“…ICSI , intracytoplasmic sperm injection; ARTs , assisted reproductive techniques; CHDs , congenital heart diseases; TOF , tetralogy of Fallot) Author (et al); reference Year of publication Type of study Patients Results Quality assessment (NOS score) Morimoto [ 17 ] 2022 Retrospective cohort study 418 Higher proportion of infants conceived by ART in univentricular heart defects, regardless of maternal age and maternal history of miscarriage. 7 Bjorkman [ 19 ] 2021 Retrospective cohort study 9252 The odds ratio for CHD in the ART group compared with statewide population rates was not significantly different from baseline population rates (1.4; 95% CI 0.9–2.1). 7 Fauque [ 22 ] 2021 Retrospective cohort study 3,501,495 Increased risk of eight malformations in the fresh-ET group compared with the NC group, also heart defects.…”
Section: Resultsmentioning
confidence: 99%
“…Selecting studies that evaluated major CHDs only [ 12 , 21 , 26 ], the pooled incidence decreased to 1% (95% CI 0.00–0.01; I 2 = 93%). Conversely, considering studies that considered minor CHDs only [ 10 , 18 , 19 , 28 ] resulted in a pooled incidence of 3% (95% CI 0.02–0.04; I 2 = 97%). Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Bjkorman et al [ 19 ], in a 2021 retrospective cohort study, analyzed fetal echocardiographies performed in 2230 IVF pregnancies (mean gestational age 22.2 ± 1.4 weeks), most without other known risk factors for CHD. The odds ratio for CHD in the ART group compared with statewide population rates was 1.4 (95% CI 0.9–2.1).…”
Infertility is a growing phenomenon and leads to an increased use of assisted reproductive techniques (ARTs). In recent years, concerns about the safety of these procedures emerged and ARTs were hypothesized to be a risk factor for developing congenital heart diseases (CHDs) in offspring. Our aim is to investigate the association between ART and CHD, specifying results according to various subtypes of defects. We performed a systematic review and random-effects meta-analysis following the PRISMA guidelines. MEDLINE and Google Scholar were searched from January 2011 to May 2022. Data about incidence of CHD in ART were tabulated and extracted from all the studies included. Twenty-four studies were included. Pooled incidence of CHDs after IVF pregnancies was 3% (95% CI 0.3–0.4; I2 = 99%), decreasing to 1% (95% CI 0.00–0.01; I2 = 93%) for major CHDs only. An increased risk of CHDs, especially minor (i.e., not requiring surgical correction), seems to occur in ART compared with non-ART pregnancies [RR 1.71 (95% CI 1.25–2.34; I2 = 99%)]. For major CHDs, not enough evidence is available to assess the real risk. Moreover, some confounding factors (i.e., maternal age and male infertility) seem to play a critical role to determine an increased risk of CHDs. Conflicting results emerged among the studies, setting the need for further research to validate the actual evidence and state the real risk of CHD following ART pregnancies.
“…ICSI , intracytoplasmic sperm injection; ARTs , assisted reproductive techniques; CHDs , congenital heart diseases; TOF , tetralogy of Fallot) Author (et al); reference Year of publication Type of study Patients Results Quality assessment (NOS score) Morimoto [ 17 ] 2022 Retrospective cohort study 418 Higher proportion of infants conceived by ART in univentricular heart defects, regardless of maternal age and maternal history of miscarriage. 7 Bjorkman [ 19 ] 2021 Retrospective cohort study 9252 The odds ratio for CHD in the ART group compared with statewide population rates was not significantly different from baseline population rates (1.4; 95% CI 0.9–2.1). 7 Fauque [ 22 ] 2021 Retrospective cohort study 3,501,495 Increased risk of eight malformations in the fresh-ET group compared with the NC group, also heart defects.…”
Section: Resultsmentioning
confidence: 99%
“…Selecting studies that evaluated major CHDs only [ 12 , 21 , 26 ], the pooled incidence decreased to 1% (95% CI 0.00–0.01; I 2 = 93%). Conversely, considering studies that considered minor CHDs only [ 10 , 18 , 19 , 28 ] resulted in a pooled incidence of 3% (95% CI 0.02–0.04; I 2 = 97%). Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Bjkorman et al [ 19 ], in a 2021 retrospective cohort study, analyzed fetal echocardiographies performed in 2230 IVF pregnancies (mean gestational age 22.2 ± 1.4 weeks), most without other known risk factors for CHD. The odds ratio for CHD in the ART group compared with statewide population rates was 1.4 (95% CI 0.9–2.1).…”
Infertility is a growing phenomenon and leads to an increased use of assisted reproductive techniques (ARTs). In recent years, concerns about the safety of these procedures emerged and ARTs were hypothesized to be a risk factor for developing congenital heart diseases (CHDs) in offspring. Our aim is to investigate the association between ART and CHD, specifying results according to various subtypes of defects. We performed a systematic review and random-effects meta-analysis following the PRISMA guidelines. MEDLINE and Google Scholar were searched from January 2011 to May 2022. Data about incidence of CHD in ART were tabulated and extracted from all the studies included. Twenty-four studies were included. Pooled incidence of CHDs after IVF pregnancies was 3% (95% CI 0.3–0.4; I2 = 99%), decreasing to 1% (95% CI 0.00–0.01; I2 = 93%) for major CHDs only. An increased risk of CHDs, especially minor (i.e., not requiring surgical correction), seems to occur in ART compared with non-ART pregnancies [RR 1.71 (95% CI 1.25–2.34; I2 = 99%)]. For major CHDs, not enough evidence is available to assess the real risk. Moreover, some confounding factors (i.e., maternal age and male infertility) seem to play a critical role to determine an increased risk of CHDs. Conflicting results emerged among the studies, setting the need for further research to validate the actual evidence and state the real risk of CHD following ART pregnancies.
“…62 However, a recent prospective cohort study reported that the incidence of CHD in pregnancies achieved with IVF without other risk factors is not significantly different from baseline population rates (OR, 1.4; 95% CI, 0.9e2.1), although these findings were based on data from a single academic medical center, limiting the generalizability. 63 The cost-effectiveness of routine screening for CHD in pregnancies following IVF has also been questioned. 63,64 It is important to note that in this recent study by Chung et al 64 , universal fetal echocardiography in pregnancies achieved by IVF was associated with a higher detection rate of CHDs than with screening only when abnormal cardiac findings were noted on a detailed anatomy scan.…”
Section: Are Congenital Anomalies Increased In Pregnancies Achieved W...mentioning
confidence: 99%
“…63 The cost-effectiveness of routine screening for CHD in pregnancies following IVF has also been questioned. 63,64 It is important to note that in this recent study by Chung et al 64 , universal fetal echocardiography in pregnancies achieved by IVF was associated with a higher detection rate of CHDs than with screening only when abnormal cardiac findings were noted on a detailed anatomy scan. Therefore, we suggest that fetal echocardiography be offered to patients with pregnancies achieved with IVF and ICSI (GRADE 2C).…”
Section: Are Congenital Anomalies Increased In Pregnancies Achieved W...mentioning
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