The number of couples using assisted reproduction techniques (ART) continues to go up. The problem is that, in most cases, the reason the couple cannot get pregnant is lifestyle. While they exist, few represent true problems with the ability to reproduce, vs the ability to reproduce RIGHT NOW.
As an example, polycystic ovarian syndrome accounts for a large proportion of the cases of infertility. This is strongly associated with being prediabetic. To do the right thing, you address the prediabetic lifestyle in order to allow pregnancy to occur. Trying to force a pregnancy on a body that is not ready for it can lead to problems. It’s just really, really not a good idea to mess with Mother Nature in this way.
To understand this current article, we need to understand a process called methylation, which uses factors such as folic acid and B12 to put “marks” onto regions of DNA to turn them on or off. This allows liver cell DNA, which contains all the information to perform the functions of every other type of cell, to only do “liver” stuff and not “brain” stuff.
This process also occurs in our reproductive cells (sperm and oocyte), where methylation is turned on and off at critical points in the transition from production of the reproductive cells to fertilization to the time spent in the womb. This process can be called “imprinting” in that it allows messages not contained in the DNA to be passed on to the next generation.
The problem with certain ART procedures is that they may grab these cells at the inappropriate times when the methylation “imprinting” is not present. Thus, adaptive traits that may protect the newborn may be lost.
While this concept is evolving, I can’t see that the outcome is a good thing, and may be one of the reasons why we see increased risk of preterm labor as well as increased risk of chronic diseases such as obesity, heart disease and diabetes in children conceived through ART.
Let me give a good example. Had a couple as patients a few years back. Somehow the topic came up of pregnancy in an office visit and there was obvious tension between the two. Turns out that they had been trying and her OB was pushing her towards ART. Well, we did a diet history, made some changes and put her on a high quality prenatal. Two months later I had a thank you card delivered to me and some 8 months later their little daughter was born.
Had this couple gone through ART, it is impossible to say if the outcome would have been different. But the bottom line is that ART was NOT what was needed. Lifestyle was what was needed.