Congenital malformations in infants born after IVF: a population-based study

Abstract

The presence of congenital malformations in infants born after IVF was studied from a register consisting of practically all infants born in Sweden after IVF, 1982--1997 (n = 9111). A further 64 infants were studied using only medical records. It is a nation-wide study and has a population-based control group (n = 1,690,577) and relevant potential confounders have been taken into account. There was an excess of congenital malformations registered in the Medical Birth Registry (n = 516, odds ratio = 1.47) but this excess disappeared when confounders were taken into consideration: year of birth, maternal age, parity, and period of unwanted childlessness (odds ratio = 0.89). For some specific conditions, an approximately 3-fold excess risk was seen: neural tube defects, alimentary atresia, omphalocele, and hypospadias (after intracytoplasmatic sperm injection). No excess risk for hypospadias was seen after standard IVF. Various explanations for these findings are discussed. It is postulated that the excess risk for alimentary atresia, like the excess risk for monozygotic twinning after IVF, is a direct consequence of the IVF procedure. The excess risk for hypospadias after ICSI may be related to paternal subfertility with a genetic background. The absolute risk for a congenital malformation in association with IVF is small.

Effects of assisted reproductive technologies on human sex ratio at birth

“…The apparent lack of risk of SSR alteration under IUI may reflect a genuine lack of effect of it could be due to the relatively small sample size recorded for IUI. Overall, these results are qualitatively consistent with previous observations of lower SSR after ICSI and higher SSR following IVF (8,(27)(28)(29)(30)(31).…”

A meta-analysis of the impact of IVF and ICSI on major malformations after adjusting for the effect of subfertility

“…The details of the meta-analysis-including the literature search, the study selection and the data extraction processes-are described there. We found 19 studies [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] for inclusion in the meta-analysis and found that ART increased the risk of MM with an odds ratio of 1.29 (95% CI 1.01-1.67). Our major conclusion was that the risk we found may be inflated by the fact that none of the studies used the most appropriate control group, namely subfertile couples conceiving spontaneously.…”

ART babies: a time bomb in the making?

“…The range varies from no difference compared to a naturally conceived population to a doubling of the congenital malformation rate (Table 2). 16,17 The Norwegian Health Technology Assessment systematic review 18 of offspring of ICSI pregnancies summarises that there is a small increased risk of Where no detail of case matching is given none is reported. CA ϭ child's age I ϭ previous subfertility M ϭ multiplicity MA ϭ maternal age MB ϭ multiple births ME ϭ maternal education OR ϭ odds ratio (95% CI) P ϭ parity Qs ϭ quads R ϭ race RB ϭ region of birth RR ϭ relative risk (95% CI) S ϭ child's sex SC ϭ social class Sgs ϭ singletons Trs ϭ triplets Tws ϭ twins YOB ϭ year of birth major birth defects (RR 1.13, 95% CI 1.00-1.29, P = 0.06) in children born using ICSI in comparison with naturally conceived controls, although clearly the confidence interval for this meta-analysis does reach 1.0.…”