Study Reveals Higher Teratogenic Medicine Exposure in ART Pregnancies

A recent study delved into the prevalence of teratogenic medicine exposure in pregnancies conceived through assisted reproductive technology (ART) compared to non-ART pregnancies. Assisted reproductive technology accounts for a significant proportion of births in Australia, with known higher rates of birth defects compared to non-ART pregnancies. The reasons behind this disparity are complex, potentially involving various factors such as the ART procedure itself, parental subfertility, advanced parental age, or existing medical conditions.

To gain deeper insights, researchers categorized non-ART conceptions into subfertile and fertile groups to create more informative comparison sets. Surprisingly, the influence of teratogenic medicines on ART pregnancies had not been extensively explored. These medications, known for their potential to cause fetal harm, were of particular interest when taken during the critical first trimester. While past estimates indicated a low overall exposure of pregnancies to teratogenic medicines in Australia, data specific to ART pregnancies were lacking.

The study examined extensive individual-level records of live births and stillbirths in Western Australia, linking them with ART, hospital, and Pharmaceutical Benefits Scheme data. By analyzing medicines dispensed before and during pregnancy, researchers identified a higher likelihood of ART and ovulation induction pregnancies being exposed to Category D teratogenic medicines in the first trimester compared to non-ART pregnancies. Notably, medications like medroxyprogesterone acetate and immunomodulators were more commonly used during this period in ART and ovulation induction groups.

While the study revealed reassuringly low exposure to Category X medicines (high risk of fetal harm) during pregnancy across all groups, the increased exposure to Category D medicines in ART pregnancies raises concerns. The findings suggest that the higher exposure in ART pregnancies may be linked to fertility treatments rather than underlying chronic conditions. Further research is warranted to explore potential associations between these medicines and specific birth defects, such as genital anomalies observed with medroxyprogesterone acetate exposure.

Looking ahead, clinicians face the challenge of balancing the risks and benefits of medications during pregnancy, especially in the context of fertility treatments. Despite the majority of ART babies being healthy, personalized medical care and vigilant monitoring during early pregnancy are crucial. This study underscores the need for ongoing research and tailored medical interventions to ensure the well-being of women undergoing fertility treatments and their babies in ART pregnancies.