O-25: The Risk of Major Birth Defects in-ICSI and Normal Infants

Background: In the past 22 years, intracytoplasmic sperm injection (ICSI) on human oocytes become a successful method of treatment for most categories of infertility. But there are real concerns that possible malformations among ICSI infants are still not fully recognized. Despite the success of ICSI, the risk of major birth defects due to various parental factors or treatment may increase. We report our experience to determine whether use of ICSI is associated with an increase in major birth defects or adverse pregnancy outcomes. Materials and Methods: Historical cohort study of Major Birth defects was performed in 789 births in Royan Institute. The data for this analysis were derived from Tehran's ICSI linked data file by simple sampling method. In our study, the risk of birth defects was compared in 263 ICSI infants and 526 naturally conceived (NC) infants. We also performed multiple logistic regression analyses to calculate the odds ratio (OR) and 95% confidence intervals for the independent association of ICSI on each outcome. Results: We found 50 infants with major birth defects: these included 24 NC infants (4.6%) and 26 ICSI infants (9.9%). In comparison with NC infants, ICSI infants had a significant 2.29-fold increased risk of major birth defects. After adjustment for maternal age, infant's sex stillbirth, abortion and type of delivery, we found a relatively difference in risk (OR=1.51). In this study, the majority (93.7%) of all infants were normal but 6.3% of infants had at least one major birth defect. Conclusion: Although available data are limited, there appears to be no indication that birth defects increased in pregnancies resulting from ICSI. In this study, we reported major birth defects s in ICSI infants more than naturally conceived infants. We also found evidence of a difference in risk of major birth defects between normal and ICSI. Musculoskeletal and urogenital malformations were the most reported major birth defects in ICSI infants according to organs and systems classification