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Reproductive technology and birth defects.

The risk of having a child with a birth defect is greater after conceiving with assisted reproductive technology compared with spontaneous conception. Of course the vast majority of assisted or unassisted pregnancies result in healthy infants, but couples entering assisted reproduction programs are entitled to know if the process on which they are embarking may result in a child with a defect. It is not a simple question to answer, as it requires accurate statistics of defects in the population at large, a record of those conceived with assistance, in addition to the likelihood of any defects being caused by the technique used or the background risk of both particular parents. 
 
To provide answers, Davies and colleagues1 studied the South Australian birth registry spanning 15 years, which contained data about infants’ method of conception and linked it to the birth defects registry for the region that had complete information pertaining to all children at age 5. Defects of the cardiovascular, musculoskeletal, urogenital, and gastrointestinal systems were recorded, as well as cerebral palsy, and their relationship to ovulation induction, in vitro fertilization and intracytoplasmic sperm injection (ICSI) techniques, plus the parents’ age and reproductive history. 
 
According to the research, there is a greater risk to those born using assisted reproductive therapy (8% vs 6% using their criteria), but the cause of the risk is attributable to the parental profile rather than due to the assisted reproductive technique used. In other words, if these couples were to conceive spontaneously their risk would remain raised to the same degree and manipulations (other than ICSI) do not change the odds. This means that those working with couples experiencing infertility can reassure their clients that most of their techniques will not increase the slightly raised risk they already have of conceiving a child with a defect, which is overall good news.