Ibuprofen link to offspring’s fertility

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Taking ibuprofen in early pregnancy could have an impact on the fertility of baby girls, a new study has found

The French study used fetal ovarian tissue from pregnancies legally terminated at between seven and 12 weeks, and grew the tissue in the laboratory with and without ibuprofen.

They found that ovarian tissues exposed to ibuprofen had fewer follicles than those which were not exposed.

Exposure to ibuprofen during the first three months of foetal development results in a “dramatic loss” of the germ cells which go into making the follicles from which eggs develop, the researchers suggest.

The germ cells either died or failed to grow and multiply at the normal rate.

The authors of the study, published in Human Reproduction, say that their findings raise concerns about the long-term effects of ibuprofen on the future fertility of women exposed to the pain killer when in their mothers’ wombs.

“Baby girls are born with a finite number of follicles in their ovaries and this defines their future reproductive capacity as adults,” said Dr Séverine Mazaud-Guittot, a researcher at INSERM in Rennes, France, who led the study.

“A poorly stocked initial reserve will result in a shortened reproductive life span, early menopause or infertility – all events that occur decades later in life.

“The development of the follicles in the foetus has not been completed by the end of the first trimester, so if the ibuprofen treatment is short then we can expect the ovarian reserve to recover to some extent.

“However, we found that two to seven days of exposure to ibuprofen dramatically reduced the germ cell stockpile in human foetal ovaries during the first trimester of pregnancy and the ovaries did not recover fully from this damage.

“This suggests that prolonged exposure to ibuprofen during foetal life may lead to long-term effects on women’s fertility and raises concern about ibuprofen consumption by women during the first 24 weeks of pregnancy.

“These findings deserve to be considered in light of the present recommendations about ibuprofen consumption during pregnancy.”

Around 30% of women are estimated to use ibuprofen in the first three months of pregnancy, the researchers say.

“This is the first study to look at the effects of ibuprofen on the ovarian tissue of baby girls, and the first to show that ibuprofen can cross the placental barrier during the first trimester of pregnancy, exposing the foetus to the drug,” said Dr Mazaud-Guittot.

“The implications of our findings are that, just as with any drug, ibuprofen use should be restricted to the shortest duration and at the lowest dose necessary to achieve pain or fever relief, especially during pregnancy.”

Associate Professor Peter Illingworth is the Medical Director of IVF Australia said that the findings were “interesting” and highlighted a need for future epidemiological studies.

“However, the conditions under which cells survive and grow in a laboratory setting are so different from within the body that one cannot ascribe any clinical significance to these findings until there is epidemiological evidence of a similar effect in the children of women who have taken ibuprofen in early pregnancy,” he said.
“It is really important for all pregnant women to avoid any unnecessary medications in early pregnancy but this study alone would not make me advise a woman to completely avoid ibuprofen in early pregnancy.”

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