IVF risks 'may outweigh benefits' for some couples, say experts
Fertility experts have called for more consideration before IVF treatment is offered to childless couples.
Writing in the BMJ, they said the risks of in vitro fertilisation may outweigh the benefits for some couples.
IVF was developed to treat fallopian tube disorders and male infertility, but it is now routinely used in cases of general unexplained infertility.
The authors called for caution in using the treatment when chances of natural conception were still reasonable.
The experts, including Aberdeen University's professor of reproductive medicine, Siladitya Bhattacharya, raised concern over whether IVF and a closely related treatment, intra-cytoplasmic sperm injection (ICSI), were always the right option.
"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," they said.
The authors claimed evidence showing that IVF and ICSI could help couples with unexplained infertility was weak.
Meanwhile, evidence was emerging that children born through IVF techniques may be more likely to have health problems such as higher blood pressure and vascular dysfunction, they said.
Fertility treatment is also associated with twins and multiple births, which carry higher risks for mothers and babies.
The experts said many couples would go on to have children without undergoing any treatment.
In one Dutch study of 500 couples with two years of unexplained infertility, 60% conceived naturally after the initial assessment at the fertility clinic.
They said there was no doubt over the effectiveness of IVF for the problems it was originally developed to treat.
However, they said there was a lack of will to question the perceived success of IVF - a treatment which was increasingly being offered privately.
"As a society we face a choice," they concluded. "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 optimize the IVF procedure."