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评估与辅助生殖技术使用相关的出生缺陷风险:一项更新的系统评价。

Evaluation of the Risk of Birth Defects Related to the Use of Assisted Reproductive Technology: An Updated Systematic Review.

机构信息

Serafin Clinic, 44-100 Gliwice, Poland.

Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland.

出版信息

Int J Environ Res Public Health. 2022 Apr 18;19(8):4914. doi: 10.3390/ijerph19084914.

Abstract

Fertility problems constitute a serious medical, social, and demographic problem. With this review, we aim to critically appraise and evaluate the existing literature surrounding the risk of birth defects in offspring conceived using techniques based on assisted reproductive technology (ART). Based on searches of the literature in PubMed and ScienceDirect, we obtained a total of 2,003,275 works related to the topic. Ultimately, 11 original papers published in the last 10 years qualified for inclusion in the study. Based on five studies included in this analysis, it was shown that ART significantly increases the risk of congenital malformations in associated newborns. Due to the specifics of given studies, as well as potential confounding risk factors, this influence cannot be ignored. Therefore, considering the information contained in the articles included in this systematic review, it was determined that the risk of birth defects is not directly related to the use of ART itself but also depends on the age of partners, causes of infertility, comorbidities, and the number of fetuses during a pregnancy, as well as many other factors not covered in the literature. It is thus necessary to impress upon infertile couples who wish to have offspring that the use of ART is not risk-free but that the benefits outweigh the risks. Further education in this field, as well as social understanding, is also required.

摘要

生育问题构成了严重的医学、社会和人口问题。本综述旨在批判性地评价和评估辅助生殖技术(ART)相关技术受孕后代出生缺陷风险的现有文献。通过在 PubMed 和 ScienceDirect 中搜索文献,我们共获得了 2003275 篇与该主题相关的文章。最终,11 篇发表在过去 10 年内的原始论文符合纳入研究的标准。基于这 5 项研究,结果表明 ART 显著增加了相关新生儿先天畸形的风险。由于特定研究的特殊性以及潜在的混杂风险因素,这种影响不容忽视。因此,考虑到本系统评价中纳入的文章所包含的信息,确定出生缺陷的风险不仅与使用 ART 本身直接相关,还取决于伴侣的年龄、不孕的原因、合并症以及怀孕期间胎儿的数量,以及文献中未涵盖的许多其他因素。因此,有必要向希望生育的不孕夫妇强调,使用 ART 并非没有风险,但收益大于风险。还需要在这一领域进行进一步的教育,以及社会的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbea/9027614/6db5e484fb4b/ijerph-19-04914-g001.jpg

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