Imbar T, Tsafrir A, Lev-Sagie A, Hurwitz A, Laufer N, Holzer H
Department of Obstetrics and Gynecology, Hadassah University Hospital, Mt Scopus, Jerusalem, Israel.
Harefuah. 2006 Mar;145(3):223-8, 243-4.
Assisted reproduction techniques allowed thousands of otherwise infertile couples to attain pregnancy. As this technology moves into the mainstream of infertility treatment, it has become more critical to reassess its safety.
To review the birth outcome of patients undergoing conventional in-vitro fertilization and intracyto- plasmic sperm injection regarding fetal malformations, chromosomal and genetic abnormalities.
Selective review of the literature.
Most of the published data is from observational studies and is not randomized or blinded. Unfortunately, most articles are inherently biased. Chromosomal and genetic abnormalities are increased probably only as a direct corollary to the underlying parental risk and not due to the technology itself. There is a slight increase in the congenital malformations rate, but inspection of these malformations reveal no clustering of any specific abnormality.
Children born after assisted reproduction technologies have an increased risk of a major congenital malformation and chromosomal abnormalities compared with those born after natural conception. The risk is mainly due to paternal and maternal risk factors, which are more prevalent in couples who use assisted reproduction techniques for reproduction. Infertility-linked risk is highly probable for the observed findings. A technique-related risk, however, cannot be ruled out. Intracytoplasmic sperm injection appears to be a safe alternative for couples who otherwise would be unable to achieve pregnancy. The inherent risks associated with these genetically "at risk" couples mandate thorough evaluation and counseling before undertaking ICSI.
辅助生殖技术使成千上万原本不孕的夫妇能够怀孕。随着这项技术进入不孕治疗的主流，重新评估其安全性变得更加关键。
回顾接受常规体外受精和卵胞浆内单精子注射的患者在胎儿畸形、染色体和基因异常方面的出生结局。
对文献进行选择性回顾。
大多数已发表的数据来自观察性研究，没有进行随机分组或设盲。不幸的是，大多数文章本身存在偏倚。染色体和基因异常的增加可能只是潜在父母风险的直接结果，而非技术本身所致。先天性畸形率略有上升，但对这些畸形的检查未发现任何特定异常的聚集。
与自然受孕出生的儿童相比，辅助生殖技术后出生的儿童患重大先天性畸形和染色体异常的风险增加。风险主要归因于父方和母方的风险因素，这些因素在使用辅助生殖技术进行生育的夫妇中更为普遍。观察到的结果很可能与不孕相关风险有关。然而，不能排除技术相关风险。对于那些否则无法怀孕的夫妇，卵胞浆内单精子注射似乎是一种安全的选择。在进行卵胞浆内单精子注射之前，这些具有遗传“风险”的夫妇所固有的风险要求进行全面评估和咨询。
