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Incidence of congenital malformations in children born after ICSI
U B Wennerholm1, C Bergh, L Hamberger
1Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg, Sweden.
Insights
Children born after intracytoplasmic sperm injection (ICSI) have a slightly increased risk of congenital malformations, primarily due to a higher rate of multiple births. Hypospadias was the only specific malformation found in excess.
Area of Science:
- Reproductive Medicine
- Pediatrics
- Genetics
Background:
- Intracytoplasmic sperm injection (ICSI) is a widely used assisted reproductive technology.
- Concerns exist regarding the potential impact of ICSI on offspring health, particularly congenital malformations.
Purpose of the Study:
- To determine the incidence of congenital malformations in a complete cohort of infants born after ICSI.
- To compare malformation rates in ICSI-conceived children with the general population.
Main Methods:
- Retrospective analysis of medical records for 1139 infants born after ICSI.
- Comparison with national data from the Swedish Medical Birth Registry and Registry of Congenital Malformations.
- Statistical analysis including odds ratios and confidence intervals, with stratification for confounding factors.
Main Results:
- Overall incidence of identified anomalies was 7.6% (87/1139), with 40 minor anomalies.
- Initial analysis showed an increased odds ratio (OR) for malformations in ICSI children (1.75).
- After stratification for multiple births, the OR reduced significantly (1.19), indicating multiple births as the primary driver.
- Hypospadias was the only specific malformation found in excess (relative risk 3.0).
Conclusions:
- The increased rate of congenital malformations in children conceived via ICSI is largely attributable to the higher incidence of multiple births.
- Paternal subfertility may be a contributing factor to the excess of hypospadias observed.
- Further research is warranted to elucidate the specific risks associated with ICSI and paternal factors.
Abstract:
The aim of this study was to determine the incidence of congenital malformations in a complete cohort of children born after intracytoplasmic sperm injection (ICSI). The medical records were retrieved for 1139 infants, 736 singletons, 200 sets of twins and one set of triplets. The total number of infants with an identified anomaly was 87 (7.6%), 40 of which were minor. The incidence of malformations in children born after ICSI was also compared with all births in Sweden using data from the Swedish Medical Birth Registry and the Registry of Congenital Malformations. For ICSI children, the odds ratio (OR) for having any major or minor malformation was 1.75 [95% confidence interval (CI) 1.19-2.58] after stratification for delivery hospital, year of birth and maternal age. If stratification for singletons/twins was also done, the OR was reduced to 1.19 (95% CI 0.79-1.81). The increased rate of congenital malformations is thus mainly a result of a high rate of multiple births. The only specific malformation which was found to occur in excess in children born after ICSI was hypospadias (relative risk 3.0, exact 95% CI 1. 09-6.50) which may be related to paternal subfertility.