The Risk of Congenital Anomalies by Fertility Treatment Modality

Area of Science:

• Reproductive Medicine
• Obstetrics
• Genetics

Background:

• Assisted reproductive technology (ART) accounts for up to 4% of births in developed nations.
• ART pregnancies are associated with an increased risk of congenital anomalies.
• Understanding these risks is crucial for patient counseling and management.

Purpose of the Study:

• To review the risk of birth defects in pregnancies conceived via ART and other fertility treatments.
• To summarize current fertility treatment modalities and their associated risks.

Main Methods:

• Literature search of PubMed.
• Review of committee opinions from the American College of Obstetricians and Gynecologists and American Society of Reproductive Medicine.

Main Results:

• In vitro fertilization (IVF) linked to a 25%-50% increased risk of birth defects affecting cardiovascular, genitourinary, gastrointestinal, and musculoskeletal systems.
• Intracytoplasmic sperm injection (ICSI) may increase defect risk, especially hypospadias.
• Risks associated with fresh vs. frozen cycles and embryo transfer stages are uncertain.
• Preimplantation genetic testing and ovulation induction appear safe; oocyte cryopreservation data is limited.

Conclusions:

• The relative risk of birth defects in ART pregnancies is elevated compared to spontaneous conceptions, but the absolute risk remains low.
• No standard screening recommendations exist for ART pregnancies.
• Counseling on risks and antenatal evaluations (e.g., fetal echocardiogram, detailed ultrasound) is recommended for ART patients.