Powered by Blogger.

Making Baby Series - Part 4 : The Risks






WHY RISK IT?
The possible health risks of many fertility treatments are often glossed over—and not just by doctors who don’t want to emphasize them, but also by patients who don’t really want to think about them. The risks are an important part of the big picture, however. They are small but real.
Negative effects on both mothers and babies are seen more frequently in children of ARTs than in naturally conceived babies. If you’ve already tried any of these techniques, we want you to keep these risks in perspective. In fact, everyone should keep them in perspective, because there may come a time when these are the right strategies for you. These may be risks you are ready to assume. What we wish for all couples trying to conceive is that any risks are necessary risks. What breaks our hearts is people opening themselves up to potential problems when safer options are available.
Our aim is not to scare women but rather to underscore why they must view ARTs as options of last resort. The risks are worth it when there is no other way to have a baby, but they are unnecessary if you can get pregnant in a more natural way. Following the Making Babies program will allow you to avoid the potential problems associated with fertility drugs, IVF, and other ARTs, including an increased risk of ovarian cancer in the mother; a tubal pregnancy; eggs or embryos with genetic defects; fetal abnormalities; perinatal complications; pregnancy with two or more babies at once (and all the potential health problems that go along with that); premature birth (and all the potential health problems that go along with that); neurological and physical handicaps, developmental delays, learning disabilities, and mental and behavioral disorders later in life; and possible infertility (for the baby) later in life.
There are potential immediate health risks for the mother from ARTs as well, including allergic reactions to fertility drugs, infection, injury during retrieval of eggs, bleeding, blood clots, and damage to organs or blood vessels. Poor lab work, including mix-ups of samples and/or results as well as basic quality issues, introduces another kind of risk in pursuing technological solutions to fertility problems.

The Risks of Fertility Drugs
Most of the risks to the mother come from fertility drugs, and we’ll look at the potential problems in more detail in chapter 25. On their own, fertility drugs are the most common approach to infertility issues, and each cycle of IVF begins with fertility drugs. In both cases, the drugs are used to stimulate the ovaries to release more eggs. The usual strategy boils down to using more and more of the drugs, in an attempt to get more and more eggs. But some women receive doses that are too high. Others are given too many courses of the drugs. And some are given drugs when they don’t really need them or have a fertility problem the drugs can’t solve.
High-dose fertility drugs put women at risk in both the short and long term and increase the risks for babies as well. At the most basic level, many women experience headaches, hot flashes, and mood swings, among other familiar unpleasant signs of hormones at work. These effects may not be dangerous, but they can make a woman quite miserable, and they place even more physical and emotional stress on women and couples already pushed to the edge by fertility issues.
Over the long term, the repercussions are more serious. Some studies show an increase in cancer risk from fertility drugs, which aligns with what we’ve seen in some patients with a history of extreme fertility drug use. The most common serious side effect of fertility drugs is ovarian hyperstimulation syndrome (OHSS; see page 323). The most severe cases require hospitalization and sometimes termination of pregnancy. Even with careful monitoring by their doctors, up to 10 percent of women using these drugs for IVF experience OHSS, with up to 2 percent having severe cases. OHSS is widely considered to be an overreaction to the drugs. We might do better to see it as a sign that we are overreacting in our use of such high doses of these extremely powerful drugs.
Once women go to all this trouble to get more eggs, it isn’t exactly smooth sailing from there. Many eggs harvested this way are abnormal, increasingly so as a woman gets older, and are more likely to produce embryos with genetic defects than those from a natural cycle. These defects can cause fertility treatment to fail. Experts worry, too, that the drugs may be causing problems that have yet to be pinpointed in children born as a result of fertility drug pregnancies.

The Risks of Multiples
The goal of using large doses of fertility drugs is to get lots of eggs. Not surprisingly, this raises the risk of pregnancy with more than one baby at a time. Only about 2 percent of naturally conceived children are twins. Fertility drugs alone increase the chances of multiples between 6 and 20 percent, depending on the medication. With IVF the number of multiples goes up even further—about a third of IVF pregnancies are twins—thanks to the standard American approach of transferring multiple embryos in each cycle to increase the chances of conception.
Multiples pregnancies are high-risk pregnancies. Essentially, a system designed to grow one new human being is strained to the limit by larger demands. Multiples pregnancies are more likely to end in miscarriage. They are more likely to involve cesarean delivery, premature birth (more than half of twins are born prematurely), and/or low birth weight. (The number of babies born prematurely has increased drastically over the past two decades, right alongside the number of babies conceived with technological assistance.) Babies born early or small have more health problems at birth and over the long term, as well as a higher risk of death in infancy, than full-term infants. Consider, too, the high economic costs of the neonatal intensive care premature babies require.
Even the “solution” to the problem of multiples pregnancies created by IVF is problematic. “Reduction”—the euphemism used for selective abortion of one or more fetuses to lower the risks of the pregnancy—is a horrible situation to have to contemplate. And now evidence is showing that single infants born after selective (or spontaneous) reduction have many of the same risks and problems as twins.

The Risks of IVF
Research shows that babies conceived through IVF are at greater risk, even when they are in single pregnancies. If you’ve used any ART, or if you think you might, it is important to remember that the risks of serious, long-term problems in children born through ARTs are small. For couples with no other viable options for getting pregnant, these are acceptable risks. But for the many couples for whom these are avoidable risks, it is unnecessary to run them.
Less than 2 percent of naturally conceived children have birth defects, and although that figure certainly provokes some anxiety in would-be parents, it rightly doesn’t dissuade anyone from conceiving that way. In babies born through ARTs, the risks are 50 percent higher: 3 percent. If you could lower the risks for your child even 1 percent, wouldn’t you?
IVF babies also are two and a half times more likely than spontaneously conceived babies to have low birth weight, and that brings with it a raft of health risks, just as multiple and premature births do. Scientists do not yet agree on what to blame for the increased risks with ARTs. What is clear is that the more involved or intense the fertility intervention, the more likely it is that some problems will emerge over the long term.

The Risks of Not Knowing
Of all the risks faced by people struggling with fertility issues, the biggest one is not having a child. That’s what makes all the other risks acceptable—when they are necessary. But the way the infertility industry operates in America today, these very real risks are too easily dismissed, never really considered, or taken for granted. If nothing else, they should give you pause, even if they don’t change your decision in the end.
Modern infertility medicine poses subtler risks as well, and these receive even less consideration. There’s the risk of receiving a diagnosis and being told there’s nothing to be done about it (and so you’ll never have a baby). There’s also the risk of receiving the vague diagnosis of “unexplained infertility,” meaning, really, that Western medicine can’t find anything that needs fixing and so, again, there’s nothing to be done.
So many patients come to us having failed IVF, or having been turned down as candidates for IVF, and their doctors don’t have anything else to offer them, with the possible exception of donor eggs. They’ve been told that they’ll never have a baby, perhaps because they are too old or their FSH is too high. For these women, that’s a terrifying position to be in.
These are the risks of not knowing—not knowing what is preventing pregnancy and/or not knowing what to do about it—which the one-size-fits-all approach of fertility medicine today not only deems acceptable but also implicitly encourages. But you don’t have to accept them if you follow the Making Babies path.
Thank you for reading the article about Making Baby Series - Part 4 : The Risks in blog Get Natural Pregnant and if you found this article useful please bookmark this page in your web browser, by pressing Ctrl D on your keyboard.

Artikel terbaru :