Chapter 34 - Congenital anomalies and assisted reproductive technologies

Summary

The population of children born after assisted reproductive technologies (ART) has increased dramatically around the world. Intracytoplasmic sperm injection (ICSI) pregnancies were comparable to those from in vitro fertilization (IVF), and both had worse perinatal outcomes than naturally conceived pregnancies. Chromosomal study of abortuses following ART techniques showed no increase in the incidence of anomalies when compared with naturally conceived pregnancies, or between in IVF (54.5%) and ICSI (61.5%), but there was an increase in ICSI. Specific anomalies reported with IVF include the extrophy epispadius complex, which showed a 7.3-fold relative increase in incidence in IVF infants. In the French registry, a higher rate of congenital malformations was found among IVF pregnancies compared with intrauterine insemination (IUI). Some congenital malformations are more common following ART pregnancies, including hypospadias, especially after testicular sperm extraction, and the extrophy-epispadius complex. The incidence of congenital malformations is higher in spontaneous pregnancies of infertile couples.