GESTIÓN EN SALUD PÚBLICA: BioEdge: IVF kids risk early arterial hypertension

domingo, 9 de septiembre de 2018

BioEdge: IVF kids risk early arterial hypertension

BioEdge: IVF kids risk early arterial hypertension

Bioedge

IVF kids risk early arterial hypertension

by Michael Cook | 8 Sep 2018 |

Children conceived through assisted reproductive technologies may be at an increased risk of developing arterial hypertension early in life, among other cardiovascular complications, according to a Swiss study in the Journal of the American College of Cardiology.

The most common ART methods are in vitro fertilization and intracytoplasmic sperm injection, which can expose the gamete and embryo to a variety of environmental factors before implantation. Children conceived using ART make up 1.7 percent of all infants born in the United States every year and currently over six million persons worldwide.

The study assessed the circulatory system of 54 young, healthy ART adolescents (mean age 16) by measuring ambulatory blood pressure, as well as plaque build-up, blood vessel function and artery stiffness. It found that they had significantly higher arterial hypertension. “This places ART children at a six times higher rate of hypertension than children conceived naturally,” said the lead author of the study, Emrush Rexhaj, of University Hospital in Bern.

In an accompanying editorial, Larry A. Weinrauch, a cardiologist at Mount Auburn Hospital, said that the study’s small cohort may understate the importance of this problem for ART adolescents, especially since multiple birth pregnancies and maternal risk factors (such as eclampsia, chronic hypertension and diabetes) were excluded from the study.

“Early study, detection and treatment of ART conceived individuals may be the appropriate course of preventative action,” Weinrauch said. “We need to be vigilant in the development of elevated blood pressure among children conceived through ART to implement early lifestyle-based modifications and, if necessary, pharmacotherapy.”

IVF specialists acknowledged the warning, but observed that the study was a small one and that larger population studies should be carried out to see if these sombre results could be confirmed.

Yutang Wang, of Federation University Australia, commented that “ARTs involve the manipulation of early embryos at a time when they may be particularly vulnerable to external disturbances. Therefore, it is not surprising that ARTs could increase individual’s susceptibility to some diseases. Mice generated by IVF have a shortened lifespan compared with control mice. Whether this is the case in humans remains unknown. Future research will tell us whether ARTs increase long-term cardiovascular diseases such as stroke and heart attack in humans, and research into methods to minimise such risks are urgently needed."

Sunday, September 9, 2018

John Robertson was an American scholar in law and bioethics who died last year. He is best known for making a strong case for “procreative liberty”, whether procreation takes place naturally or with the help of technology. As a tribute to his influence, the current issue of the Journal of Law and the Biosciences contains several articles about this theory.

Robertson’s theme was that reproductive choices which do not harm the interests of others should not be subject to regulation or prohibition. In his best-known book, Children of Choice, published in 1996, he discussed abortion, IVF, surrogacy and pre-natal genetic modification. But time has moved on. The principle of effectively unconstrained “procreative liberty” is being used to justify other developments, some of which are discussed in the Journal, including unisex gestation.

What I found interesting was that Robertson, in a paper written not long before his death, agreed that a male pregnancy (after a womb transplant) could be ethically justified, but only if it were necessary for genetic reproduction. Even he wanted to draw a line somewhere.

However, the author of one of tribute essays questions this restriction. Enjoying the experience of gestation is reason enough, she says. (See below). I suppose that this raises the question of whether it is possible to draw any lines, anywhere, once we agree that reproductive rights should not be limited.