Obstetric outcome and incidence of congenital anomalies in 2351 IVF/ICSI babies.
OBJECTIVE
The aim of this study was to provide a comprehensive follow-up of fetal and perinatal outcome and the incidence of congenital anomalies in babies born after fresh embryo transfers compared to those conceived spontaneously in infertile couples.


METHODS
Retrospective comparative analysis of all clinical pregnancies from fresh cleavage-stage embryo transfer cycles (IVF and ICSI) compared with infertile patients who conceived spontaneously in the same time period (control). Congenital anomalies were classified following the European Surveillance of Congenital Anomalies (EUROCAT) classification.


RESULTS
A total of 2414 assisted reproductive technology (ART) pregnancies were compared to 582 spontaneous conceptions in the control infertile group representing 2306 deliveries. No significant differences were found in pregnancy outcome between the two groups (delivery rate, abortion rate, ectopic pregnancies, medical abortions for fetal anomalies, single and twins mean gestational age, and weight at delivery). A significant difference (p < 0.001) was found in the twin (21.3 vs 2.3 %) and triplet rates (2.3 vs 0 %). A total of 2351 babies were delivered in the ART group and 449 in the control group. A total of 90 babies (3.8 %) were diagnosed with a major congenital anomaly in the ART group and 15 (3.3 %) in the control group (p = ns). The overall rate of major congenital anomalies (105/2800) in ART and spontaneous pregnancies in infertile couples was significantly higher when compared to the EUROCAT 2.0 versus 3.75 % (p = 0.0002).


CONCLUSIONS
Babies born after ART treatments and from spontaneous conception in infertile couples had rates of congenital anomalies higher than those recorded by the EUROCAT. However, the rates of anomalies were not different within the infertile population whether conceived by ART or spontaneously. These data suggest that the diagnosis of infertility in itself is the common denominator for the increase in the rates of anomalies seen in both ART and spontaneous conceptions.
Humanitas Fertility Center, Department of Gynaecology, Division of Gynaecology and Reproductive Medicine, Humanitas Research Hospital, 20084, Rozzano, Milan, Italy. paolo.levi_setti@humanitas.it.
Paolo Emanuele
PE
Levi Setti
Humanitas Fertility Center, Department of Gynaecology, Division of Gynaecology and Reproductive Medicine, Humanitas Research Hospital, 20084, Rozzano, Milan, Italy.
Melita
M
Moioli
Humanitas Fertility Center, Department of Gynaecology, Division of Gynaecology and Reproductive Medicine, Humanitas Research Hospital, 20084, Rozzano, Milan, Italy.
Antonella
A
Smeraldi
Humanitas Fertility Center, Department of Gynaecology, Division of Gynaecology and Reproductive Medicine, Humanitas Research Hospital, 20084, Rozzano, Milan, Italy.
Elisa
E
Cesaratto
Humanitas Fertility Center, Department of Gynaecology, Division of Gynaecology and Reproductive Medicine, Humanitas Research Hospital, 20084, Rozzano, Milan, Italy.
Francesca
F
Menduni
Department of Obstetrics and Gynecology, University of Milan, Buzzi Children's Hospital, Milan, Italy.
Stefania
S
Livio
Biostatistics Unit, Humanitas Research Hospital, Rozzano, Milan, Italy.
Emanuela
E
Morenghi
Department of Obstetrics, Gynaecology and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT, USA.
Pasquale
P
Patrizio
D000328:Adult; D000013:Congenital Abnormalities / Q000453:epidemiology*; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007246:Infertility / Q000150:complications; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012189:Retrospective Studies
ART; ICSI; IVF; Neonatal anomalies; Pregnancy outcome