Women undergoing fertility treatment are more likely to use medications that could harm a fetus before or during pregnancy, according to a study analyzing over 57,000 births in Australia. Researchers examined pregnancies conceived between July 2012 and December 2014, comparing natural conceptions, subfertile pregnancies without treatment, and those resulting from Assisted Reproductive Technology (ART), such as IVF, or ovulation induction (OI).

The study, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, focused on exposure to over 200 medications categorized by Australia’s Therapeutic Goods Administration as D (potentially harmful depending on circumstances) or X (high risk of fetal harm). It found that nearly eight percent of women were prescribed teratogenic medications in the year before conception, with less than one percent exposed during pregnancy.

Women using ART or OI had significantly higher exposure to category D medications during pregnancy, especially in the first trimester—almost five percent for ART and two percent for OI, compared to one percent or less in subfertile or naturally conceived pregnancies. These medications, including progestogens and immunomodulators, are often used after ART to prevent recurrent miscarriage or failed implantation. Exposure to category X drugs was minimal across all groups, at less than 0.5 percent.

Lead author Dr. Anna Kemp-Casey emphasized that these medications are typically prescribed as part of additional fertility treatments, rather than for pre-existing conditions. The authors recommend reviewing medication use for all women planning pregnancy, especially those undergoing fertility treatments, to mitigate potential risks. Further research is needed to assess whether birth defects occur more frequently in pregnancies involving ART or OI.

Source: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/ajo.13911