I-42: Do Birth Defects Increase with Assisted Reproductive Technologies

Assisted reproductive technologies (ART) like in vitro fertilization have enabled many infertile couples to achieve pregnancy. Although ART pregnancies have long been known to be characterized by increased rates for certain maternal complications, these complications are predictable based on the mother’s more advanced age - increased medical complications like hypertension or diabetes mellitus. Increased pregnancy loss also occurs, mostly reflecting the increased fetal aneuploidy again associated with advanced maternal age. Neonatal outcome complications include low birth weight, which is predictable in the context of multiple gestations. However, low birth weight also occurs in singleton pregnancies, suggesting inherent differences in offspring of ART pregnancies versus non-ART pregnancies. Frequency of congenital anomalies in offspring of ART pregnancies is 25-30 % higher (odds ratio 1.25- 1.3) than in offspring of pregnancies in the general population. There is no increase in any particular anomaly, excepting hypospadias in offspring of ICSI pregnancies. Of relevance, women who become pregnant without ART but whose time to pregnancy exceeds 12 months also show increased odds ratio for birth defects. Thus, the factors that cause infertility must predispose to birth defects as well. The increase in birth defects seems less likely to be due to the ART procedure per se than to the underlying problem that necessitated ART. The magnitude of the increase is not enough to deter couples wishing to achieve pregnancy, but it becomes necessary to provide adequate counseling to couples Abstracts of the 12th Royan International Congress on Reproductive Biomedicine International Journal of Fertility & Sterility (IJFS), Vol 5, Suppl 1, Summer 2011 20 undergoing ART.