Defectos congénitos mayores en reproducción asistida

Since the beginning, the possibility of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) causing congenital malformations has been frequently suggested but, untill now, it has been never directly confirmed. Moreover, the introduction of new techniques, such as the cryopreservation of gametes and/or embryos, have strengthened this item. Recent studies seem to indicate that the incidence of major birth defects or chromosomal anomalies in IVF and ICSI is not higher than that observed in spontaneous pregnancies. Our data, referred to 577 liveborns by IVF and 487 liveborns by ICSI all along ten years (1992-2002), have shown an incidence of 2% and 1.6% major birth defects respectively, confirming, the findings reported in recent meta-analyses. In terms of developmental outcome, the follow-up at 12-24 months of age did not show any significant difference between children born after ICSI and spontaneous conceivements. In conclusion, even though further studies on larger cohort of subjects must be carried out to obtain a definitive answer about this crucial issue, our findings seem to confirm that IVF and ICSI must be actually considered techniques not correlated with an increment of major birth defects or with inheritance of parental chromosomal anomalies.