Higher Rate of Congenital Malformations with Fertility Treatments

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A higher rate of heart diseases and other major congenital malformations have been reported in births that result from fertility treatments, specifically those from assisted reproductive technology (ART). Dr. Gerald Viot, a clinical geneticist at the Maternit Port Royal Hospital in Paris presented the findings at the annual European Society of Human Genetics conference.

Assisted reproductive technology, according to the Centers for Disease Control and Prevention (CDC) includes all fertility treatments in which both eggs and sperm are handled. Generally, ART procedures involve surgically removing eggs from a woman’s ovaries and then combining them with sperm in a laboratory. The fertilized eggs are then placed in the donating woman’s uterus or in the uterus of another woman. This technique is called in vitro fertilization.

ART does not include any treatment that only involves sperm (e.g., artificial insemination) or fertility treatments in which a woman takes medications to stimulate egg production if there is no intention to have the eggs retrieved. In the United States, ART has been used since 1981 to help women become pregnant, and today more than 1 percent of all children born in the United States are conceived using ART.

Dr. Viot and her associates surveyed 33 centers in France that perform ART and collected data on 15,162 children born from 2003 to 2007. Both the parents and the pediatricians answered questions about the prevalence of congenital malformations, and the researchers compared these data with those from national registers and published papers.

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The researchers found that 4.24 percent of the children born as a result of ART had major congenital malformations, compared with the 2 to 3 percent they had expected from previous study results. However, the investigators also noted that some earlier studies had reported a rate of 11 percent. Dr. Viot explained that “Given that our study is the largest to date, we think that our data are more likely to be statistically representative of the true picture.”

Much is not understood about the origins of congenital malformations associated with fertility treatments. Dr. Viot noted that the high number of children born with these challenges makes the malformation rate a public health concern. “It is important that all doctors and also politicians are informed about this. We also need to follow up all children born after ART and to put much more effort into trying to understand which of the procedures involved is implicated in this problem.”

To hopefully understand more about ART and why it is associated with a higher rate of congenital malformations, Dr. Viot and her fellow researchers plan to follow all these children using additional questionnaires and studying the motor development of the children born in 2003. The scientists are also attempting to discover the origin of the parents’ infertility for each child who was born after ART who had major malformation or epigenetic disorders.

The higher rate of congenital malformations associated with ART fertility treatments will continue to be the subject of much further research. “It is vitally important that we find out as much as we can about what is causing malformation in these children,” noted Dr. Viot, “not only so that we can try to counteract the problem but also in order for health services to be able to plan for their future needs.”

SOURCES:
Centers for Disease Control and Prevention
European Society of Human Genetics

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