Hum. Reprod. Advance Access originally published online on November 26, 2004
Human Reproduction 2005 20(2):328-338; doi:10.1093/humrep/deh593
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SYSTEMATIC REVIEW |
Assisted reproductive technologies and the risk of birth defects—a systematic review
1 Centre for Child Health Research, The University of Western Australia Telethon Institute for Child Health Research, West Perth, Western Australia 6872, Australia and 2 The National Perinatal Epidemiology Unit, University of Oxford, OX3 7LF, UK
3 To whom correspondence should be addressed at: Telethon Institute for Child Health Research, PO Box 855, West Perth, Western Australia 6872. Email: michele{at}ichr.uwa.edu.au
BACKGROUND: The risk of birth defects in infants born following assisted reproductive technology (ART) treatment is a controversial question. Most publications examining the prevalence of birth defects in ICSI and IVF infants compared to spontaneously conceived infants have serious methodological limitations; despite this, most researchers have concluded that there is no increased risk. METHODS: We carried out a systematic review to identify all papers published by March 2003 with data relating to the prevalence of birth defects in infants conceived following IVF and/or ICSI compared with spontaneously conceived infants. Independent expert reviewers used criteria defined a priori to determine whether studies were suitable for inclusion in a meta-analysis. Fixed effects meta-analysis was performed for all studies and reviewer-selected studies. RESULTS: Twenty-five studies were identified for review. Two-thirds of these showed a 25% or greater increased risk of birth defects in ART infants. The results of meta-analyses of the seven reviewer-selected studies and of all 25 studies suggest a statistically significant 30–40% increased risk of birth defects associated with ART. CONCLUSIONS: Pooled results from all suitable published studies suggest that children born following ART are at increased risk of birth defects compared with spontaneous conceptions. This information should be made available to couples seeking ART treatment.
Key words: assisted reproductive technology/congenital malformations/IVF/meta-analysis/systematic review
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