Assisted reproductive technology and major structural birth defects in the United States

Reefhuis, Jennita; Honein, Margaret A.; Schieve, Laura A.; Correa, Adolfo; Hobbs, Charlotte A.; Rasmussen, Sonja A.

doi:10.1093/humrep/den387

Cited by 259 publications

(235 citation statements)

References 28 publications

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“…More recently, a multicenter American case-control study has corroborated these observations (Reefhuis et al 2009). Nevertheless, none of the studies looked into a possible association between the administration of drugs used for ovarian stimulation and the incidence of congenital diseases.…”

Section: Perinatal Outcomesmentioning

confidence: 70%

The impact of ovarian stimulation for IVF on the developing embryo

Santos¹,

Kuijk²,

Macklon³

2010

Reproduction

174

128

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The use of assisted reproductive technologies (ART) has been increasing over the past three decades, and, in developed countries, ART account for 1-3% of annual births. In an attempt to compensate for inefficiencies in IVF procedures, patients undergo ovarian stimulation using high doses of exogenous gonadotrophins to allow retrieval of multiple oocytes in a single cycle. Although ovarian stimulation has an important role in ART, it may also have detrimental effects on oogenesis, embryo quality, endometrial receptivity and perinatal outcomes. In this review, we consider the evidence for these effects and address possible underlying mechanisms. We conclude that such mechanisms are still poorly understood, and further knowledge is needed in order to increase the safety of ovarian stimulation and to reduce potential effects on embryo development and implantation, which will ultimately be translated into increased pregnancy rates and healthy offspring.

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Section: Perinatal Outcomesmentioning

confidence: 70%

The impact of ovarian stimulation for IVF on the developing embryo

Santos¹,

Kuijk²,

Macklon³

2010

Reproduction

174

128

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“…In addition to maternal ethnicity and geographic location, previous studies have reported EA to be associated with maternal age (Leck et al, 1968;Harris et al, 1995), multiple gestation (Harris et al, 1995;Riley et al, 1998), infant sex (Robert et al, 1993) and use of assisted reproductive technology (Reefhuis et al, 2009). In a recent study of EA in the United States, women using assisted reproductive technology had a 4.5-fold increased risk of having an infant with EA (Reefhuis et al, 2009). Prevalence of EA has also been found to be higher among multiple births compared with singletons (Harris et al, 1995;Riley et al, 1998), and increased risk was reported with increasing maternal age (Leck et al, 1968;Harris et al, 1995).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of esophageal atresia among 18 international birth defects surveillance programs

Nassar

Leoncini²,

Amar³

et al. 2012

Birth Defects Research

130

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“…Some of the complications have been attributed to a higher frequency of multiple births and to the increased risk of premature delivery; however, other reports indicate that also singleton IVF children have a greater risk of low birth weight and of congenital anomalies [8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Obstetric outcome and incidence of congenital anomalies in 2351 IVF/ICSI babies

Levi-Setti

Moioli

Smeraldi

et al. 2016

J Assist Reprod Genet

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Purpose The aim of this study was to provide a comprehensive follow-up of fetal and perinatal outcome and the incidence of congenital anomalies in babies born after fresh embryo transfers compared to those conceived spontaneously in infertile couples. Methods Retrospective comparative analysis of all clinical pregnancies from fresh cleavage-stage embryo transfer cycles (IVF and ICSI) compared with infertile patients who conceived spontaneously in the same time period (control). Congenital anomalies were classified following the European Surveillance of Congenital Anomalies (EUROCAT) classification. Results A total of 2414 assisted reproductive technology (ART) pregnancies were compared to 582 spontaneous conceptions in the control infertile group representing 2306 deliveries. No significant differences were found in pregnancy outcome between the two groups (delivery rate, abortion rate, ectopic pregnancies, medical abortions for fetal anomalies, single and twins mean gestational age, and weight at delivery). A significant difference (p < 0.001) was found in the twin (21.3 vs 2.3 %) and triplet rates (2.3 vs 0 %). A total of 2351 babies were delivered in the ART group and 449 in the control group. A total of 90 babies (3.8 %) were diagnosed with a major congenital anomaly in the ART group and 15 (3.3 %) in the control group (p = ns). The overall rate of major congenital anomalies (105/2800) in ART and spontaneous pregnancies in infertile couples was significantly higher when compared to the EUROCAT 2.0 versus 3.75 % (p = 0.0002). Discussion Babies born after ART treatments and from spontaneous conception in infertile couples had rates of congenital anomalies higher than those recorded by the EUROCAT. However, the rates of anomalies were not different within the infertile population whether conceived by ART or spontaneously. These data suggest that the diagnosis of infertility in itself is the common denominator for the increase in the rates of anomalies seen in both ART and spontaneous conceptions.

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Assisted reproductive technology and major structural birth defects in the United States

Abstract: These findings suggest that some birth defects occur more often among infants conceived with ART. Although the mechanism is not clear, couples considering ART should be informed of all potential risks and benefits.

Cited by 259 publications

References 28 publications

The impact of ovarian stimulation for IVF on the developing embryo

The impact of ovarian stimulation for IVF on the developing embryo

Prevalence of esophageal atresia among 18 international birth defects surveillance programs

Obstetric outcome and incidence of congenital anomalies in 2351 IVF/ICSI babies

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