News | Study Finds Pregnant Women Using ART Are More Likely to Be Exposed to Teratogenic Medications
A new Australian study found that pregnant women who conceived through assisted reproductive technology (ART) were more likely than those who conceived naturally to be exposed to teratogenic medications that may affect the fetus. Women who conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) had higher exposure during early pregnancy, which may be a potential factor in some birth defects among babies conceived through ART.
Under Australia's Therapeutic Goods Administration (TGA) classification, teratogenic medications are placed in categories D and X. Category D risks may be accepted when clinical benefits justify them, such as in treating mental health disorders or epilepsy. Category X medications are strongly contraindicated during pregnancy because of the substantial risk of fetal harm.
Researchers from the University of South Australia (UniSA), the University of Western Australia (UWA), and The Kids Research Institute Australia analyzed more than 57,000 pregnancies across four conception groups: women using ART (2,041), women using medication to induce ovulation (590), women with untreated subfertility (2,063), and women who conceived naturally (52,987).
Early-pregnancy exposure to category D medications was highest among women using ART at 4.9%, compared with 0.6% among those who conceived naturally. The pattern continued later in pregnancy, with exposure in 3.4% of ART pregnancies versus 0.6% of natural conceptions.
Exposure to category X medications was very low in every group and did not exceed 0.5% at any point in pregnancy.
Medication Use and Its Effects
“These differences mainly relate to medications used after ART treatment, particularly to prevent recurrent miscarriage or implantation failure, rather than medications for underlying chronic conditions,” said lead researcher Dr. Anna Kemp-Casey.
For example, women using ART had greater exposure during the study period to progestogens such as medroxyprogesterone acetate, which may be used for threatened or recurrent miscarriage.
Across all stages of pregnancy and conception methods, the most commonly used category D and X medications included paroxetine, lamotrigine, valproate, carbamazepine, and treatments for nicotine dependence.
Potential Implications and Future Research
Co-investigator Professor Roger Hart of UWA, an IVF clinician and National Medical Director of City Fertility, said early exposure to category D and X medications may be associated with the higher rate of birth defects among babies conceived through ART.
“Although ART pregnancies are usually carefully planned, medications used during fertility treatment may unintentionally increase the risk of birth defects, particularly during critical stages of fetal development,” Professor Hart said.
The researchers said the findings do not mean ART pregnancies are unsafe; most IVF babies are healthy. Instead, they emphasize the need for individualized care during ART and close monitoring in early pregnancy.
Professor Hart said further research is needed into exposure to category D and X medications during pregnancy and how underlying maternal health conditions affect birth-defect risk among babies conceived through ART.
The study was published in the Australian and New Zealand Journal of Obstetrics and Gynaecology.
News | Study Finds Pregnant Women Using ART Are More Likely to Be Exposed to Teratogenic Medications
News | Study Finds Pregnant Women Using ART Are More Likely to Be Exposed to Teratogenic Medications
A new Australian study found that pregnant women who conceived through assisted reproductive technology (ART) were more likely than those who conceived naturally to be exposed to teratogenic medications that may affect the fetus. Women who conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) had higher exposure during early pregnancy, which may be a potential factor in some birth defects among babies conceived through ART.
Under Australia's Therapeutic Goods Administration (TGA) classification, teratogenic medications are placed in categories D and X. Category D risks may be accepted when clinical benefits justify them, such as in treating mental health disorders or epilepsy. Category X medications are strongly contraindicated during pregnancy because of the substantial risk of fetal harm.
Researchers from the University of South Australia (UniSA), the University of Western Australia (UWA), and The Kids Research Institute Australia analyzed more than 57,000 pregnancies across four conception groups: women using ART (2,041), women using medication to induce ovulation (590), women with untreated subfertility (2,063), and women who conceived naturally (52,987).
Early-pregnancy exposure to category D medications was highest among women using ART at 4.9%, compared with 0.6% among those who conceived naturally. The pattern continued later in pregnancy, with exposure in 3.4% of ART pregnancies versus 0.6% of natural conceptions.
Exposure to category X medications was very low in every group and did not exceed 0.5% at any point in pregnancy.
Medication Use and Its Effects
“These differences mainly relate to medications used after ART treatment, particularly to prevent recurrent miscarriage or implantation failure, rather than medications for underlying chronic conditions,” said lead researcher Dr. Anna Kemp-Casey.
For example, women using ART had greater exposure during the study period to progestogens such as medroxyprogesterone acetate, which may be used for threatened or recurrent miscarriage.
Across all stages of pregnancy and conception methods, the most commonly used category D and X medications included paroxetine, lamotrigine, valproate, carbamazepine, and treatments for nicotine dependence.
Potential Implications and Future Research
Co-investigator Professor Roger Hart of UWA, an IVF clinician and National Medical Director of City Fertility, said early exposure to category D and X medications may be associated with the higher rate of birth defects among babies conceived through ART.
“Although ART pregnancies are usually carefully planned, medications used during fertility treatment may unintentionally increase the risk of birth defects, particularly during critical stages of fetal development,” Professor Hart said.
The researchers said the findings do not mean ART pregnancies are unsafe; most IVF babies are healthy. Instead, they emphasize the need for individualized care during ART and close monitoring in early pregnancy.
Professor Hart said further research is needed into exposure to category D and X medications during pregnancy and how underlying maternal health conditions affect birth-defect risk among babies conceived through ART.
The study was published in the Australian and New Zealand Journal of Obstetrics and Gynaecology.
Source:
Collected online