Busting myths about Developmental Delays

MYTH: The babies conceived through ART will have problems such as birth defects, low birth weight, developmental delays.

"Busted!: Though we hope all babies will be born without any problems, unfortunately this is not the case. Children conceived naturally to couples who have never struggled with infertility have a 3-5% risk of birth defects and a 1-2% likelihood of experiencing developmental delays. Pregnancies conceived naturally in women experiencing infertility may be at a slightly higher risk for pregnancy complications. IUI, when used without stimulation medication, does not appear to further increase the risk of birth defects or developmental delays. Pregnancy related complications are increased with ovarian stimulation, though this can be largely attributed to risks associated with multiple pregnancy. Babies born from IVF may be a little smaller than those conceived naturally, though they are typically still in the normal range. The majority of studies have not found an increased risk of birth defects in babies conceived with IVF. The use of intra-cytoplasmic sperm injection (ICSI), which is typically used when sperm quantity and/or quality is reduced, is associated with a very slight increase in chromosomal abnormalities and birth defects. Fortunately, if there is an increase in problems such as birth defects, low birth weight, and developmental delays in babies conceived through ART, it is very small. The overwhelming majority of babies born as a result of fertility treatment are fine!"

As a professional who works with children with developmental delays, I know this isn't true. Any child who receives therapy (whether it be speech, physical, or occupational) and is younger than 3 is labeled as having a developmental delay where I live. Birth defects, low birth weight, and developmental delays, in my experience, are more often caused be negligence and abuse than fertility treatments (think smoking cigarettes during pregnancy, fetal alcohol syndrome, lack of a stimulating environment, etc.) Other times, problems are the result of chromosomal, cranio-facial abnormalities, genetic, and neurological problems that are impossible to prevent.

In the 4 years I have been seeing children for speech therapy, only a handful of them were conceived with the help of fertility treatments (to my knowledge). One was a triplet and was delayed more as a result of competing with two brothers to communicate and from being premature. I think his issue was more a result of having the most laid-back personality of the three rather than being conceived with IVF.  I work now with a little boy who is the 4th boy in his family. His 3 brothers were conceived through IVF and he was a surprise "natural" accident. He receives speech therapy and occupational therapy to address sensory issues. His older brother also has many of the same issues and the boys were conceived in very different ways. All signs point to genetics in that family.

When I first started working I fell victim to this mentality. This was long before I ever knew we would have difficulty conceiving. I was down on IVF and fertility treatments since I thought we would have no problems. I looked at those triplets and thought they had an "IVF look." I realized later they looked a lot like their father (who I rarely saw). When I was telling my Dad about the family with the 4 boys and telling him how the mom was always very open about fertility treatments he said to me, "You know why she told you that so soon? Because the mom think that is why the child you work with has problems." It was nice to be able to tell him he was the only child in the family not conceived through IVF. 

I think many of the issues that children face are a result of their environment, whether it be pre or post natal. If there are multiple children in the same pregnancy then there will likely be complications. If babies are born early, whether conceived naturally or not, they are more likely to have developmental delays. If children are living in a home where this is little engagement or time spent with them, they are likely to demonstrate delays. If my caseload was comprised only of children conceived through fertility treatments I would be A) a lot less busy and B) regularly going into much nicer homes. If anything, children conceived through fertility treatments have parents who are more involved and concerned, and delays just happen to be the result of being unlucky.