The impact of female infertility on the occurrence of congenital malformations after medically assisted reproduction
Fauque, Patricia
The impact of female infertility on the occurrence of congenital malformations after medically assisted reproduction - 2022.
47
Do in vitro fertilization (IVF) and intrauterine insemination (IUI) lead to an increased risk of congenital anomalies? This is a major question, which most of the available epidemiological studies unfortunately seem to answer with a “yes.” However, these results are based on data obtained at birth or during the neonatal period, on small populations, and above all without taking into account the possible role of underlying female infertility, a potential confounding factor. Using the French national health system database, we performed a comparative analysis of all singleton births in France over a five-year period (2013–2017), by natural conception (NC), embryo transfer (ET), or IVF. A total of 3,501,495 singleton births were included (3,417,089 NC, 20,218 IUI , and 64,188 ET). The risks of major congenital malformations (ICD-10) were investigated according to mode of conception in multivariate analyses using multiple logistic regression models adjusted for maternal age, primiparity, obesity, smoking, history of hypertension or diabetes, and female infertility. The prevalence of malformations after ET was significantly higher than after NC, with adjusted odds ratios (AOR) of 1.15 and 1.13. The overall risk was similar in the IUI and NC groups (AOR of 1.01). An independent and overall increase in risk was observed in the presence of endometriosis (AOR of 1.16), polycystic ovary syndrome (1.20), or premature ovarian failure (1.52). This study therefore shows that causes of maternal infertility are associated with an increased risk of congenital anomalies, in addition to those associated with IVF.
The impact of female infertility on the occurrence of congenital malformations after medically assisted reproduction - 2022.
47
Do in vitro fertilization (IVF) and intrauterine insemination (IUI) lead to an increased risk of congenital anomalies? This is a major question, which most of the available epidemiological studies unfortunately seem to answer with a “yes.” However, these results are based on data obtained at birth or during the neonatal period, on small populations, and above all without taking into account the possible role of underlying female infertility, a potential confounding factor. Using the French national health system database, we performed a comparative analysis of all singleton births in France over a five-year period (2013–2017), by natural conception (NC), embryo transfer (ET), or IVF. A total of 3,501,495 singleton births were included (3,417,089 NC, 20,218 IUI , and 64,188 ET). The risks of major congenital malformations (ICD-10) were investigated according to mode of conception in multivariate analyses using multiple logistic regression models adjusted for maternal age, primiparity, obesity, smoking, history of hypertension or diabetes, and female infertility. The prevalence of malformations after ET was significantly higher than after NC, with adjusted odds ratios (AOR) of 1.15 and 1.13. The overall risk was similar in the IUI and NC groups (AOR of 1.01). An independent and overall increase in risk was observed in the presence of endometriosis (AOR of 1.16), polycystic ovary syndrome (1.20), or premature ovarian failure (1.52). This study therefore shows that causes of maternal infertility are associated with an increased risk of congenital anomalies, in addition to those associated with IVF.
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