Risk Assessment of the Increased Occurrence of Congenital Cardiac and Non-Cardiac Defects in Fetuses with a Normal Karyotype after Assisted Fertilization in Comparison to Natural Fertilization Based on Ultrasound Diagnostics

Abstract

The goal of the study was to assess changes in parameters based on ultrasound examinations—these were Crown Rump Length (CRL), Nuchal Translucency (NT), Fetal Heart Rate (FHR), and Pulsatility Index for Ductus Venosus (DV-PI)—in the first trimester of pregnancy in women in which there was a natural initiation of the pregnancy due to spontaneous ovulation, women in which the pregnancy was initiated as a result of stimulated ovulation, as well as in the group in which pregnancy was achieved through the use of In-Vitro Fertilization (IVF)-assisted reproduction. A total of 1581 women became pregnant without the use of assisted reproduction methods. Out of 283 pregnancies, in 178 patients, induced ovulation was utilized. Next, 137 women had sexual intercourse and became pregnant; 41 of them became pregnant through Intrauterine Insemination (IUI) as a result of Artificial Insemination by Husband (AIH), and 13 became pregnant after Artificial Insemination by Donor (AID). The third group consisted of 105 women subjected to Controlled Ovarian Hyperstimulation (COH). In this group of pregnant women, 53 pregnancies were resultant of Intracytoplasmic Sperm Injection (ICSI), and 52 pregnancies were the result of Intracytoplasmic Morphologically selected Sperm Injection (IMSI). The obtained results did not indicate that the chosen method of fertilization or the chosen ovulation method had a statistically significant effect on the development risk of congenital heart or non-heart defects in the fetus.

Assisted reproduction and congenital malformations: A systematic review and meta‐analysis

“…Five studies were conducted in Australia, 19,20,[31][32][33] five in Belgium, 21,[34][35][36][37] three in Canada, [38][39][40] five in China, 18,[41][42][43][44] four in Denmark, [22][23][24][25] three in Finland, 26,27,46 two in France, 47,48 one in Germany, 28 two in Iran, 49,50 one in Israel, 29 two in Italy. 51,52 Two in Japan, 53,54 two in Netherlands, 55,56 one in Poland, 57 one in Portugal, 58 one in Singapore, 59 one in UK, 60 and seven in USA, [61][62][63][64][65][66][67] and two multicenter studies. 30,…”

“…Thirty-six studies were awarded a high-GRADE rating, thirteen moderate 20,21,40,43,44,49,50,52,56,57,60,66,67 and one a low-GRADE rating 45 (Table S4). S1B).…”

“…Fifty‐three studies were eligible for full‐text screening. A total of 50 observational studies were included in both the systematic review and the meta‐analysis, 13 prospective 18–30 and 37 retrospective studies 31–67 (Figure 1). Country of origin was recorded to quantify possible geographical bias stemming from populations.…”

“…Forty‐seven studies were considered of good quality and two of fair 60,66 and one poor 45 (Figure 1B,C). Thirty‐six studies were awarded a high‐GRADE rating, thirteen moderate 20,21,40,43,44,49,50,52,56,57,60,66,67 and one a low‐GRADE rating 45 (Table S4).…”

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

“…Of 105 women in whom the pregnancy was a result of extracorporeal in vitro fertilization, a congenital heart defect was diagnosed in two cases, one representing a pregnancy resulting from each of the fertilization methods (ICSI, IMSI). Furthermore, a congenital non-cardiac defect was diagnosed in two cases when fertilization was achieved through the use of sperm that had not undergone prior morphological assessment [45].…”