Malformations

More than one million children have been born worldwide after conception through IVF or ICSIFrom English "Intra-Cytoplasmic Sperm Injection." Assisted fertilization by microscope, where a single sperm is injected directly into the oocyte. ICSI is indicated in cases of male fertility problems, so if there are only very few normal sperm in the sperm or the fertilization capacity of sperm is extremely small.. Epidemiological data on the health and development of these children are all reassuring. However, several teams, including ours, are following the development of the children through telephone follow-ups and customized questionnaires.

To date, the number of birth defects in children born of after IVF or ICSIFrom English "Intra-Cytoplasmic Sperm Injection." Assisted fertilization by microscope, where a single sperm is injected directly into the oocyte. ICSI is indicated in cases of male fertility problems, so if there are only very few normal sperm in the sperm or the fertilization capacity of sperm is extremely small. is slightly higher (5.3%) to that observed in the general population (3-4%).

In our unit, among 757 children born after IVF, 19 children (2.5%) had a severe malformation and 15 (2.0%) a minor malformation. Of the 589 children born through ICSIFrom English "Intra-Cytoplasmic Sperm Injection." Assisted fertilization by microscope, where a single sperm is injected directly into the oocyte. ICSI is indicated in cases of male fertility problems, so if there are only very few normal sperm in the sperm or the fertilization capacity of sperm is extremely small., the number of children with major malformations was 10 (1.7%) and 21 (3.6%) for minor ones.

Birth defects do not appear to be directly related to the technique of ART (IVF or ICSIFrom English "Intra-Cytoplasmic Sperm Injection." Assisted fertilization by microscope, where a single sperm is injected directly into the oocyte. ICSI is indicated in cases of male fertility problems, so if there are only very few normal sperm in the sperm or the fertilization capacity of sperm is extremely small.). The origins of malformations are mostly attributable to inherited genetic factors or to maternal factors.

Children born after IVF have a higher prevalence of heart defects, while those born after ICSIFrom English "Intra-Cytoplasmic Sperm Injection." Assisted fertilization by microscope, where a single sperm is injected directly into the oocyte. ICSI is indicated in cases of male fertility problems, so if there are only very few normal sperm in the sperm or the fertilization capacity of sperm is extremely small. show a majority of urogenital malformations.

Chromosomal abnormalities such as trisomy 21 (Down syndrome), can be detected by blood tests and ultrasound early in the pregnancy (12th week), or by another blood test between the 16th and 18th weeks, and / or by a chorionic test or amniocentesisAnalysis performed in the amniotic fluid; it is a prenatal examination performed between the 14th and 18th week of pregnancy to detect fetal anomalies.. Other malformations can be detected by ultrasound. Depending on the severity of the malformation, a therapeutic termination of pregnancy may need to be considered.

Therefore, a close medical follow-up with these investigations is strongly recommended.

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Position of ESHRE (European Society for Human Reproduction and Embryology), April 7, 2009

Birth defects occur at low levels in all populations. This rate may vary over time and countries, so it is important to continuously monitor it.

In Europe, the Nordic countries have the ability to track these rates on the basis of health registers continuously updated with an identifying number applied to each individual. This register allows to compare data on children born to IVF to those of the total population. Data on congenital malformations of the Nordic countries have been confirmed by similar studies conducted in other European countries.

Based on studies of Nordic and European countries, the presence of congenital malformations in relation to infertilityDifficulty for a man or a woman to procreate as a result of a functional disorder or an organic lesion of the reproductive system, generally acknowledged after one year of regular, unprotected sexual relations. and IVF treatment can be summarized as follows:

1. All children are at risk of approximately 3% to have a birth defect.
2. The children of couples who become pregnant after assisted reproductive technique such as IVF / ICSIFrom English "Intra-Cytoplasmic Sperm Injection." Assisted fertilization by microscope, where a single sperm is injected directly into the oocyte. ICSI is indicated in cases of male fertility problems, so if there are only very few normal sperm in the sperm or the fertilization capacity of sperm is extremely small. have an increased risk of 40-50% higher than after natural conception. A similar increased risk was reported for subfertile couples who have a spontaneous pregnancy after a prolonged wait. The increased risk appears mostly due to the characteristics and parental status and not infertilityDifficulty for a man or a woman to procreate as a result of a functional disorder or an organic lesion of the reproductive system, generally acknowledged after one year of regular, unprotected sexual relations. treatment given. A case-control study conducted in the United States has recently confirmed these results.

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Ongoing research. Discoveries or observations should be taken, in most cases, as indications and not certainties: the results of studies involving small numbers of subjects must be confirmed by larger cohort studies that present significant values.