Birth defects and congenital health risks in children conceived through assisted reproduction technology (ART): a meeting report

Abstract

Purpose Assisted Reproduction Treatment (ART) is here to stay. This review addresses the parental background of birth defects, before, during and after conception and focuses both on the underlying subfertility and on the question whether ART as a treatment is an additional contributing factor. Methods Searches were performed in Medline and other databases. Summaries were discussed in a Delphi panel set-up by the European Society of Human Reproduction and Embryology (ESHRE). Results Several birth defects and adult diseases arise during the earliest stages of ovarian development and oocyte differentiation: this is the case of cleft palate disorders in offspring from female rat exposed to Dioxin during fetal life or the polycystic ovary diseases in female offspring (primates) exposed to elevated androgen concentration during fetal life. Human oocytes and embryos often fail to stop the propagation of aneuploid cells but maintain their ability to repair DNA damages including those introduced by the fertilizing sperm. There is a 29 % increased risk of birth defects in the newborns spontaneously conceived by subfertile couples and the risk is further increased (34 %) when conception is achieved by treating infertlity with ART (Danish IVF Registry). Periconceptional conditions are critical for ART babies: their birth weight is in general smaller (Norvegian Registry) but a more prolonged culture time doubled the number of large babies (Finnish Registry). Conclusion The long-term developmental effects of ART on child and subsequent health as an adult remains a subject worthy of futher monitoring and investigation. Capsule Remaining mindful of the growing body of evidence showing that during gamete production, genetic and epigenetic changes influence offspring health, serves to reinforce the need to continue to monitor ART children.

Placental imprinting variation associated with assisted reproductive technologies and subfertility

“…Although most ART children appear healthy, ART infants face increased rates of prematurity, twinning, small for gestational age (SGA) birth, low birth weight (LBW), neonatal intensive care unit (NICU) admission, congenital abnormalities, and imprinting disorders. [4][5][6][7][8][9] Of these, LBW is of particular concern as birth weight has long-term implications for cardiovascular disease, obesity, type 2 diabetes, muscle strength, and cognitive function, per the Developmental Origins of Health and Disease hypothesis. [10][11][12][13] However, subfertility has been independently linked to similar poor obstetric, infant, and childhood outcomes, including lower birth weights, [14][15][16][17] in couples who did not use ART to conceive, making it difficult to determine whether the increased risks associated with ART are due to the procedures used or to the underlying subfertility that makes the procedures necessary.…”

Does IVF cleavage stage embryo quality affect pregnancy complications and neonatal outcomes in singleton gestations after double embryo transfers?

“…Top quality cleavage stage embryo at freezing, thawing, or transfer improves the likelihood of a live birth in frozen-thawed cycles [4]. It is well-known that adverse obstetric and perinatal outcomes of singletons and twins following IVF, such as low birth weight (LBW), preterm delivery (PTD) and congenital malformations, are more common than spontaneous conception [5][6][7][8][9][10][11][12][13][14][15]. Two studies have shown that singletons born from Capsule The current study describes association between cleavage stage embryo quality and miscarriage based on 11721 IVF-ET cycles.…”

Health status of children conceived by assisted reproductive technologies: endocrinologist’s position

“…По данным рабочей группы ESHRE (Европейская ассоциация репродуктологов) 2014 г., риск рождения ребенка с врожденными аномалиями развития у субфертильной пары на 29% выше, чем у фертильной, и возрастает до 34%, если субфертильная пара использует для зачатия технологии ВРТ [41]. По результатам метаанализа, относительный риск врожденных пороков развития в соответствующих случаях колеблется от 1,01 до 1,4.…”