Although she may be one of People Magazine's "50 Most Beautiful People," model and actress Cindy Margolis struggled to fulfill one of the most important goals in her life: becoming a mother.
"I always wanted to be a mom and I knew my husband would be a wonderful father," said Margolis, who was a hostess on the television show "The Price Is Right." "We wanted kids right away, and even hoped to conceive on our honeymoon."
After a year of not being able to conceive, Margolis and her husband, restaurateur Guy Starkman, sought the help of a fertility specialist -- an increasingly popular option for the more than 6 million women of child-bearing age unable to conceive, according to the U.S. Department of Health and Human Services. In 2001, for example, more than 40,000 infants were born as a result of assisted reproductive technology (ART).
ART includes relatively simple techniques like sperm insemination, to more complex procedures such as in vitro fertilization (IVF), and surgeries that actually introduce the egg and sperm directly into the fallopian tube. Margolis, now 40, and Starkman decided to try IVF.
Until recently, there has been a lack of research investigating how often women and their babies will experience ART-related health problems. It meant that women like Margolis had to accept a certain amount of unknown risk in order to have a baby.
Today, however, a study published in the November issue of The Journal of Obstetrics and Gynecology sheds some light on these risks.
Researchers with the First and Second Trimester Evaluation of Risk group analyzed more than 36,000 pregnancies, approximately five percent of which were conceived using ART.
The study had good news and bad news. Although babies conceived through ART didn't seem to be at increased risk for birth defects, their mothers did not fare so well. For example, women who used IVF were 2.7 times more likely to have a dangerous rise in blood pressure than women who did not use IV. They also were 8.4 times more likely to have an abnormal placenta and 2.3 times more likely to undergo a cesarean delivery.
Not unlike many of the IVF patients in the study, Margolis started experiencing contractions when she was just 23 weeks pregnant.
"I was in constant fear. Half the battle was getting pregnant. Keeping the baby was the other half," Margolis said. Doctors recommended that she remain on bed rest for the remainder of her pregnancy.
But it's not just women who used IVF who were at increased risk. In the study, the researchers also found that women who used less invasive ART methods, such as medication to induce ovulation or artificial insemination, were 2.4 times more likely to have placental abruption, or an abnormal separation of the placenta from the uterus that can be harmful for both mother and baby.
These women also were 2.1 times more likely to have a miscarriage during their second or third trimester of pregnancy.
While the increased risks are disconcerting, the study's lead author said that the most important finding of this study is that babies born from ART did not have higher rates of birth defects or chromosomal abnormalities like Down syndrome.
"The take-home message from this study is a positive one," said Dr. Tracy Shevell, a perinatologist at Stamford Hospital in Stamford, Conn. "If anything, this study should reassure patients and doctors that there isn't an increased risk for birth defects and Down syndrome."
Overall, the study is unlikely to sway parents from using ART, Shevell said. Instead, it should help them understand the risks better.
"These complications had little impact on how the pregnancy fared. Having a C-section or high blood pressure during pregnancy didn't affect the babies' health or the families' quality of life. That's what we care most about," Shevell said.
For example, although she endured months of bed rest and invasive medical procedures, Margolis gave birth to a healthy baby boy. She and her husband are now the parents of a 3-year-old son, Nicholas, and have just welcomed 3-month-old twin girls to their family.
If she could go back in time, Margolis said the study's results about IVF would not change her mind.
"Absolutely not," she said. "It was all so worth it. The rewards so outweigh the risks."
Dr. Tracy Wimbush is an emergency physician at Massachusetts General Hospital in Boston.