CHD risk elevated in children conceived through IVF/ICSI
The risk of congenital heart disease (CHD) Is significantly higher in foetuses conceived through in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), according to a recent study.
Researchers performed a systematic review and meta-analysis of studies comparing the neonatal incidence of CHD in spontaneous and IVF/ICSI conceptions. Those conceived through other types of assisted reproductive technologies were excluded. The databases of Scopus, PubMed and Embase were accessed for the study.
The meta-analysis included 41 observational studies corresponding to 25,856 IVF/ICSI and 287,995 spontaneously conceived children. In this cohort, the total rate of CHD events was 1.30 (n=337 of 25,658) and 0.68 (n=1,952 of 287,995) percent in the IVF/ICSI and spontaneous conception groups, respectively.
The risk of CHD was significantly higher in children conceived through IVF/ICSI than those spontaneously conceived (odds ratio [OR], 1.45; 95 percent CI, 1.20 to 1.76; p=0.0001).
Because of significant heterogeneity, subsequent sensitivity analyses were performed. When only the seven high-quality studies were analysed, the risk of CHD was still elevated in IVF/ICSI children, suggesting that the study quality did not affect the association (OR, 1.45; 1.19 to 1.77; p=0.0003).
When specific types of CHD were considered, the meta-analysis showed that all cardiac malformations were unrelated to mode of conception (OR, 1.13; 0.68 to 1.86; p=0.16). Moreover, while neither were significant, IVF/ICSI conception seemed to be more related to minor CHD (OR, 1.30; 0.66 to 2.56) than to major CHD (OR, 0.62; 0.16 to 2.39).
CHD risk was also significantly elevated in children from IVF/ICSI than from natural conception when the researchers considered only singleton pregnancies (OR, 1.55; 1.21 to 1.99) and after adjusting for parity and maternal age (OR, 1.29; 1.03 to 1.60).