Birth defects and congenital health risks in children conceived through assisted reproduction technology (ART): a meeting report
Assisted Reproduction Treatment (ART) is here to stay. This review addresses the parental background of birth defects, before, during and after conception and focuses both on the underlying subfertility and on the question whether ART as a treatment is an additional contributing factor.
Searches were performed in Medline and other databases. Summaries were discussed in a Delphi panel set-up by the European Society of Human Reproduction and Embryology (ESHRE).
Several birth defects and adult diseases arise during the earliest stages of ovarian development and oocyte differentiation: this is the case of cleft palate disorders in offspring from female rat exposed to Dioxin during fetal life or the polycystic ovary diseases in female offspring (primates) exposed to elevated androgen concentration during fetal life. Human oocytes and embryos often fail to stop the propagation of aneuploid cells but maintain their ability to repair DNA damages including those introduced by the fertilizing sperm. There is a 29 % increased risk of birth defects in the newborns spontaneously conceived by subfertile couples and the risk is further increased (34 %) when conception is achieved by treating infertlity with ART (Danish IVF Registry). Periconceptional conditions are critical for ART babies: their birth weight is in general smaller (Norvegian Registry) but a more prolonged culture time doubled the number of large babies (Finnish Registry).
The long-term developmental effects of ART on child and subsequent health as an adult remains a subject worthy of futher monitoring and investigation.
KeywordsBirth defects Malformations Congenital health risks Genetic diseases Epigenetic defects
The secretarial assistance of Mrs Simonetta Vassallo is gratefully acknowledged.
The meeting was organized by the European Society of Human Reproduction and Embryology with an unrestricted educational grant from Institut Biochimique S.A. (Switzerland).
- 1.Harvey W. Exercitationes de Generatione Animalium. Londinii 1651.Google Scholar
- 2.Wilson EB. The Cell in Development and Heredity: Macmillan, New York; 1925Google Scholar
- 3.Raven Chr. P. Oogenesis: the storage of developmental information. Pergamon Press, The Macmillan Company, New York. 1961.Google Scholar
- 45.Forsdahl A. Are poor living conditions in childhood and adolescence an important risk factor for arteriosclerotic heart disease. J Prevent Soc Med. 1977;31:91–5.Google Scholar
- 51.Sinclair KD, Allegrucci C, Singh R, Gardner DS, Sebastian S, Bispham J, et al. DNA methylation, insulin resistance, and blood pressure in offspring determined by maternal periconceptional B vitamin and methionine status. Proc Natl Acad Sci U S A. 2007;104:19351–6.PubMedCentralPubMedCrossRefGoogle Scholar
- 72.Scott Jr RT, Upham KM, Forman EJ, Hong KH, Scott KL, Taylor D, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril. 2013;100:697–703.PubMedCrossRefGoogle Scholar
- 73.Rubio C, Bellver J, Rodrigo L, Bosch E, Mercader A, Vidal C, et al. Preimplantation genetic screening using fluorescence in situ hybridization in patients with repetitive implantation failure and advanced maternal age: two randomized trials. Fertil Steril. 2013;99:1400–7.PubMedCrossRefGoogle Scholar
- 79.Ceelen M, van Weissenbruch MM, Prein J, Smit JJ, Vermeiden JP, Spreeuwenberg M, et al. Delemarre-van de Waal HA. Growth during infancy and early childhood in relation to blood pressure and body fat measures at age 8–18 years of IVF children and spontaneously conceived controls born to subfertile parents. Hum Reprod. 2009;24:2788–95.PubMedCrossRefGoogle Scholar