OBJECTIVE: To assess the risk of
birth defects in infants born after assisted human reproduction (
AHR). DESIGN:
Retrospective cohort study. SETTING: Niday Perinatal Database for the province of Ontario, 82 sites, both primary and tertiary centers. PATIENT(S): In 2005, information about reproductive assistance was reported for 61,569 deliveries. INTERVENTION(S): The
prevalence of
birth defects diagnosed in the
prenatal period or at birth was estimated for all types of
AHR together and then by type of procedure. MAIN OUTCOME MEASURE(S): The
excess risks of
birth defects by
AHR were calculated by unconditional
logistic regressions using spontaneously conceived
pregnancies as the reference and were expressed by
odds ratio and 95%
confidence intervals and adjusted for
maternal age,
smoking, infant gender, gestation, and parity. RESULT(S): The
prevalence of
birth defects with
AHR procedures was 2.91%, which was 1.55-fold higher (95%
confidence interval [CI], 1.03-2.38) than in the non-AHR population (1.86%). Specific anomalies that increased with
AHR were
gastrointestinal (
odds ratio [OR], 9.85; 95% CI, 3.44-28.44),
cardiovascular (OR, 2.30; 95% CI, 1.11-4.77), and
musculoskeletal defects (OR, 1.54; 95% CI, 0.48-4.94). The risks of
birth defects by types of
AHR were 2.35% for
ovulation induction, 2.89% for
IUI, and 3.45% for
IVF. CONCLUSION(S): There is a significant increased risk of
birth defects associated with
AHR, and the risk is higher in
IVF and
IUI. The potential risk of anomalies associated with
AHR may be considered in the counseling that is offered to
infertile couples.
