Whats next for the worlds 5 million IVF babies?

Making contact: a single sperm is injected directly into the egg using intracytoplasmic injection. Photograph: MedicalRF.com/Alamy

When in-vitro fertilisation (IVF) began in 1978, some scientists were worried that the babies born as a result of it might suffer birth defects and health problems.

Intensive research in the early years, and a thriving population that has now grown to more than 5 million IVF children worldwide, have reassured scientists, but they have not stopped studying and trying to improve the process.

Recent discoveries in epigenetics the study of how environmental factors can affect gene activity, and how a persons risk of getting chronic diseases is programmed into them before they are even born have opened up new possibilities.

In IVF, eggs are removed from the ovaries and fertilised with sperm in a laboratory before being placed in the uterus. Initially, women are often given drugs to suppress their menstrual cycles before taking fertility hormones designed to make them produce more eggs to be collected and fertilised. The technique can be used to overcome infertility caused by blocked fallopian tubes, reduced fertility in the male partner or unexplained infertility, among others.

Researchers are looking into the subtle effects each part of the IVF process can have on a developing embryo effects that continue into later life.

A priority is finding out how elements of the IVF process such as freezing the embryos, how they are grown in the lab, how long they are kept out of the mother and how they are stored could be responsible for those effects and how tweaks to the process could make it even safer.

Much of todays research stems from the Barker hypothesis, which proposes that birth weight may be linked to the likelihood of getting certain diseases. IVF babies are known to have lower average birth weights even if the difference, at about 20-30 grams, is small. Scientists are now investigating whether IVF conception equates with more hospital admissions, and an increased risk of cardiovascular disease, high blood pressure and diabetes in later life.

Researchers take great pains to point out that the risks for an individual born after IVF are tiny but they could be significant for society.

Im involved in IVF treatment myself, says Professor Daniel Brison, scientific director of the department of reproductive medicine at Central Manchester and Manchester University Hospitals NHS Foundation Trust, who is looking at the long-term health of IVF children as part of the EpiHealth consortium, an EU research project.

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Whats next for the worlds 5 million IVF babies?