Effect of maternal and treatment-related factors on the prevalence of birth defects after PESA-ICSI and TESE-ICSI: a retrospective cohort study.
BACKGROUND
We performed a retrospective cohort study with the aim to evaluate the effect of maternal and treatment-related factors on the prevalence of birth defects after intracytoplasmic sperm injection (ICSI) using percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE).


METHODS
643 newborns born after PESA-ICSI (n = 406) and TESE-ICSI (n = 237) in Radboud University Medical Center, after a gestational age of 12 weeks, 1 January 2002-1 January 2011 and 1 March-1 November 2014, respectively, were included in this study. Three sources of data were used for analysis: questionnaires, national obstetrics registration forms, and a lab-database of all ICSI treatments. Data were analyzed using generalized estimating equations and logistic regression analysis.


RESULTS
The prevalence of major birth defects in newborns born after PESA-ICSI was 6.9% and after TESE-ICSI was 5.9% (odds ratio 0.89, 95% confidence interval 0.46-1.75). No significant association was found between maternal or treatment-related factors and the prevalence of birth defects.


CONCLUSIONS
We found a similar overall prevalence of birth defects in newborns born after PESA-ICSI and TESE-ICSI. The maternal and treatment-related factors investigated did not show a significantly increased cumulative risk of birth defects.
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Aukje M
AM
Meijerink
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Reinoud E
RE
Oomen
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Kathrin
K
Fleischer
Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Joanna
J
IntHout
Department of Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
Gwendolyn H
GH
Woldringh
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Didi D M
DD
Braat
D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval; D011795:Surveys and Questionnaires
Congenital abnormalities; infertility - male; sperm injections - intracytoplasmic; sperm retrieval