Evaluation of the Risk of Birth Defects Related to the Use of Assisted Reproductive Technology: An Updated Systematic Review

Abstract

Fertility problems constitute a serious medical, social, and demographic problem. With this review, we aim to critically appraise and evaluate the existing literature surrounding the risk of birth defects in offspring conceived using techniques based on assisted reproductive technology (ART). Based on searches of the literature in PubMed and ScienceDirect, we obtained a total of 2,003,275 works related to the topic. Ultimately, 11 original papers published in the last 10 years qualified for inclusion in the study. Based on five studies included in this analysis, it was shown that ART significantly increases the risk of congenital malformations in associated newborns. Due to the specifics of given studies, as well as potential confounding risk factors, this influence cannot be ignored. Therefore, considering the information contained in the articles included in this systematic review, it was determined that the risk of birth defects is not directly related to the use of ART itself but also depends on the age of partners, causes of infertility, comorbidities, and the number of fetuses during a pregnancy, as well as many other factors not covered in the literature. It is thus necessary to impress upon infertile couples who wish to have offspring that the use of ART is not risk-free but that the benefits outweigh the risks. Further education in this field, as well as social understanding, is also required.

Type of infertility and prevalence of congenital malformations

“…[1][2][3][4][5][6][7][8][9][10] The higher prevalence may be due to the procedures (e.g., altered hormonal environment, culture medium composition, manipulation of gametes) or to the underlying infertility, itself associated with malformations. 2,5,[11][12][13][14][15][16] However, little is known about whether type of infertility influences the prevalence of malformations. In a recent study, polycystic ovary syndrome (PCOS), premature ovarian insufficiency (POI), and endometriosis predicted a higher prevalence of malformations, after accounting for fertility treatment.…”

“…Children conceived with assisted reproductive technology (ART) have a higher prevalence of congenital malformations than children conceived without 1–10 . The higher prevalence may be due to the procedures (e.g., altered hormonal environment, culture medium composition, manipulation of gametes) or to the underlying infertility, itself associated with malformations 2,5,11–16 . However, little is known about whether type of infertility influences the prevalence of malformations.…”

Oxidative Stress and Acrosomal Status of Human Spermatozoa Subjected to Hydrophobic Carbon Soot Treatments

“…Not surprisingly, if regular sexual intercourses within a period of 12 months do not lead to clinical pregnancy, due to impaired spermatogenesis, the infertile couples strongly rely on a positive outcome of assisted reproduction [ 4 , 5 , 6 ]. This term comprises all clinical methods used to assist in gaining pregnancy, amongst which the classic in-vitro fertilization (IVF) has the highest efficiency, attributed to the opportunity for preliminary selection of both female (oocytes) and male (spermatozoa) gametes [ 5 ].…”

“…Not surprisingly, if regular sexual intercourses within a period of 12 months do not lead to clinical pregnancy, due to impaired spermatogenesis, the infertile couples strongly rely on a positive outcome of assisted reproduction [ 4 , 5 , 6 ]. This term comprises all clinical methods used to assist in gaining pregnancy, amongst which the classic in-vitro fertilization (IVF) has the highest efficiency, attributed to the opportunity for preliminary selection of both female (oocytes) and male (spermatozoa) gametes [ 5 ]. Thus, controlled ovarian hyperstimulation can be implemented to increase the number of oocytes available for IVF, while as an integral part of the assisted reproductive technologies, semen processing via gradient density centrifugation and microfluidic sperm-sorting devices, for instance, facilitates the choice of mature spermatozoa [ 4 , 6 ].…”

Infantile Prognosis of Neonates Conceived by Assisted Reproductive Technology: A Prospective Study

“…Serafin et al reported that birth defects are not directly related to the use of ART (13). Cardiometabolic risk in children conceived using ART had no significant difference compared to those conceived without treatment (14).…”