Women who struggle to conceive via IVF are more likely to suffer from long-term health problems 

Women who struggle to conceive via IVF are 26 per cent MORE likely to suffer from long-term health problems

  • Women who have problems with IVF suffer more age-related health issues
  • This is based on a study of 20,000 women going through IVF for the first time
  • Research into various IVF treatments, discoveries and outcomes was presented at the European Society of Human Reproduction and Embryologys conference

Women who don’t have much luck with IVF treatment due to fewer eggs being collected on their first cycle are more likely to suffer long-term health issues. 

The research into fertility problems and the link to illness later in life was presented at the conference of the European Society of Human Reproduction and Embryology.  

The team behind the study examined data on almost 20,000 young women who had gone through one cycle of IVF between 1995 and 2014 in Denmark.

After then looking at other long-term health issues, they found there was a link between unsuccessful IVF and an accelerated ageing process in general.

Women with fewer eggs collected during IVF had a 26 per cent greater risk of all-cause ageing diseases compared to those with a normal ovarian response.

The team behind the study examined data on almost 20,000 young women who had gone through one cycle of IVF between 1995 and 2014 in Denmark 

Mette Wulf Christensen from Aarhus University in Denmark, who has been investigating fertility rates and its link to age-related illness says her findings are consistent with previous studies into early menopause. 

This has been shown in several studies to be associated with an increased risk of cardiovascular diseases, osteoporosis and mortality. 

‘Identifying women at risk of early menopause may thus allow early preventive health initiatives in terms of a healthy lifestyle,’ says Christensen.

This is the first time that the yield of eggs in IVF as a measure of ovarian ageing—and thus as a risk predictor of age-related ill-health and mortality—has been investigated in a large-scale cohort study.  

The study was based on the national registries of Denmark in which each individual has their own identifying number.

This allows researchers to cross-link between various registries of health outcomes and treatments over a long period of time.

In this case women below the age of 37 who had a first cycle of IVF in Denmark between 1995 and 2014 were divided into one of two groups according to their response to ovarian stimulation.

One group was for those who produced five or fewer eggs for collection, defined as ‘early ovarian ageing’ and the other for those who produced at least eight eggs.

The number of eggs harvested was then used as a marker of ovarian reserve. There were 1,234 women in the former group, and 18,614 in the latter.

The team found that incidence of chronic disease int he two groups helped provide a real-life estimate of the risk of cardiovascular disease, osteoporosis, type-2 diabetes, cancer, and all-cause mortality.   

 This higher risk was statistically significant, and evident in cardiovascular diseases and osteoporosis, the team found. 

Women with fewer eggs collected during IVF had a 26 per cent greater risk of all-cause ageing diseases compared to those with a normal ovarian response

Women with fewer eggs collected during IVF had a 26 per cent greater risk of all-cause ageing diseases compared to those with a normal ovarian response 

The two groups were also cross-checked with the ‘early retirement benefit’ register, in which the early ovarian ageing group were also more likely to be listed.

The risk of cancer, other age-related diseases and all-cause death was not significantly different between the two groups.

Commenting on the implications of the results, Christensen said the common biological mechanisms behind ovarian and general ageing are ‘somewhat obscure’.

However, the data from this study demonstrate that young women with early ovarian ageing have an increased risk of age-related morbidity and possibly mortality.

In fact, a low ovarian reserve may be a useful marker of later health problems. 

Counselling this group of patients at fertility clinics, she added, ‘may therefore be important for introducing preventive measures such as lifestyle changes or the use of HRT to reduce the adverse health risks which follow an earlier menopause’.

‘SCRATCH’ TREATMENT MAKES NO DIFFERENCE TO IVF SUCCESS RATES, STUDY FINDS 

A common ‘scratch’ treatment offered to patients preparing for IVF has proven to be ineffective in a large-scale trial of more than 1,000 women.

The treatment involved an endometrial scratch before their first IVF treatment – this saw a small biopsy taken from the lining of the uterus.

This UK Multicentre Endometrial Scratch Randomised Controlled Trial is the biggest and most powerful study of the add-on so far reported

This UK Multicentre Endometrial Scratch Randomised Controlled Trial is the biggest and most powerful study of the add-on so far reported 

The idea was that it would help to improve embryo implantation, but the new study – presented at the conference of the European Society of Human Reproduction and Embryology – has shown this treatment to be innefective.

In a randomised trial, those recieving the treatment were found to be no more successful than a control group receiving routine treatment.  

This UK Multicentre Endometrial Scratch Randomised Controlled Trial is the biggest and most powerful study of the add-on so far reported. 

The results ‘provide conclusive evidence’ that endometrial scratch is not beneficial in women having IVF for the first time, says chief investigator Mostafa Metwally from Sheffield Teaching Hospitals. 

Although some earlier studies have cast doubt on the efficacy of endometrial scratch, it is still commonly available and offered to IVF patients as an add-on. 

The trial was performed at 16 UK centres during 2016 to 2019 and involved more than 1,000 women under 37 years of age having their first cycle of IVF. 

They were randomised equally to endometrial scratch, or no scratch, with primary outcome of the study being a live birth.

Results showed that live birth rate in the intervention group was 38.6 per cent and in the routine treatment group 37.1 per cent, with no statistical difference. 

Secondary outcomes of the trial assessed clinical pregnancy rate, embryo implantation rate and obstetric complications. 

Again, there were no differences in these secondary outcomes between the scratch and no-scratch groups – with clinical pregnancy rate 42.6 per cent in the former, and 40.6 per cent in the latter.

Dr Metwally says the strength of the study lies in the homogeneous study population, which leaves results less open to bias. 

All the subjects were having their first cycle of IVF and were expected to be good responders to treatment.  

The study was also powered to detect a 10 per cent difference in outcome  – a result considered to be practice-changing – but in these results the intervention was found to be of no value. 

Despite the similarly discouraging results of several earlier studies, Dr Metwally notes that endometrial scratch remains widely offered in IVF clinics throughout the world.

A 2016 survey found that 83 per cent of clinics in Australia, New Zealand and UK ‘are recommending endometrial scratching’ to their IVF patients.