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Impact of assisted reproduction treatments on Spanish newborns: report of 14,119 pregnancies

  • ASSISTED REPRODUCTION TECHNOLOGIES
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Abstract

Purpose

To investigate neonatal malformation, prematurity, and stillbirth in singleton and multiple pregnancies derived from different Assisted Reproductive Techniques (ART).

Methods

In this prospective cohort study data were collected, from private and public Spanish IVF units, during the years 2008 and 2009. During this period, 8,682 pregnancies were analysed from the initial 14,119 pregnancies reported. Pregnancies included in the study derived from IUI (n = 1,065), IVF (n = 838), ICSI (n = 5,080), FET (n = 1,404) and PGD (n = 295). This first analysis focuses primarily on neonatal malformation, prematurity, and stillbirth both in singleton and multiple pregnancies derived from different ART. Malformations were classified according to the WHO ICD 10 code.

Results

Malformations were found in 0.83 % of our newborns. No differences in malformations were observed between singletons or multiples independently of the ART used. There was a significant difference in prematurity rate among singletons depending on treatment but this association was not observed in multiple pregnancies. Stillbirth was significantly lower in singleton (0.72 %) than in multiple pregnancies (1.82 %).

Conclusions

The percentage of malformations observed in ART newborns was similar to the rate observed in the normally-conceived Spanish population. Multiplicity seems to be the most important factor associated with an increased incidence of newborn complications such as prematurity or stillbirth.

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References

  1. AllenVM, Douglas WR. Pregnancy outcome after assisted reproductive technology. Joint SOGC-CFAS Guideline. 2006;173:222–33.

  2. Bermejo E, Cuevas L, Grupo Periferico del ECEMC, Martinez-Frias ML. Informe de vigilancia epidemiológica de anomalías congénitas en España: datos registrados por el ECEMC en el periodo 1980–2009. Boletin del ECEMC: Revista de Dismorfologia y Epidemiologia. 2010;Serie V, 9:68–99.

  3. Bergh T, Ericson A, Hillensjo T, Nygren KG, Wennerholm UB. Deliveries and children born after in-vitro fertilisation in Sweden 1982–95: a retrospective cohort study. Lancet. 1999;354:1579–85.

    Article  PubMed  CAS  Google Scholar 

  4. Blondel B, Macfarlane A, Gissler M, Breat G, Zeitlin J. Preterm birth and multiple pregnancy in European countries participating in the PERISTAT Project. BJOG. 2006;113:528–35.

    Article  PubMed  CAS  Google Scholar 

  5. Bonduelle M, Liebaers I, Deketelaere V, Derde MP, Camus M, Devroey P, et al. Neonatal data on a cohort of 2889 infants born after ICSI (1991–1999) and of 2995 infants born after IVF (1983–1999). Hum Reprod. 2002;17(3):671–94.

    Article  PubMed  Google Scholar 

  6. Davies MJ, Moore VM, Willson K, Van Essen P, Priest K, Scott HB, et al. Reproductive technologies and the risk of birth defects. N Engl J Med. 2012;366:1803–13.

    Article  PubMed  CAS  Google Scholar 

  7. Dolk H, Loane M, Garne E. The prevalence of congenital anomalies in Europe. Adv Exp Med Biol. 2010;686:349–64.

    Article  PubMed  Google Scholar 

  8. El-Chaar D, Yang Q, Gao J, Bottomley J, Leader A, Wen SW, et al. Risk of birth defects increased in pregnancies conceived by assisted human reproduction. Fertil Steril. 2009;92:1557–61.

    Article  PubMed  Google Scholar 

  9. Ericson A, Kallen B. Congenital malformations in infant born alter IVF; a population-based study. Hum Reprod. 2001;16:504–9.

    Article  PubMed  CAS  Google Scholar 

  10. Fernandez-Shaw S, Bruna I, Arroyo G, Carrera M, Gris JM, Fernandez M, et al. Resultados gestacionales de los tratamientos de reproduccion asistida en españa. Año 2008. Rev Iber Fértil. 2010;27:489–98.

    Google Scholar 

  11. Fernandez-Shaw S, Fernandez-Sanchez M, Herrer R, Arroyo G, Mercader A, Carrera M, et al. Resultados gestacionales de los tratamientos de reproduccion asistida en España. Año 2009. Rev Iber Fértil. 2011;28:303–11.

    Google Scholar 

  12. Gaudoin M, Dobbie R, Finlayson A, Chalmers J, Cameron IT, Fleming R. Ovulation induction/intrauterine insemination in infertile couples is associated with low-birth-weight infants. Am J Obstet Gynecol. 2003;188:611–6.

    Article  PubMed  Google Scholar 

  13. Gonzalez-Gonzalez NI et al. Base de datos perinatales nacionales 2004. Documento SEGO. Progreso Obstet Ginecol. 2006;49:645–55.

    Article  Google Scholar 

  14. Hansen M, Kurinczuk JJ, Bower C, Webb S. The risk of major birth defects after intracytoplasmatic sperm injection and in Vitro fertilizacion. N Engl J Med. 2002;346:725–30.

    Article  PubMed  Google Scholar 

  15. Helmerhorst FM, Perquin DA, Donker D, Keirse MJ. Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ. 2004;328:261.

    Article  PubMed  Google Scholar 

  16. ICD-code. The International Statistical Classification of Diseases and Related Health Problems (ICD-code). 2007. 10th Revision from WHO (version 2007) Available at: www.who.int/classifications/apps/icd/icd10online/.

  17. Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis. Obstet Gynecol. 2004;103:551–63.

    Article  PubMed  Google Scholar 

  18. Källén B, Finnström O, Lindam A, Nilsson E, Nygren KG, Otterblad PO. Congenital malformations in infants born after in vitro fertilization in Sweden. Birth Defects Res A Clin Mol Teratol. 2010;88(3):137–43.

    PubMed  Google Scholar 

  19. Koivurova S, Hartkainen AL, Gisseler M, Hemminki E, Sovio U, Jarvelin MR. Neonatal outcome and congenital malformatios in children born after in-vitro fertilizacion. Hum Reprod. 2002;17:1391–8.

    Article  PubMed  Google Scholar 

  20. Koudstaal J, Braat DDM, Bruinse HW, Naaktgeboren Nvermeiden JPW, Wisser GHA. Obstetric outcome of singleton pregnancies after IVF: a matched control study in four Duth university hospitals. Hum Reprod. 2000;15:1819–25.

    Article  PubMed  CAS  Google Scholar 

  21. Lancaster PAL. Congenital malformations alter in vitro fertilization. Lancet. 1987;ii:1392–3.

    Article  Google Scholar 

  22. Lie RT, Lyngstadaas A, Orstavik KH, Bakketeig LS, Jacobsen G, Tanbo T. Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods; a meta-analysis. Int J Epidemiol. 2005;34:696–701.

    Article  PubMed  Google Scholar 

  23. Ludwig M. Malformation rate in fetuses and children conceived after ICSI: results of a prospective cohort study. Repr Biol. 2002;5:171–8.

    Google Scholar 

  24. McDonald SD, Han Z, Mulla S, Murphy KE, Beyene J, Ohlsson A. Preterm birth and low birth weight among in vitro fertilization singletons: a systematic review and meta-analyses. Eur J Obstet Gynecol Reprod Biol. 2009;146:138–48.

    Article  PubMed  Google Scholar 

  25. Ooki S. Birth defect in Singleton versus Multiple ART births in Japan (2004–2008). J Pregnancy. 2011;Article ID 285706.

  26. Pandey S, Shetty A, Hamilton M, Bhattacharya S, Maheshwari A. Obstetric and perinatal outcomes in singleton pregnancies resulting form IVF/ICSI: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:485–503.

    Article  PubMed  Google Scholar 

  27. Pinborg A, Loft A, Andersen AN. Neonatal outcome in a Danish national cohort of 8602 children born after in vitro fertilization or intracytoplasmic sperm injection: the role of twin pregnancy. Acta Obstet Gynecol Scand. 2004;83:1071–8.

    PubMed  Google Scholar 

  28. Queiber-luft A, Stolz G, Wiesel A. Malformacions in newborn: results based on 30940 infants and fetuses from Mainz congenital birth defect monitoring system (1990–1998). Arch Gynecol Obstet. 2002;266:163–7.

    Article  Google Scholar 

  29. Reefhuis J, Honein MA, Schieve LA, Correa A, Hobbs CA, Rasmussen SA. Assisted reproductive technology and major structural birth defects in the United States. Hum Reprod. 2009;24:360–6.

    Article  PubMed  CAS  Google Scholar 

  30. Rimm AA, Katayama AC, Katayama KP. A meta-analysis of the impact of IVF and ICSI on major malformations after adjusting for the effect of subfertility. J Assist Reprod Genet. 2011;28:699–705.

    Article  PubMed  Google Scholar 

  31. Sagot P, Bechoua S, Ferdynus C, Facy A, Flamm X, Gouyon JB, et al. Similarly increased congenital anomaly rates after intrauterine insemination and IVF technologies: a retrospective cohort study. Hum Reprod. 2012;27:902–9.

    Article  PubMed  CAS  Google Scholar 

  32. Verpoest W, Van Lanuyt L, Desmyttere S, Cremers A, Devroey P, Liebaers I. The incidence of monoygotic twinning following PGD is not increased. Hum Reprod. 2009;24:2945–50.

    Article  PubMed  CAS  Google Scholar 

  33. Vulliemoz NR, McVeigh E, Kurinczuk J. British fertility society. In vitro Fertilisation: Perinatal Risks and Early Childhood Outcomes. Hum Fertil. 2012;15(2):62–8.

    Article  CAS  Google Scholar 

  34. Wang JX, Norman RJ, Kristiansson P. The effect of various infertility treatments on the risk of preterm birth. Hum Reprod. 2002;17:945–9.

    Article  PubMed  CAS  Google Scholar 

  35. Wen J, Jiang J, Ding C, Dai J, Liu Y, Xia Y, et al. Birth defects in children conceived by in vitro fertilization and intracytoplasmic sperm injection: a meta-analysis. Fertil Steril. 2012;97:1331–7.

    Article  PubMed  Google Scholar 

  36. Wennerholm UB, Bergh C, Hamberger L, Lundin K, Nilsson L, Wikland M, et al. Incidence of congenital malformations in children born alter ICSI. Hum Reprod. 2000;15:944–8.

    Article  PubMed  CAS  Google Scholar 

  37. Westergaard HB, Nyboe Andersen A, Erb K. Register data on Assisted Reproductive Technology (ART) in Europe including a detailed description of ART in Denmark. Int J Androl. 2006;29:12–6.

    Article  Google Scholar 

  38. Westergaard HB, Tranberg J, Erb K, Andersen N. Danish National in vitro Registry 1994 and 1995: a controlled study of births, malformations and cytogenetic finding. Hum Reprod. 1999;14:1896–902.

    Article  PubMed  CAS  Google Scholar 

  39. Wisborg K, Ingerslev HJ, Henriksen TB. IVF and stillbirth: a prospective follow-up study. Hum Reprod. 2010;25:1312–6.

    Article  PubMed  CAS  Google Scholar 

  40. Zhu J, Basso O, Obel C, Bille C, Jørn Olsen J. Infertility, infertility treatment, and congenital malformations: Danish national birth cohort. BMJ. 2006;333:679.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Dr. Eleuterio Hernández for the suggestions and revision of the manuscript and Rosa Cercas for statistical support. We thank the Spanish Fertility Society (SEF) for all the support given and all the collaborating centers: CIRH, Barcelona; CER, Santander; CGB, Bilbao; Clínica Ginecol Juana Hernández, Logroño; Instituto Universitario Dexeus, Barcelona; Embriogyn, Tarragona; ESIMER, Barcelona; FIV Recoletos, Madrid; FIVMadrid, Madrid; Fundación Puigvert, Barcelona; GineFIV, Madrid; Gine 3, Barcelona; GMER, Cádiz; H. Fundación Son Llatzer, Palma di Mallorca; Hospital Virgen de las Nieves, Granada; Hospital Universitario Doce de Octubre, Madrid; Hospital Universitario La Fe, Valencia; Hospital Clinic, Barcelona; Hospital Universitario Gregorio Marañon, Madrid; Hospital Universitario La Paz, Madrid; Hospital Quirón, Barcelona; Hospital Universitario Madrid-Monteprincipe, Madrid; Hospital Universitario Vall de Hebron, Barcelona; IMARA, Barcelona; Institut de Ginecologia i Reproduccio, Barcelona; Instituto Balear Infertilidad, Palma de Mallorca; URH-García del Real, Madrid; IVI-Sevilla, Sevilla; IVI-Madrid, Madrid; IVI-Valencia, Valencia; IVI-Barcelona, Barcelona; Procreatec, Madrid.

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Correspondence to E. Ricciarelli.

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Capsule This report examines the impact of Assisted Reproductive Techniques (ART) on malformation in Spain. Malformations were found in 0.83 % of newborns, similar to levels in the general Spanish birth population.

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Ricciarelli, E., Bruna, I., Verdú, V. et al. Impact of assisted reproduction treatments on Spanish newborns: report of 14,119 pregnancies. J Assist Reprod Genet 30, 897–905 (2013). https://doi.org/10.1007/s10815-013-0023-0

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  • DOI: https://doi.org/10.1007/s10815-013-0023-0

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