Bukulmez Orhan
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL 32610-0294, USA.
Curr Opin Obstet Gynecol. 2009 Jun;21(3):260-4. doi: 10.1097/GCO.0b013e32832924a7.
Observational studies have reported small but increased risk of birth defects associated with assisted reproductive technology (ART) pregnancies. We intend to review the current data on this issue to provide essential information for patient counseling.
There is lack of consensus on whether ART per se increases the risk of birth defects, genetic and imprinting disorders, mostly due to the bias inherent to the observational studies, which suggest 30-40% increased risk of birth defects with ART. Recent reports suggest that apparent risks for adverse outcome following ART may be largely related to parental infertility-linked factors. Criteria used to define birth defects bring challenges as well.
All couples undergoing these procedures should be counseled about the current information suggesting elevated risks of birth defects, genetic abnormalities and imprinting disorders associated with infertility and the infertility treatment with ART. In order to elucidate the controversy whether ART is associated with adverse outcome in the offspring, a multinational collaborative effort is needed, as the required sample size is between 10 000 and 84 000 or more.
观察性研究报告称，辅助生殖技术（ART）妊娠与出生缺陷相关的风险虽小但有所增加。我们旨在回顾有关此问题的当前数据，为患者咨询提供重要信息。
关于ART本身是否会增加出生缺陷、遗传和印记障碍的风险，目前尚无共识，这主要是由于观察性研究固有的偏差，这些研究表明ART导致出生缺陷的风险增加30%-40%。最近的报告表明，ART后不良结局的明显风险可能在很大程度上与父母的不孕相关因素有关。用于定义出生缺陷的标准也带来了挑战。
所有接受这些程序的夫妇都应被告知当前的信息，即与不孕不育及ART治疗相关的出生缺陷、遗传异常和印记障碍风险升高。为了阐明ART是否与后代不良结局相关的争议，需要开展跨国合作，因为所需样本量在10000至84000或更多之间。
