Assisted Reproduction is Not Associated with Increased Risk of Congenital Head and Neck Defects.

Colin Neumann,Heidi Thorson,Dane A Thompson,James D Sidman,Brianne B Roby

doi:10.7759/cureus.2287

Abstract

This abstract was presented at the American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting, Orlando, FL, September 2014 with the abstract published (Neumann C, Thompson D, and Sidman J; Assisted reproduction is not associated with increased risk of head and neck defects; Otolaryngology-Head and Neck Surgery; Vol 151, Issue 1, supplement, 2014).Objectives- Compare the rate of head and neck anomalies between children conceived via artificial reproductive technology (ART) versus those conceived via natural methods.- Determine the risk of congenital head and neck abnormalities associated with ART.Study designA retrospective chart review cross-sectional study from 2004-2014 of all patients admitted to the neonatal intensive care unit (NICU) at a tertiary pediatric hospital.ResultsA total of 14,857 charts were examined; 2,288 patients were conceived via ART, while 12,569 patients were conceived via natural methods. There were 8,022 males and 6,637 females. There were 40 patients born with defects via ART, while there were 681 patients born with defects via natural conception. The total occurrence of congenital malformations was higher for patients conceived naturally versus those conceived with artificial reproduction (5.41% vs. 1.74%). The odds ratio was 0.31 with a 95% CI of 0.23 to 0.43 and a P-value of < 0.0001; the relative risk of having any one of the head and neck defects with ART was 1.04 with a 95% CI of 1.03 to 1.05 and a P-value < 0.0001.ConclusionThere appears to be no increased risk of congenital head and neck defects in children conceived via ART versus those conceived naturally.

Highlights

Assisted reproductive technology (ART) is the technology that involves handling eggs, sperm, or both outside the human body in order to achieve pregnancy [1]
The total occurrence of congenital malformations was higher for patients conceived naturally versus those conceived with artificial reproduction (5.41% vs. 1.74%)
A type of in vitro fertilization (IVF) called IVF-intracytoplasmic sperm injection (IVF-ICSI) has an increased risk for major malformations of 8.9% in single live births compared with 6.0% in spontaneous conceptions of single gestations and a similar, increased risk in newborns among twin gestations compared to single gestations conceived with IVF-ICSI [21,22]

Summary

Introduction

Assisted reproductive technology (ART) is the technology that involves handling eggs, sperm, or both outside the human body (in vitro) in order to achieve pregnancy [1]. Infertility has been identified as a significant independent predictor of adverse obstetrical and perinatal outcomes [2]. Maternal age and obesity are two major factors related to both an increased risk of infertility and an increased risk of adverse obstetrical outcomes. Infertility is associated with male factor or abnormal sperm parameters in approximately 50% of cases [3]. Infertile men with chromosomal abnormalities are more likely to have genetically abnormal spermatozoa and to father chromosomally abnormal pregnancies [5]. Due to the association of infertility and birth defects, there has been some question as to whether it is the inherent risk or the techniques used in ART that cause a higher rate of birth defects or whether there is a combined risk from both factors

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