Fertility Treatments and Birth Defects

This week in the NewEngland Journal of Medicine announced that researchers at the University ofAdelaide found an elevated risk of defects among IVF babies, confirming earlierresearch that supported the same conclusion. The odds for any birth defect inpregnancies involving assisted reproductive technologies (ARTS) are 8.3%, compared to 5.8% for unassisted pregnancies.

The risk factors seem to be linked to issues within thecontrol of the patient, such as obesity and smoking. But ICSI (intracytoplasmicsperm injection) is an exception to this. ICSI involves injecting a single sperm intothe egg. And with ICSI, the risk ofbirth defects is 57% over normal IVF. ICSI is especially popular in Europe. 

The risk is tripled for women taking the inexpensive andwidely used medication, clomiphene citrate, to stimulate ovulation outside of closely supervisedclinical settings.  

Surprisingly, cryopreservation (freezing) embryos was shownto be associated with a greatly reduced risk of birth defects, particularly forICSI.  But this could be due to the factthat developmentally compromised embryos fail to survive the freeze/thawprocess.