title: Birth defects in children conceived by in vitro fertilization and intracytoplasmic sperm injection: a meta-analysis.
abstract: OBJECTIVE
  To conduct a meta-analysis of studies assessing the effect of IVF and intracytoplasmic sperm injection (ICSI) on birth defects.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  Centers for reproductive care.
  
  
  METHODS
  Patients treated by IVF and/or ICSI.
  
  
  METHODS
  We identified all studies published by September 2011 with data related to birth defects in children conceived by IVF and/or ICSI compared with spontaneously conceived children, or birth defects in the children conceived by IVF compared with those by ICSI. Risk ratios from individual studies were pooled with the fixed and random effect models.
  
  
  METHODS
  Risk of birth defects in children conceived by IVF and/or ICSI.
  
  
  RESULTS
  Of 925 studies reviewed for eligibility, 802 were excluded after screening titles and abstracts, 67 were excluded for duplicated data, data unavailable, or inappropriate control group, 56 were included in the final analysis. Among the 56 studies, 46 studies had data on birth defects in children conceived by IVF and/or ICSI (124,468) compared with spontaneously conceived children. These studies provided a pooled risk estimation of 1.37 (95% confidence interval [CI]: 1.26-1.48), which is also evident in subgroup analysis. In addition, 24 studies had data on birth defects in children conceived by IVF (46,890) compared with those by ICSI (27,754), which provided an overall no risk difference.
  
  
  CONCLUSIONS
  Children conceived by IVF and/or ICSI are at significantly increased risk for birth defects, and there is no risk difference between children conceived by IVF and/or ICSI.
authors.affiliation: State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Juan
authors.initials: J
authors.lastname: Wen
authors.forename: Jie
authors.initials: J
authors.lastname: Jiang
authors.forename: Chenyue
authors.initials: C
authors.lastname: Ding
authors.forename: Juncheng
authors.initials: J
authors.lastname: Dai
authors.forename: Yao
authors.initials: Y
authors.lastname: Liu
authors.forename: Yankai
authors.initials: Y
authors.lastname: Xia
authors.forename: Jiayin
authors.initials: J
authors.lastname: Liu
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Hu
mesh_terms: D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects* / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D020379:Risk Adjustment / Q000379:methods; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects* / Q000592:standards*