Risk of Birth Defects in Pregnancies Associated with Assisted Reproductive Technology

view the interview video: Assisted Reproductive Technology and the Risk of Birth Defects

Abstract

Objective: The aim of the study is to determine the rate of birth defects in children born after artificial reproductive technology (ART).

Study Design: Data was collected from the Niday database which is an Ontario Provincial Perinatal Database. In 2005, a total of 66,258 deliveries reported the information about reproductive assistance. The cases were analyzed for the overall rate of birth defects for all ART, and subsequently broken down for risk of cardiovascular (CVS), gastrointestinal (GI), musculoskeletal (MSK), neural tube defects (NTD) or facial defects. The risks were also compared between different types of ART: intra-uterine insemination (IUI), in-vitro fertilization (IVF) or ovulation induction. Odds ratio were calculated for the risk of birth defects with all spontaneously conceived babies as the reference group. A logistic regression was used to adjust odds ratio for maternal age, fetal gender, smoking and maternal complications.

Results: The prevalence rate of birth defects with ART was 2.68%, which was 1.69-fold higher (95% CI 1.07-2.51) than that in the non-ART population (1.94%). GI defects were the most increased in the ART group (OR 11.21, 95% CI 3.67-28.26). CVS defects were increased in ART group (OR 2.62, 95% CI 1.17-5.03). There was an increase in MSK defects as well (OR 1.74, 95% CI 0.43-4.68). No cases were found with NTD or facial defects in the ART group. The risks of birth defects for different types of ART were: 2.72% for IUI, 3.35% for IVF and 2.23% for ovulation induction.

Conclusion: There is a significant increase in birth defects with ART. This appears to be higher in infants conceived through IVF, but further studies in basic science are important to establish the effect of changes in methylation sequence from sperm processing on fetal development. This research will be important in counseling couples for the general risk of birth defects when undergoing ART. Further research is required to clarify the contribution of infertility itself to congenital anomalies.

References:

0002-9378/$ - see front matter

doi:10.1016/j.ajog.2006.10.055

American Journal of Obstetrics and Gynecology

Volume 195, Issue 6, Supplement S (December 2006)