Why fetal echocardiograms are essential in IVF pregnancies

Riley Heart Center |

06/17/2024

Woman window pregnant

For many expectant parents, the ultrasound is the first image they see of their growing baby. When that ultrasound image shows a concerning issue with the baby’s heart–or if the parents have a history of heart problems–the doctor may order a fetal echocardiogram, or fetal echo, to get a better look at the baby’s heart.

When a baby is conceived by in-vitro fertilization (IVF) the baby has an increased risk for congenital heart disease, so parents can expect to undergo a fetal echo. Dr. Timothy Cordes, MD, pediatric cardiologist at Riley Children’s Health, discusses why a fetal echo is used during IVF pregnancy.

When you need a fetal echocardiogram

Whenever a pregnant mother has a higher-than-average risk of heart issues, an echo is used to screen for congenital heart defects or CHD.

Risk factors that may call for a screening echo include:

  • A prenatal ultrasound detecting a potential heart problem
  • A family history of CHD in the baby’s parent or siblings
  • Chromosomal abnormalities detected in prenatal genetic testing
  • Any other fetal abnormalities
  • IVF pregnancies
  • Twin, triplet or other pregnancies of multiples
  • Use of certain anti-seizure or anti-depressant medications during pregnancy
  • A mother with diabetes, lupus or other chronic diseases

IVF pregnancies carry a slightly higher risk for CHD than the average pregnancy, so an echo is likely to be ordered.

“The average population’s risk of delivering a baby with a CHD is slightly under 1%. IVF increases the risk to about 2%–and IVF twins increases to over 2%– which would also qualify for a CHD screening,” Dr. Cordes said.

Do IVF babies have more heart problems?

Research has examined IVF pregnancies from every angle: the use of donated eggs versus a mother’s own eggs; donated sperm versus parent sperm; implantation IVF versus artificial insemination. Dr. Cordes says research has not shown a link between the method used and risks for heart problems. While a lot of factors may influence the risk of CHD for IVF pregnancies, the true cause remains unclear.

“Heart defects are the most common birth defects in pregnancy, but the heart is also one of the most complicated organ to develop. So, while there could be something different about the ways the egg and sperm are formed during IVF, the link is still unknown,” Dr. Cordes said. “We still expect 98% of IVF babies to have a normal heart, but that 1.8% is significant enough for us to perform an echocardiogram.”

While the link between assisted reproductive technology like IVF and heart defects remains unclear, the American College of Obstetricians and Gynecologists recommends that the use of this screening be balanced with patient risk factors and available resources.

Fetal echocardiography can help with early intervention

There will always be babies born with heart conditions that aren’t identified in utero. However, the use of fetal echocardiograms for at-risk pregnancies can not only help address issues before delivery, but it can also help parents and care providers prepare for delivering a child with known heart issues.

“Knowing about these heart issues can help ensure the mother is delivering at a hospital with a program that can address fetal heart problems and manage them safely,” Dr. Cordes said. “Knowing these things can help inform the birth plan, the delivery time and location. That alone can ensure a better long-term outcome, even if the baby doesn’t require any immediate medical intervention.”

Dr. Cordes says learning about potential heart issues before the baby is born can also give parents more time to process the news and explore their options for support.

Planning an IVF pregnancy

While there’s no clear reason why IVF pregnancies carry a higher risk for CHD, prenatal screenings and fetal echocardiograms can help identify potential problems early and help parents and medical teams alike prepare for a safe arrival.

Related Doctor

Timothy M. Cordes, MD

Timothy M. Cordes, MD

Pediatric Cardiology