In vitro fertilization is associated with an increase in major birth defects

Objective: To determine the risk of major birth defects in cohorts of children conceived through IVF of through IUI as compared with naturally concieved children. Design: Retrospective cohort study. Setting: Academic medical center. Patient(s): Children concieved by IVF of IUI at the University of Iowa from 1989 through 2002, compared with a matched cohort of naturally concieved children. Intervention(s): None. Main Outcome Measure(s): Outcome data were obtained from Iowa Birth Defects Registry. Results(s): Ninety of 1,462 IVF-conceived children (6.2%) and 17 of 343 IUI-conceived children (5.0%) had a major birth defect, compared with 369 of 8,422 naturally concieved children (4.4%). The adjusted odds ratio of a major birth defect in all IVF-concieved children. The birth defect rate was increased after IVF when the analysis was limited to term singletons. Cardiovascular and mucusoskeletal defects and known birth defect syndromes were increased after IVF. Among IVF-concieved children, there was no difference in birth defect rates after intracytoplasmic sperm injection (ICSI) or after transfer of cryopreserved embryos. Conclusion(s): Infants conceived through IVF have a slightly higher rate of major birth defects. More birth defects are noted among children born to infertile couples after all types of infertility treatment are needed to definitively determine whether the increased risk of birth defects is secondary to problems inherent in the infertile couple and/or factors associated with some respect of treatment. (Fertil Steril (R) 2005; 84:1308-15. (c) 2005 by American Society for Reproductive Medicine).