Assisted reproduction and congenital malformations: A systematic review and meta‐analysis

Assisted reproduction and congenital malformations: A systematic review and meta‐analysis

Prior studies have explored the links between congenital anomalies and assisted reproduction techniques, among other factors. However, it remains unclear whether a particular technique harbors an inherent risk of major congenital anomalies, either cumulatively or in an organ‐specific manner. A meta‐...

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Bibliographic Details
Published in:Congenital anomalies Vol. 64; no. 3; pp. 107 - 115
Main Authors: Veeramani, Meenakshi, Balachandren, Neerujah, Hong, Yong Hwa, Lee, Jiyoon, Corno, Antonio F., Mavrelos, Dimitrios, Kastora, Stavroula L.
Format: Journal Article
Language:English
Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01-05-2024
Wiley Subscription Services, Inc
Subjects:
assisted reproduction
Congenital Abnormalities - epidemiology
Congenital anomalies
Congenital defects
Female
Fertilization in Vitro - methods
Geographical distribution
Geographical locations
Heart
Heterogeneity
Humans
ICSI
In vitro fertilization
Infant, Newborn
IVF
Meta-analysis
Neonates
Pregnancy
Reproduction
Reproductive Techniques, Assisted - adverse effects
Sperm Injections, Intracytoplasmic - adverse effects
Sperm Injections, Intracytoplasmic - methods
IVF
ICSI
assisted reproduction
congenital anomalies
meta‐analysis
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Summary:Prior studies have explored the links between congenital anomalies and assisted reproduction techniques, among other factors. However, it remains unclear whether a particular technique harbors an inherent risk of major congenital anomalies, either cumulatively or in an organ‐specific manner. A meta‐analysis was conducted using relevant studies from inception to February 2023 using six databases and two appropriate registers. Sources of heterogeneity were explored using sub‐group analysis, using study weight, risk of bias and geographical location of original studies. Neonates conceived through assisted reproduction appear to have a higher risk of major congenital anomalies compared to naturally conceived neonates, OR 0.67 [95% CI 0.59, 0.76], I2 = 97%, p < 0.00001, with neonates conceived through intracytoplasmic sperm injection (ICSI) at a 9% higher chance of being affected in comparison to neonates conceived through in vitro fertilization (IVF). The increase in cardiac, gastrointestinal (GI), and neurological congenital anomalies appears to be independent of the assisted reproduction technique, while urogenital and musculoskeletal (MSK) anomalies were found to be increased in ICSI compared with IVF, OR 0.83 [95% CI 0.69, 0.98]; p = 0.03, I2 = 0%, and OR 0.65 [95% CI 0.49, 0.85]; p = 0.002, I2 = 80%, respectively. Neonates conceived using assisted reproduction techniques appear to be at higher risk of major congenital anomalies, with a higher risk attributable to conception using ICSI. The increase in cardiac, neurological, and GI congenital anomalies does not appear to be technique‐specific, while the opposite held true for urogenital and MSK anomalies.
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ISSN:0914-3505
1741-4520
DOI:10.1111/cga.12561