Birth defects of 1,397 newborns conceived by in vitro fertilization/intracytoplasmic sperm injection and embryo transfer

Abstract

To evaluate risk of birth defects of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment and to determine the safety of IVF/ICSI. Retrospective study in academic hospital. To review the 1397 infants (1997–2006) whose mothers underwent IVF/ICSI and embryo transfer at Center for Reproductive Medicine, Nanfang Hospital, Southern Medical University .1076 IVF infants and 321 ICSI infants were born after replacement of fresh embryos. Congenital malformations at birth was evaluated based on IVF or ICSI, sington and multiple pregnancies and infant's sex. ICSI was carried out using ejaculated, epididymal or testicular sperm. There were 18 birth defect in 1379 IVF/ICSI-conceived newborn at birth and total birth defect rates was 1.31%. 10 of 1,076 IVF-conceived children (0.93%) and 8 of 321 ICSI-conceived children (2.49%) had a birth defect at birth. The birth defect rate was increased after ICSI compared with IVF. There was statistical difference in birth defect rates between IVF infants and ICSI infants (P=0.018). 9 of 1,462 sington (1.38%) and 9 of 690 twin and triplet (1.19%) had a birth defect at birth. There was no statistical difference in birth defect rates between these two groups (P<0.05). 12 of 754 male IVF/ICSI-conceived infants (1.59%) and 7 of 643 IVF/ICSI-conceived infants (1.09%) had a birth defect at birth. There was no statistical difference in birth defect rates between male and female babies (P<0.05). 5 of 18 (27.8%) were cardiovascular defects. Infants conceived through ICSI have a higher rate (2.67 times) of birth defects compared with IVF. More birth defects are noted among male babies at birth, although this difference is not statistically significant. The follow-up study included to genetic counseling and eventual prenatal diagnosis, followed by a physical examination of the children after 1 year and after 2 years or longer time needs to be performed.