Pharmacy Daily | Meds behind ART birth defects

BIRTH defects linked with pregnancies achieved through assisted reproductive technology (ART) may be due to increased exposure to teratogenic medicines, an Australian study suggests.

Pregnancies resulting from in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) had the highest exposure to Category D and X medicines that can potentially harm the fetus during the first trimester, the researchers found.

The study used data from more than 57,000 pregnancies over a two-year period, including women who used ART and those who conceived naturally.

The study found that 4.9% of the ART pregnancies were exposed to Category D medication in the first trimester, compared to only 0.6% of naturally conceived pregnancies.

The trend persisted in later trimesters, with 3.4% of ART pregnancies exposed to CategoryD medications versus 0.6% of naturally conceived pregnancies.

Exposure to Category X medications (causing the most harm during pregnancy) was low across all groups and trimesters, at less than 0.5% of pregnancies.

"These differences in exposure are primarily linked to medications used as additional treatment following ART to prevent repeat miscarriages or failed implantation, rather than medications to treat underlying chronic conditions," said study lead Dr Anna Kemp-Casey from UniSA.

"For example, ART pregnancies, during the study period were more often exposed to progestogens like medroxyprogesterone acetate, which may have been used to treat threatened or recurrent miscarriages," Dr Kemp said.

The five most frequently used Category D and X medications across all pregnancies regardless of conception status were paroxetine, lamotrigine, valproic acid, carbamazepine and nicotine dependence treatments.

Researchers said the findings demonstrate that the vast majority of IVF babies are healthy, and do not suggest that ART pregnancies are unsafe.

However, they underscore the importance of personalised medical care for women undergoing ART treatment and close monitoring for women in early pregnancy.

Read the full paper HERE. KB