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68 - Congenital Anomalies and Assisted Reproductive Technology

from PART III - ASSISTED REPRODUCTION

Published online by Cambridge University Press:  04 August 2010

Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

INTRODUCTION

Assisted reproductive technology (ART) has become the standard of care for the treatment for many types of infertility. In Denmark, 4 percent of all infants are born after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). It is well established that children born after ART have poorer outcomes than spontaneously conceived children mainly due to the high rate of multiple births and the associated perinatal mortality, preterm birth, and low birth weights. The evidence relating to ART and congenital anomalies will be discussed in this chapter.

Lancaster's study from the late 1980s was the first to report a higher prevalence of neural tube defects and transposition of the great vessels among IVF children (1). Though ART is considered to be relatively safe, recent evidence has shown an increase in the order of 30–40 percent in birth defects among children conceived by ART compared to infants conceived spontaneously (2–4). This enforces the importance of counseling prospective patients effectively.

Many congenital anomalies are noted at birth and some become apparent later in life. Some malformations are incompatible with life, some can be corrected with surgery, and others are compatible with continued life but cannot be corrected with treatment (5). Some malformations are related to prematurity (e.g., patent ductus arteriosus), some to multiple births, and some to infertility itself.

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Publisher: Cambridge University Press
Print publication year: 2008

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