Higher risk of birth defects from assisted reproductionMay 05, 2012
A University of Adelaide study has identified the risk of major birth defects associated with different types of assisted reproductive technology.
In the most comprehensive study of its kind in the world, researchers from the University's Robinson Institute have compared the risk of major birth defects for each of the reproductive therapies commonly available internationally, such as: IVF (in vitro fertilization), ICSI (intracytoplasmic sperm injection) and ovulation induction. They also compared the risk of birth defects after fresh and frozen embryo transfer.
The results are being published today in the prestigious New England Journal of Medicine, and presented in Barcelona, Spain at the World Congress on Building Consensus in Gynecology, Infertility and Perinatology.
"While assisted reproductive technologies are associated with an increased risk of major birth defects overall, we found significant differences in risk between available treatments," says the lead author of the study, Associate Professor Michael Davies from the University of Adelaide's Robinson Institute and School of Paediatrics and Reproductive Health.
Researchers linked a census of more than 6100 assisted reproductive technology births in South Australia to a registry of more than 300,000 births and 18,000 birth defects. They compared risks of birth defects across all infertility treatments to pregnancies in women with no record of infertility. They also compared successive pregnancies for women.
Previous studies have identified an increased risk of birth defects associated with infertility treatment, but this is the first study to compare all forms of available treatment. This is also the first study to compare pregnancies within women by the treatments received.
"The unadjusted risk of any birth defect in pregnancies involving assisted conception was 8.3% (513 defects), compared with 5.8% for pregnancies not involving assisted conception (17,546 defects)," Associate Professor Davies says.
"The risk of birth defects for IVF was 7.2% (165 birth defects); and the rate for ICSI was higher at 9.9% (139 defects).
"A history of infertility, either with or without assisted conception, was also significantly associated with birth defects. While factors associated with the causes of infertility explained the excess risk associated with IVF, the increased risk for a number of other treatments could not readily be explained by patient factors. ICSI, for instance, had a 57% increase in the odds of major defect, although the absolute size of the risk remained relatively small," he says.
Associate Professor Davies says cryopreservation (freezing) of embryos was associated with a substantially reduced risk of birth defects, particularly for ICSI. "This may be due to developmentally compromised embryos failing to survive the freeze/thaw process," he says.
Also of concern was the tripling of risk in women using clomiphene citrate to stimulate ovulation outside of a closely supervised clinical setting.
"While confined to a small group in our study, this is of particular concern as clomiphene citrate is now very widely available at low cost, and may easily be used contrary to manufacturers' very specific instructions to avoid use if pregnant, as it may cause fetal malformations. This aspect of the study will need additional confirmation from future research," Associate Professor Davies says.
He says the study now needs to be expanded to include more recent years of treatment, as the reproductive technologies have undergone continual innovation which may influence the associated risks of treatment.
World wide, more than 3.7 million babies are born annually as a result of assisted reproductive technology.
Assisted reproduction is usually invasive, expensive, and deals with matters of intense emotional content.
There are several areas of public health interest. These include:
- Risks associated with multiple embryo transfer
- Risks to the health of the offspring as a result of treatment
- Patient mental health as a result of treatment
- Long-term social functioning of the offspring born as a result of assisted reproduction.
University of Adelaide
Related Birth Defects Articles:
Causes of major birth defects remain largely unknown, say US researchers in The BMJ today, who were able to establish a definite cause in only one in every five infants they studied.
The research findings imply that patients with genitourinary birth defects due to 22q11.2 changes in gene dosage should also be evaluated for other potential birth defects seen in patients with DiGeorge syndrome that would affect the patient's future health.
Fresh insights into how a common virus replicates could pave the way for new therapies to stop its spread.
A study led by Cardiff University has revealed why CMV -- a virus responsible for 1,000 birth defects a year in the UK -- is so adept at evading the immune system.
A new Université de Montréal study in the British Medical Journal reveals that antidepressants prescribed to pregnant women could increase the chance of having a baby with birth defects.
A joint study conducted by researchers from the universities of Liverpool and Manchester has found a link between birth defects and certain types of epilepsy medication.
Babies born to women aged 40 and over from assisted reproduction have fewer birth defects compared with those from women who conceive naturally at the same age, according to new research from the University of Adelaide.
In a study that could one day help eliminate the tragic birth defects caused by Zika virus, scientists from the Florida campus of The Scripps Research Institute (TSRI) have elucidated how the virus attacks the brains of newborns, information that could accelerate the development of treatments.
A study of 1.3 million pregnant women suggests antipsychotic medication early in pregnancy was not associated with a meaningful increase in the risk of birth defects when other mitigating factors were considered, although the medication risperidone needs further research, according to a study published online by JAMA Psychiatry.
For the first time, scientists believe they've discovered a cause of multiple types of birth defects triggered by environmental stresses.
Related Birth Defects Reading:
Before We Are Born: Essentials of Embryology and Birth Defects, 9e
by Keith L. Moore BA MSc PhD DSc FIAC FRSM FAAA (Author), T. V. N. Persaud MD PhD DSc FRCPath (Lond.) FAAA (Author), Mark G. Torchia MSc PhD (Author)
As the study of embryology continues to be integrated with a range of disciplines, Before We Are Born remains the ideal solution for students who need to quickly learn the basics. Fully updated by the world’s foremost embryologists, this medical reference book provides concise guidance on human embryology at every stage of development, utilizing rich illustrations and photographs designed to further explain content.Understand all of the latest advances in embryology, including normal and abnormal embryogenesis, causes of birth defects, and the role... View Details
God Heals Birth Defects: First Fruits
by Andy Hayner (Author), Margaret Weishuhn (Author)
In this revolutionary book, you will discover solid Biblical truth that demonstrates beyond all doubt that God doesn’t cause birth defects— He HEALS them! You will also read firsthand testimonies written by parents from around the world who are seeing God heal their children from diagnoses such as cerebral palsy, autism, and down syndrome. You will read of: ~ Doctors amazed by disappearing defects ~ Children moved to normal classes because they no longer qualify as "special needs" ~ Organs, bones, facial features, and muscles restored to normal function ~ Families restored to joy and... View Details
Birth Defects Compendium
by Daniel Bergsma (Author)
Reincarnation and Biology: A Contribution to the Etiology of Birthmarks and Birth Defects (2 Vols.)
by Ian Stevenson (Author)
Based on some 30 years of research on people who claim to remember past lives, this work encompasses the full spectrum of theory and case study on the subject to date. Early in his investigations, Stevenson became aware that some who remember past lives had birthmarks or birth defects that corresponded to wounds, usually fatal, on the person whose life was remembered. The work suggests surprising answers to such questions as the following: Why does someone born with a birth defect have the one he or she has, instead of another one? Why do some children show phobias in early infancy when... View Details
Poster Child: A Memoir
by Emily Rapp (Author)
Emily Rapp was born with a congenital defect that required, at the age of four, that her left foot be amputated. By the time she was eight she'd had dozens of operations, had lost most of her leg, from just above the knee, and had become the smiling, indefatigable "poster child" for the March of Dimes. For years she made appearances at church suppers and rodeos, giving pep talks about how normal and happy she was. All the while she was learning to live with what she later described as "my grievous, irrevocable flaw," and the paradox that being extraordinary was the only way to be ordinary.... View Details
The Encyclopedia of Genetic Disorders and Birth Defects (Library of Health and Living)
by James Wynbrandt (Author), Mark D. Ludman (Author)
A collection of clear, comprehensive, and up-to-date resources for understanding and coping with the complexities of modern health and social concerns provides an objective overview of each topic profiled, covering essential facts and the wider social ramifications of the subject. View Details
Before We Are Born: Essentials of Embryology and Birth Defects With STUDENT CONSULT Online Access, 7e (Before We Are Born: Essentials of Embryology & Birth Defects)
by Keith L. Moore BA MSc PhD DSc FIAC FRSM FAAA (Author), T. V. N. Persaud MD PhD DSc FRCPath (Lond.) FAAA (Author)
Zero in on the most essential concepts in human embryology and development! Concise and richly illustrated, this popular book delivers the embryology knowledge you need in a highly efficient, reader-friendly format. The comprehensively updated 7th edition comes with access to the complete contents online via Student Consult, plus 18 phenomenal embryology animations, additional review questions and answers, and moreEditor Keith L. Moore, BA, MSc, PhD, FIAC, FRSM is the recipient of the first (2007) "Henry Gray/Elsevier Distinguished Educator Award"―the American Association of Anatomists'... View Details
Before We Are Born: Essentials of Embryology and Birth Defects, 8 Edition
by Keith L. Moore (Author), T. V. N. Persaud (Author), Mark G. Torchia (Author)
Before We Are Born: Essentials of Embryology and Birth Defects, by Drs. Keith L. Moore, T.V.N. Persaud, and Mark G. Torchia, allows you to efficiently and quickly assimilate the most important concepts related to this subject. Concise and richly illustrated, this popular book delivers the embryology knowledge you need in a highly efficient, reader-friendly manner. You can also access the complete contents online at www.studentconsult.com, along with 17 remarkable animations, downloadable illustrations, additional review questions and answers, and more.Access the full contents of the... View Details
Birth Defects (Perspectives on Diseases and Disorders)
by Jacqueline Langwith (Editor)
The ailments and conditions that afflict people today can be confusing, disturbing, and painful---both emotionally and physically. The Perspectives on Diseases and Disorders series provides clear, careful explanations that offer readers and researchers insight into what these conditions are, what causes them, how people live with them, and the latest about treatment and prevention. All volumes in the series include primary and secondary viewpoints, bibliographies, detailed indexes, and lists of organizations to contact for additional information. View Details
Bendectin and Birth Defects: The Challenges of Mass Toxic Substances Litigation
by Michael D. Green (Author)
Benedictin was prescribed to more than thirty-five million American women from its introduction in 1956 until 1983, when it was withdrawn from the market. The drug's manufacturer, Merrill Dow Pharmaceuticals, a major U.S. pharmaceutical firm, joined a list of other companies whose product liabilities would result in precedent-setting litigation. Before it was over, the Benedictin litigation would involve 2,000 claimants over a fifteen-year period.
Michael D. Green offers a comprehensive overview of the Benedictin case and highlights many of the key issues in mass toxic substances... View Details