck, 2010).
Rationale and Risks of IVF
IVF is used to treat causes of infertility including advanced maternal age, damaged or blocked fallopian tubes, endometriosis, male infertility, and unexplained infertility (Storck, 2010). These benefits are offset by a range of risks. The patient must be physically, emotionally, and financially prepared and committed to the process. Infertile couples often experience stress and depression. A woman taking fertility drugs may experience bloating, abdominal pain, mood swings, and headaches. These drugs are administered mostly by injection several times a day for eight to ten weeks—so frequently that the healthcare team must instruct the couple on how to mix and administer the medication. Bruising can result from frequent injections.
In severe but rare cases, fertility drugs may cause ovarian hyperstimulation syndrome (OHSS), characterized by fluid build-up in the abdomen and chest. Current research has not established a reliable link between fertility drugs and ovarian cancer. Egg retrieval carries risks including reactions to anesthesia, bleeding, infection, and damage to surrounding structures. Multiple pregnancies may result from implanting more than one embryo, increasing the risk of premature birth and low birth weight.
Not all IVF pregnancies result in live births. The chances of delivering a live baby are highest in women under 35, at up to 43%, and fall to 13–18% in women over 41. IVF is also a very costly procedure, not always covered by health insurance. One IVF cycle must cover medicine, surgery, anesthesia, ultrasounds, blood tests, processing of eggs and sperm, embryo storage, and embryo transfer—at a cost of approximately $12,000 to $17,000 per cycle (Storck, 2010).
References
Kashyap, S., & Davis, O. K. (2003). Ovarian cancer and fertility medications: A critical appraisal. Seminars in Reproductive Medicine, 21(1). Thieme Medical Publishers. Retrieved November 24, 2011, from http://www.medscape.com/viewarticle/56560
Koivurova, S., et al. (2007). Post-neonatal hospitalization and health care costs among IVF children: A 7-year follow-up study. Human Reproduction, 22(8). Oxford University Press. Retrieved November 22, 2011, from http://www.medscape.com/viewarticle/561435
Owen, C. M., & Segar, J. H. (2009). Imprinting disorders and assisted reproductive technology. Seminars in Reproductive Medicine, 27(5). Medscape. Retrieved November 22, 2011, from http://www.medscape.com/viewarticle/710787
Storck, S. (2010). In vitro fertilization. MedlinePlus: A.D.A.M., Inc. Retrieved November 22, 2011, from http://www.nlm.nih.gov/medlineplus/ency/article/007279.htm
Van Voorhis, B. J., & Ryan, G. L. (2010). Ethical obligation for restricting the number of embryos transferred to women: Combating the multiple birth epidemic from in vitro fertilization. Seminars in Reproductive Medicine, 28(4). Thieme Medical Publishers. Retrieved November 22, 2011, from http://www.medscape.com/viewarticle/726676
Zhu, J. L., et al. (2010). Parental infertility and cerebral palsy in children. Human Reproduction, 25(12). Oxford University Press. Retrieved November 22, 2011, from http://www.medscape.com/viewarticle/734323
Zivi, E., et al. (2010). Ovarian hyperstimulation syndrome. Seminars in Reproductive Medicine, 28(6). Thieme Medical Publishers. Retrieved November 22, 2011, from http://www.medscape.com/viewarticle/732841
Create your account
Always verify citation format against your institution’s current style guide requirements.