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Author Spotlight: Exploring the Long-Term Health Impacts of Intracytoplasmic Sperm Injection on Offspring
Published on: May 17, 2024
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Risk for Congenital Anomalies in Children Conceived With Medically Assisted Fertility Treatment : A Population-Based
Christos Venetis1, Stephanie K Y Choi2, Louisa Jorm3
1National Perinatal Epidemiology and Statistics Unit (NPESU), Centre for Big Data Research in Health, and School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Sydney, Australia, Unit for Human Reproduction, 1 Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece, and Virtus Health, Sydney Australia (C.V.).
Annals of Internal Medicine
|October 9, 2023
Summary
Assisted reproductive technologies (ARTs) show an increased risk for genitourinary abnormalities in children, independent of parental infertility. Intracytoplasmic sperm injection (ICSI) poses a higher risk, especially when male infertility is not a factor.
Area of Science:
- Reproductive Medicine
- Pediatric Health
- Medical Statistics
Background:
- Assisted reproductive technologies (ARTs) are widely used, with over 2 million conceptions annually.
- Previous research indicates a potential increased risk of congenital anomalies (CAs) in ART-conceived children.
- The specific contributions of underlying infertility versus ART procedures to CA risk require further clarification, especially with evolving ART techniques like ICSI and cryopreservation.
Purpose of the Study:
- To evaluate the association between fertility treatments (ART, OI/IUI) and the risk of congenital anomalies (CAs) in infants within their first two years of life.
- To differentiate the risks associated with underlying parental infertility from those associated with fertility treatments themselves.
- To assess the impact of specific ART techniques, such as intracytoplasmic sperm injection (ICSI), on CA risks.
Main Methods:
- A propensity score-weighted, population-based cohort study was conducted in New South Wales, Australia.
- Data from 851,984 infants born between 2009 and 2017 were analyzed.
- Congenital anomaly (CA) risks in infants conceived via fertility treatments were compared to two naturally conceived control groups: those with and without a history of infertility.
Main Results:
- ART-conceived infants had an elevated risk for major genitourinary abnormalities compared to naturally conceived infants, even after accounting for parental infertility.
- Intracytoplasmic sperm injection (ICSI) was linked to a higher risk of genitourinary abnormalities in couples without male infertility.
- No increased risk of CAs was observed in infants conceived through ovulation induction and intrauterine insemination (OI/IUI).
Conclusions:
- ART conception is independently associated with a small increased risk of genitourinary abnormalities.
- The use of ICSI, particularly in cases without male infertility, warrants careful consideration due to its association with increased risk.
- Patients undergoing fertility treatments should be counseled regarding these potential risks.
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