Minor congenital anomalies, major congenital malformations and development in children conceived from cryopreserved embryos

Abstract

A total of 91 children (68 singletons, 20 twins and three triplets) who were conceived from cryopreserved embryos between 27 December 1989 and 18 January 1994, and 83 normally conceived control children (81 singletons and two twins) of a similar age, sex and social class, were assessed for minor congenital anomalies and major congenital malformations. Their development was assessed using the Griffiths Scales of Mental Development. The incidence of minor congenital anomalies (31.9% in the cryopreserved embryo group and 21.7% in the controls) and major congenital malformations (3.3 and 2.4% respectively) in our two groups of children was statistically similar. The relative risk (odds ratio and 95% confidence interval) in the cryopreserved embryo group compared with the controls was 1.7 (0.8, 3.3) for minor congenital anomalies and 1.4 (0.2, 8.5) for major congenital malformations. The minor congenital anomalies were mostly naevi and haemangiomas. The major congenital malformations included Down's syndrome, Beckwith-Wiedemann syndrome and hypophosphataemic rickets in the cryopreserved embryo group and hydronephrosis and gastroschisis in the controls. The Griffiths assessment showed that children from the cryopreserved embryo group and the controls were functioning at a similar level. The mean Griffiths quotient and subquotient values were greater than the standard 100 in children with or without congenital abnormalities. These results in the cryopreserved embryo group are reassuring in that the minor congenital anomaly and major congenital malformation rates were similar to those in normally conceived children of a similar age, sex and social class and their development was not adversely affected by cryopreservation.

School functioning in 8- to 18-year-old children born after in vitro fertilization

“…Our findings are reassuring and in line with the recent studies in young IVF children [2,4,7,8,10,11,14,[19][20][21][22][23][24][25] and at primary school age [12,17,18]. Olivennes et al [17] found, in a follow-up study of 422 IVF children aged 6 to 13 years, according to the French school system, that 92.2% of the children had at least average school achievement.…”

“…From the psychological point of view, mental and psychomotor development in the early years was an important focus. Although IVF pregnancies appear to be associated with an increased risk of multiple pregnancy, preterm delivery, low birth weight, [2,7,8,10,14,16,[21][22][23][24][25]. Developmental and neurological problems that were found at this young age were mainly related to prematurity, low birth weight, or multiple births [2,3,15].…”

Intracytoplasmic Sperm Injection (ICSI) – What are the Risks?

“…Other older studies with less methodological consistency also report similar findings. 15,18,19,26,31 Comparison of the birth defect studies is confounded by differences in the definitions used to classify the birth defects, in the reporting of congenital abnormalities, and in the methods used for statistical analysis. These caveats present challenges for interpretation of this data.…”

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.…”