Prevalence of structural birth defects in IVF-ICSI pregnancies resulting from autologous and donor oocytes in Indian sub-continent: Results from 2444 births.

Abstract

This study was conducted to evaluate and compare the incidence of birth defects in In-Vitro Fertilization-Intra Cytoplasmic Sperm Injection (IVF-ICSI) pregnancies with autologous and donor oocytes. As a secondary outcome, the prevalence of birth defects in IVF-ICSI pregnancies was compared with those from spontaneous conceptions in India. This retrospective study included 2444 births resulting from IVF-ICSI cycles from autologous (n=1743) and donor oocytes (n=701) during a 3-year period in an Indian infertility center. Birth defects, if any, were noted antenatally and followed till the neonatal period, in case of live birth. The overall prevalence of birth defects in IVF-ICSI pregnancies in this study was 29/2444 (118.6/10000 births) and the most common congenital anomaly was cardiac malformation (32.7/10000 births) followed by genitourinary (28.6/10000 births). The risks of birth defects resulting from autologous and donor oocytes did not differ (114.7/10000 vs 128.38/10000; P>0.05). However, pregnancies resulting from autologous oocytes had a higher trend of gastrointestinal birth defects (20.5/10000 births vs 0), though not statistically significant. The risk of cardiovascular birth defects resulting from IVF-ICSI pregnancies was much higher compared with the natural conceptions in India (32.7/10000 vs 12.7/10000 births; P=0.03), whereas the risk of central nervous system malformations was much lower (8.1/10000 vs 60.18/10000 births; P=0.005). Overall, there was no significant difference in birth defects resulting from IVF-ICSI with autologous or donor oocytes. The births resulting from IVF-ICSI pregnancies did not tend to have a higher rate of birth defects a compared with natural conceptions. The differences in the prevalence of certain birth defects (cardiovascular or central nervous system) reported in IVF-ICSI pregnancies may be due to improved surveillance modalities and early detection in pregnancies following IVF-ICSI. A study with larger number of sample size will give us better understanding of the prevalence of reported incidence in this study.