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Risk of Birth Defects Associated with ART Appears Low

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Results Confirm Previous Studies

This study confirms a number of prior studies, including one from the University of Iowa, Iowa City, finding an association between ART and birth defects. A large majority of births from ART are normal and the increased risk of birth defects is small. This study also confirmed a higher rate of birth defects in children conceived among infertile couples by non-ART means (spontaneously, with intrauterine insemination, with ovulation induction). These findings suggest that something about the infertile population is the true risk factor for birth defects and the specific treatment used may be less important.

Brad J. Van Voorhis, M.D., is the F. K. Chapler Professor of Obstetrics and Gynecology and the director of the division of reproductive endocrinology and infertility at the University of Iowa, Iowa City.


 

FROM THE NEW ENGLAND JOURNAL OF MEDICINE

In a statement issued by the Society for Assisted Reproductive Technology (SART), Dr. Glenn Schattman, the society’s president, said: "It is important to note that women with a history of infertility who did not undergo ART treatments also had a higher increase of having children with birth defects. This, combined with the finding that those using ICSI ... also had slightly elevated risks of birth defects, suggests that the underlying problem that led them to seek medical assistance in the first place is likely contributing to the elevated risk of birth defects in their children."

Dr. Schattman, an ob.gyn. and reproductive endocrinologist at Weill Medical College of Cornell University, New York, pointed out that some of the results were reassuring, including the finding that in cycles that did not involve ICSI, the adjusted odds ratio for IVF-conceived children did not show a significant difference in birth defects, and the risk of birth defects among children born after embryo freezing was not higher than the risk among naturally conceived children. "These are interesting and important findings, and we will need much more research to allow us to help patients overcome their infertility with treatments that are as safe as possible for them and the children born from the treatments," he added.

In the University of Adelaide statement, Dr. Davies said that the study needs to be expanded to include more recent years of treatment, because continuing advances in reproductive technologies may have an effect on risks associated with treatment. He also said in the statement that while previous studies have found that the risk of birth defects is increased with ARTs, this was the first study to compare all forms of ART treatments available and to compare pregnancies between women by the treatments they received.

The study was supported by grants from the National Health and Medical Research Council and the Australian Research Council. The authors said they had no relevant financial disclosures.

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