According to a Swedish study, children born as a result of in vitro fertilization (IVF) are more likely to need neurological therapy than naturally conceived children (odds ratio 1.7, 95% CI 1.3-2.2). Children born using IVF were 3.7 times more likely than naturally conceived children to have cerebral palsy, the most common neurological diagnosis for IVF babies (2.0-6.6).

(Source: B. Strömberg, G. Dahlquist, A. Ericson, O Finnström, M. Köster, and K. Stjernqvist, "Neurological Sequelae in Children Born after In Vitro Fertilisation: A Population-Based Study," The Lancet, vol. 359, no. 9305 [February 2002], 461-465.) 

"The only non-arbitrary principle is the one that says human beings - irrespective of age, size, stage of development, or condition of dependency - may never be exploited and destroyed in research to benefit others. This principle recognizes the great truth that human life is intrinsically, and not merely instrumentally, valuable. It understands that human dignity is inherent, and thus it makes sense of the great principle of human equality upon which our nation was founded."

(Source: Robert P. George in Kathryn Jean Lopez, "Q&A: Reporting on the Report: Robert P. George on the president's bioethics council's report," National Review Online, July 16, 2002; http://www.nationalreview.com/interrogatory/interrogatory071602.asp.)

In vitro fertilization (IVF) was first performed in1978, with, as the authors of a recent New England Journal of Medicine report state, "little formal evaluation of its effects on the health of the children conceived with this procedure."  All that really mattered was that there was a new technique for circumventing infertility and producing a baby.  Intracytoplasmic sperm injection (abbreviated ICSI, pronounced "ick-see"), introduced in 1992, is a highly refined derivative of IVF, where sperm is injected into a single egg, is helping to re-open some of the questions that were never answered, or in some cases, never asked, concerning technological reproduction.

While previous studies have found no increased risk of major birth defects accruing from either in vitro fertilization or intracytoplasmic sperm injection, the NEJM authors point out major methodological problems with these studies, "including inadequate sample sizes and a lack of appropriate data for comparison," and differing definitions of birth defects for children conceived via ICSI and IVF vis-à-vis those children conceived naturally.

Using data gleaned from three registries of births in Western Australia, the authors examined the records of 301 children born as a result of ICSI, 837 IVF children, along with 4000 children conceived naturally.  Contrary to previous studies, significant differences were found: "Twenty-six of the 301 infants conceived with intracytoplasmic sperm injection (8.6 percent) and 75 of the 837 infants conceived with in vitro fertilization (9.0 percent) had a major birth defect diagnosed by one year of age, as compared with 168 of the 4000 naturally conceived infants (4.2 percent; P<0.001 for the comparison between either type of technology and natural conception)."  Furthermore, the authors found even after adjusting for mothers' age and other factors, as compared against natural conception, "the odds ratio for a major birth defect by one year of age...was 2.0 (95 percent confidence interval, 1.3 to 3.2) with intracytoplasmic sperm injection, and 2.0 (95 percent confidence interval, 1.5 to 2.9) with in vitro fertilization."  That is, a child conceived by means of either IVF or ICSI is more than twice as likely to be diagnosed with a major birth defect than a naturally-conceived child.

A concomitant issue attending assisted reproductive technologies, including in vitro fertilization and intracytoplasmic sperm injection, is the use of prenatal testing.  When children who were aborted because of "fetal abnormalities" detected by prenatal testing were included, the authors found that the "overall prevalence of major birth defects was 4.5 percent in the natural-conception group," 9.4 percent for the IVF children, and remained 8.6 percent for the ICSI group.

The researchers also found that children conceived using technological reproduction were "significantly more likely to have multiple"-more than one-"major birth defects than the naturally conceived infants." The odds ratio for ICSI is 4.1 [95 percent confidence interval, 1.6 to 10.2], and for IVF, 3.1 [95 percent confidence interval, 1.6 to 6.3].  That is, a child conceived by IVF is three times more likely to have more than one major birth defect than a child conceived naturally, and four times more likely, if conceived via intracytoplasmic sperm injection.

In addition to a greater prevalence of single and multiple major birth defects, the researchers discovered that children conceived using assisted reproduction were more likely than naturally-conceived children to have low birth weight, to be born prematurely, and to be delivered more often by cesarean section.

Assisted reproductive technologies have often been likened to humans "playing God."  With this study, however, we find that this analogy no longer holds, for in our playing, our manufacturing of children, we make extraordinarily more errors.

(Source: Michele Hansen, Jennifer J. Kurinczuk, Carol Bower, and Sandra Webb, "The Risk of Major Birth Defects after Intracytoplasmic Sperm Injection and In Vitro Fertilization," The New England Journal of Medicine, Vol. 346, No. 10 [March 7, 2002], p. 725-730.)