Birth Defects in Assisted Reproductive Technology and Spontaneously Conceived Children: A Meta-analysis

Objective To evaluate the risk of birth defects in children born following assisted reproductive technology (ART) and spontaneous conceptions. Methods This study carried out an updated systematic review to identify papers published by August 2013 with data relating to birth defects of children conceived using ART (IVF and/or ICSI) compared with those spontaneously conceived and also compared birth defects between subgroups of IVF and ICSI. Results Totally 76 studies were identified for review. The individual relative risk (RR) estimated for these studies ranged from 0.44 to 5.51, a significantly increased risk of birth defects was observed (RR=1.36, 95%CI=1.25–1.47) in ART compared with the spontaneously conceived group, which was also evident in the subgroup analysis. Among these studies, 16 studies simultaneously gave data of birth defects comparing IVF and ICSI children, which showed no difference in risk of combined effects (RR=0.90, 95%CI=0.80–1.02), but ICSI had a higher risk in subgroups of clinical research (RR=0.76, 95%CI=0.65–0.89) and crude RR value (RR=0.78, 95%CI=0.67–0.91). Conclusion Pooled results from all suitable published studies suggested that children born following ART were at increased risk of birth defects compared with spontaneous conceptions. There is no difference in birth defect risk between children conceived by IVF or ICSI using a summative analysis, however, ICSI had a significant higher risk in birth defect risk comparing with IVF when using subgroup analyses of sample size and RR value.