Increased Risk of Cerebral Palsy in IVF/ICSI Babies: Meta analysis of Current Literature

Abstract

Background: The correlation between assisted reproductive therapies (ARTs) and congenital or developmental anomalies has been acknowledged by prominent obstetric and reproductive science authorities. However, the orthopedic perspective on this aspect of ARTs remains largely unexplored. This meta-analysis aims to examine a plausible association between cerebral palsy and in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) therapies within the realm of assisted reproductive technologies (ARTs). Methods: The literature spanning from 1980 to February 2024 was systematically reviewed within the MEDLINE, Scopus, and Embase databases, adhering to the PRISMA guidelines. Data synthesis was conducted using the Jamovi program. Results: The literature review involved an initial search that yielded 192 articles, which were subsequently refined to 21 articles following the removal of duplicates and screening for relevance. These articles, selected according to the PRISMA model, collectively included data from 8,657,973 patients. Upon analyzing the dataset, it was found that among 8,400,080 control patients, there were 14,518 cases of cerebral palsy, while among 237,873 patients who underwent IVF or ICSI, 736 cases of cerebral palsy were documented. This analysis revealed that the incidence of cerebral palsy was approximately 1.9 times higher in IVF and ICSI cases compared to control groups (p < 0.001, adjusted odds ratio = 1.9, 95% confidence interval: 1.570–2.323). Conclusion As a result, the risk of developing cerebral palsy, as in many other congenital anomalies and pediatric diseases, in babies born with assisted reproductive techniques is statistically significantly higher than in normal babies. This, together with the sensitive monitoring of the neonatal period and perinatal period in women conceived with ART. It is recommended that teams collaborate with pediatric orthopedic surgeons.