As the use of IVF expands to a wider range of fertility problems, experts warn that the risks could outweigh the benefits.
They argue that the evidence underpinning the use of IVF for some types of infertility is weak, and question whether the long term health risks for children can be justified.
A paper, in the British journal BMJ, pleas for further for studies evaluating the effectiveness of IVF in these couples.
Paper co-author Professor Ben Mol of the University of Adelaide says there should be caution using IVF when the benefit is uncertain or the chances of natural conception are still reasonable.
In Australia and New Zealand there were 65,000 IVF treatments in 2011 resulting in almost 12,000 births.
IVF was developed for women with fallopian tube disorders and severe male infertility but in recent years it has been applied to wider conditions, including unexplained infertility.
The researchers argue that the evidence underpinning the use of IVF for some of these newer applications is weak.
They question whether IVF is equally effective in these conditions and if the long term health risks for IVF children can be justified.
Unexplained infertility accounts for up to 30 per cent of all couples presenting for IVF, many of whom will conceive when not treated immediately.
Studies have shown considerable natural conception rates in couples with no obvious cause of infertility for two to three years.
Yet the authors point out that much IVF research often does not mention how long couples have been trying to conceive. And national fertility registries in many countries do not collect data on duration of infertility.
Extended use of IVF also increases the risk of harm. Multiple pregnancies are associated with complications for mothers and infants, and even single babies born through IVF have been shown to have worse outcomes than those conceived naturally.
Concern has also been raised about the long term health of children born through IVF.
Children conceived by IVF may have higher blood pressure, body fat distribution, glucose levels and more general vascular dysfunction than children conceived naturally.
“As a society, we face a choice,” Professor Mol says. “We can continue to offer early, non-evidence based access to IVF to couples with fertility problems or follow a more challenging path to prove interventions are effective and safe and to optimise the IVF procedure.
“We owe it to all subfertile couples and their potential children to use IVF judiciously and to ensure that we are first doing no harm.”
The paper, Are we overusing IVF?, was published today in the BMJ journal.
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